St Elizabeth Nursing Home
St Elizabeth Nursing Home in Janesville, WI — inspection on April 28, 2026.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
been toileted during that time.
525639 04/28/2026
St Elizabeth Nursing Home 109 S.
Atwood Ave.
Janesville, WI 53545
cnas will get repositioning/toileting done twice.
Surveyor asked CNA K how much time it should take
indicated no.
On 4/28/26 at 10:48 AM, Surveyor interviewed NS D (nursing scheduler). NS D indicated the staffing pattern is determined by the administrator. NS D indicated the facility's staffing pattern is no less than 3 cnas on the day shift, 3 cnas on the pm shift and two cnas on the night shift. NS D indicated if the census is over 38, then 4 cnas on the day shift, 3 1/2 cnas on the pm shift, and two cnas on the night shift. NS D indicated there is a nurse on every shift and a med tech on the day and evening shifts.
The night shift has one nurse.
Surveyor asked NS D what the process is for a call in. NS D indicated if there is a call in Monday through Friday NS D tries to fill the position. If there is a call in on the weekends, the director of nursing tries to fill it. NS D indicated there is axillary staff to assist on the floor as needed. NS D indicated she is a cna and the dietary manager is a cna and both can assist when needed.
On 4/28/26 at 10:53 AM, Surveyor interviewed DON B (Director of Nursing).
Surveyor asked DON B how much time should lapse between a call light being turned on until the call light is answered. DON B indicated the facility has no set goals. DON B indicated no more than 15 minutes should lapse before staff answer call lights.
Surveyor reviewed the call light logs with DON B and asked if 20, 30, 45 minutes to over an hour before call lights are answered is addressing the residents' needs in a timely manner. DON B indicated no, there is no reason for those response times. DON B indicated there are enough staff on the floor. DON B indicated looking at the dates of the call light log she would say it is due to the staff that worked.
Example 4: R34 admitted to the facility on [DATE] with diagnoses that include, in part: acute respiratory failure with hypoxia (severe shortness of breath with low blood oxygen), acute embolism and thrombosis of left popliteal vein and left tibial vein (blood clot in vein behind and below knee), and chronic diastolic (congestive) heart failure (heart condition with symptoms that may include shortness of breath, leg swelling, and fatigue).
R34's Minimum Data Set (MDS) with Assessment Reference Date (ARD) of 2/4/26 indicates R34 has a Brief Interview for Mental Status (BIMS) score of 15 out of 15, indicating he is cognitively intact.
On 4/26/26 at 9:48 AM, Surveyor spoke with R34. R34 indicated the facility is short-staffed and needs more help. R34 indicated it takes a long time to get help and said he has waited anywhere from 30 minutes to 2 or 3 hours to get staff to answer his call light. R34 indicated he occasionally needs help with going to the bathroom and wiping himself, and if staff doesn't come in to help him, he attempts to do it by himself.
R34's most recent care plan includes the following, in part: Toileting: Toilet use: The resident requires (limited assistance) by (1) staff for toileting.
Resident goes into the bathroom frequently on his own.
Surveyor reviewed R34's call light wait times during the weekend of 4/4/26 to 4/26/26. On 4/26/26 at 5:27 AM, the report indicated R34 waited 1 hour and 9 minutes for his call light to be answered.
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.