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Part of chain: BENEDICTINE HEALTH SYSTEM (23 facilities, chain avg rating 2.8★)
1/5
Health inspection rating (on-site)
inspected Mar 5, 2025
7
Serious findings on record
most recent Jun 18, 2026
$90,784
Fines, last 3 years
3.89
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, isolated · Jun 18, 2026 · F-0686 · triggered by a complaint
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.
Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Jul 16, 2026 (Deficient, Provider has date of correction)
▲ Immediate jeopardy, isolated · Jun 11, 2024 · F-0678 · triggered by a complaint
The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes.
Why it matters: In a cardiac or breathing emergency, failure to start CPR promptly can be the difference between life and death.
Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: May 17, 2024 (Past Non-Compliance)
▲ Actual harm, isolated · Jun 18, 2026 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Jul 16, 2026 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Jan 21, 2026 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Mar 25, 2025 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Jan 11, 2024 · F-0610 · triggered by a complaint
The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do.
Why it matters: When allegations aren't investigated, harm to residents can continue unchecked.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Feb 6, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Oct 25, 2023 · F-0760 · triggered by a complaint
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication.
Why it matters: A serious medication error can cause real harm, hospitalization, or worse.
Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.
Corrected: Nov 20, 2023 (Deficient, Provider has date of correction)
Inspection findings in the public record
Showing the latest 3 of 25 inspection findings. Open the full record below to read every finding.
J · Immediate jeopardy, isolated
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaintF-0686
G · Actual harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaintF-0689
F · Potential for more than minimal harm, widespread
The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaintF-0812
View all 25 inspection findingsShow only the latest 3 findings
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.
Date
Severity
What the facility was cited for
Jun 18, 2026
▲ J · Immediate jeopardy, isolated
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint · F-0686
Jun 18, 2026
▲ G · Actual harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jun 18, 2026
F · Potential for more than minimal harm, widespread
The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaint · F-0812
Jun 18, 2026
E · Potential for more than minimal harm, pattern
The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550
Jun 18, 2026
D · Potential for more than minimal harm, isolated
The facility did not make sure the resident's doctor reviewed their care and wrote, signed, and dated progress notes and orders at each required visit. · from a complaint · F-0711
Jun 18, 2026
D · Potential for more than minimal harm, isolated
The facility did not arrange hospice services for a resident who needed them, or help the resident move to a facility that could arrange hospice. Hospice provides comfort-focused care for people nearing the end of life. · from a complaint · F-0849
Jun 18, 2026
D · Potential for more than minimal harm, isolated
The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · from a complaint · F-0880
Jan 21, 2026
▲ G · Actual harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Mar 5, 2025
▲ G · Actual harm, isolated
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686
Mar 5, 2025
E · Potential for more than minimal harm, pattern
The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. · F-0558
Mar 5, 2025
D · Potential for more than minimal harm, isolated
The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Jun 11, 2024
▲ J · Immediate jeopardy, isolated
The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes. · from a complaint · F-0678
Jan 11, 2024
▲ G · Actual harm, isolated
The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Jan 11, 2024
F · Potential for more than minimal harm, widespread
The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Jan 11, 2024
E · Potential for more than minimal harm, pattern
The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755
Jan 11, 2024
E · Potential for more than minimal harm, pattern
The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. · F-0758
Jan 11, 2024
D · Potential for more than minimal harm, isolated
The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
Jan 11, 2024
D · Potential for more than minimal harm, isolated
The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · F-0644
Jan 11, 2024
D · Potential for more than minimal harm, isolated
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Jan 11, 2024
D · Potential for more than minimal harm, isolated
The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · F-0842
Oct 25, 2023
▲ G · Actual harm, isolated
The facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760
Dec 8, 2022
F · Potential for more than minimal harm, widespread
The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Dec 8, 2022
E · Potential for more than minimal harm, pattern
The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761
Dec 8, 2022
E · Potential for more than minimal harm, pattern
The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Dec 8, 2022
D · Potential for more than minimal harm, isolated
The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. · F-0554
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (8 → 3).
Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2022
All citations:
4
Serious citations (G–L):
0
2023
All citations:
1
Serious citations (G–L):
1
2024
All citations:
9
Serious citations (G–L):
2
2025
All citations:
3
Serious citations (G–L):
1
2026
All citations:
8
Serious citations (G–L):
3
All bars start at zero. Exact values and supporting details remain below.
Year
Citations
Serious (G–L)
Worst severity that year
2022
4
0
F
2023
1
1
G ▲
2024
9
2
J ▲
2025
3
1
G ▲
2026
8
3
J ▲
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.
Date
Type
Amount / length
Jan 21, 2026
Fine
$12,438
Mar 5, 2025
Fine
$24,382
Jun 11, 2024
Fine
$10,036
Jan 11, 2024
Fine
$30,275
Oct 25, 2023
Fine
$13,653
Nurse staffing (from payroll records, adjusted for how much care residents need)
Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityWisconsin averageU.S. average
Total nurse staffing (hours per resident per day)
This facility:
3.89
Wisconsin average:
4.29
U.S. average:
3.95
Registered Nurse hours
This facility:
1.13
Wisconsin average:
1.01
U.S. average:
0.69
Weekend total nurse staffing
This facility:
3.59
Wisconsin average:
3.84
U.S. average:
3.50
All bars start at zero. Exact values and supporting details remain below.
Measure
This facility
Wisconsin avg
U.S. avg
Where it stands
Total nurse staffing (hours per resident per day)
3.89
4.29
3.95
bottom 42% in Wisconsin; top 44% in the U.S.
Registered Nurse hours
1.13
1.01
0.69
top 33% in Wisconsin; top 11% in the U.S.
Weekend total nurse staffing
3.59
3.84
3.50
bottom 45% in Wisconsin; top 38% in the U.S.
Weekend RN hours (not acuity-adjusted)
0.82
0.68
0.48
top 25% in Wisconsin; top 11% in the U.S.
Total nursing staff turnover (%)
49.4
46.9
45.8
bottom 42% in Wisconsin; bottom 38% in the U.S.
RN turnover (%)
47.4
39.7
42.9
bottom 38% in Wisconsin; bottom 40% in the U.S.
Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.56, RN 1.04, weekend 3.28.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.56 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 4/5.
Quality measures: assessments & claims
Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.
No verified facility-specific private-pay price is available in our data for Benedictine Manor of Lacrosse. CMS inspection and staffing records do not tell us what this home will charge you.
Calculate a stay from a quote you receive
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Before you compare prices
Request the room type, effective date and itemized daily rate in writing.
Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.
All 10 owning or managing parties CMS has on file are shown — none excluded.
Other facilities in the same chain
CMS lists this facility under the chain Benedictine Health System — 23 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.
Facility data as of CMS processing date 2026-08-01. CCN 525438.
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The Care File
Visit checklist — Benedictine Manor of Lacrosse
2902 East Avenue South, La Crosse, WI 54601 · (608) 788-9870
Health inspection rating 1/5 · CMS overall 1/5· Fines (3y): $90,784
Most serious findings on record:
▲ Jun 18, 2026 (F-0686, Immediate jeopardy, isolated): The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
▲ Jun 11, 2024 (F-0678, Immediate jeopardy, isolated): The facility did not provide basic life support, such as CPR, before emergency medical help arrived — care that's required when it matches the doctor's orders and the resident's own written wishes.
▲ Jun 18, 2026 (F-0689, Actual harm, isolated): The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Questions for the administrator:
☐ "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
☐ "Are staff on every shift trained and certified in CPR, and how do they know each resident's resuscitation wishes?"
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "If someone reports suspected abuse or neglect here, what happens in the first 24 hours?"
☐ "What systems do you use to prevent medication errors, and what happens when one occurs?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
☐ "How often does each resident's doctor visit and review their care in person?"
☐ "Your weekend nurse staffing is reported below the Wisconsin midpoint — how does the weekend schedule differ from a weekday?"
☐ "Can I see the plan of correction for the findings in your most recent state inspection?"
☐ "CMS reports 49% total nursing staff turnover here — who on the care team has been with you longest?"
☐ "Can I visit again unannounced, at a mealtime or on a weekend?"
While you're there, notice:
☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)
Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 525438 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)