Evergreen Health Services

Penalties

• Aug 20, 2025 — Fine ($14,020)

Inspection findings

1. Sep 16, 2025 Health · 3 findings
   • Not serious Scope/severity E Complaint

     F0677 Quality of Life and Care Deficiencies

     Provide care and assistance to perform activities of daily living for any resident who is unable.

     Corrected Oct 9, 2025 · CMS health inspection

   • Serious Scope/severity J Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected Oct 9, 2025 · CMS health inspection

   • Not serious Scope/severity E Complaint

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Oct 9, 2025 · CMS health inspection

2. Aug 20, 2025 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0693 Quality of Life and Care Deficiencies

     Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

     Corrected Sep 11, 2025 · CMS health inspection

3. May 29, 2025 Health · 8 findings
   • Not serious Scope/severity D Complaint

     F0684 Quality of Life and Care Deficiencies

     Provide appropriate treatment and care according to orders, resident’s preferences and goals.

     Corrected Jun 19, 2025 · CMS health inspection

   • Not serious Scope/severity D

     F0695 Quality of Life and Care Deficiencies

     Provide safe and appropriate respiratory care for a resident when needed.

     Corrected Jun 19, 2025 · CMS health inspection

   • Not serious Scope/severity D

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Jun 19, 2025 · CMS health inspection

   • Not serious Scope/severity E

     F0809 Nutrition and Dietary Deficiencies

     Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

     Corrected Jun 19, 2025 · CMS health inspection

   • Not serious Scope/severity D

     F0880 Infection Control Deficiencies

     Provide and implement an infection prevention and control program.

     Corrected Jun 19, 2025 · CMS health inspection

   • Not serious Scope/severity D

     K0321 Smoke Deficiencies

     Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

     Corrected Jun 20, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Jun 20, 2025 · CMS fire safety

   • Not serious Scope/severity D

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected Jun 20, 2025 · CMS fire safety

4. Mar 19, 2025 Health · 1 finding
   • Serious Scope/severity G Complaint

     F0689 Quality of Life and Care Deficiencies

     Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

     Corrected May 2, 2025 · CMS health inspection

5. Aug 7, 2024 Health · 1 finding
   • Not serious Scope/severity D Complaint

     F0761 Pharmacy Service Deficiencies

     Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

     Corrected Aug 19, 2024 · CMS health inspection

6. May 22, 2024 Health · 7 findings
   • Not serious Scope/severity D

     F0657 Resident Assessment and Care Planning Deficiencies

     Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

     Corrected Jun 20, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0755 Pharmacy Service Deficiencies

     Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

     Corrected Jun 20, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0757 Pharmacy Service Deficiencies

     Ensure each resident’s drug regimen must be free from unnecessary drugs.

     Corrected Jun 20, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0849 Administration Deficiencies

     Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

     Corrected Jun 20, 2024 · CMS health inspection

   • Not serious Scope/severity D

     F0883 Infection Control Deficiencies

     Develop and implement policies and procedures for flu and pneumonia vaccinations.

     Corrected Jun 20, 2024 · CMS health inspection

   • Not serious Scope/severity F

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Jun 10, 2024 · CMS fire safety

   • Not serious Scope/severity D

     K0511 Services Deficiencies

     Have properly installed electrical wiring and gas equipment.

     Corrected Jun 10, 2024 · CMS fire safety

7. Jan 29, 2024 Health · 2 findings
   • Not serious Scope/severity D Complaint

     F0580 Resident Rights Deficiencies

     Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

     Corrected Feb 29, 2024 · CMS health inspection

   • Not serious Scope/severity D Complaint

     F0686 Quality of Life and Care Deficiencies

     Provide appropriate pressure ulcer care and prevent new ulcers from developing.

     Corrected Feb 29, 2024 · CMS health inspection

8. May 10, 2023 Health · 8 findings
   • Not serious Scope/severity D

     F0757 Pharmacy Service Deficiencies

     Ensure each resident’s drug regimen must be free from unnecessary drugs.

     Corrected Jun 8, 2023 · CMS health inspection

   • Not serious Scope/severity F

     F0812 Nutrition and Dietary Deficiencies

     Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

     Corrected May 31, 2023 · CMS health inspection

   • Not serious Scope/severity E

     K0324 Smoke Deficiencies

     Provide properly protected cooking facilities.

     Corrected May 25, 2023 · CMS fire safety

   • Not serious Scope/severity F

     K0345 Smoke Deficiencies

     Have approved installation, maintenance and testing program for fire alarm systems.

     Corrected Jun 15, 2023 · CMS fire safety

   • Not serious Scope/severity F

     K0353 Smoke Deficiencies

     Inspect, test, and maintain automatic sprinkler systems.

     Corrected Jun 15, 2023 · CMS fire safety

   • Not serious Scope/severity D

     K0363 Smoke Deficiencies

     Install corridor and hallway doors that block smoke.

     Corrected Jun 12, 2023 · CMS fire safety

   • Not serious Scope/severity E

     K0521 Services Deficiencies

     Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

     Corrected May 31, 2023 · CMS fire safety

   • Not serious Scope/severity E

     K0923 Gas, Vacuum, and Electrical Systems Deficiencies

     Have proper medical gas storage and administration areas.

     Corrected Jun 15, 2023 · CMS fire safety

Owners and managers (as published by CMS)

• BAUMANN, TROY — operational/managerial control, NOT APPLICABLE, since 10/01/2019
• BAUMANN, TROY — adp of the snf, NOT APPLICABLE, since 10/01/2019
• BAUMANN, TROY — corporate director, NOT APPLICABLE, since 10/01/2019
• BELONGIA, CHRISTINA — operational/managerial control, NOT APPLICABLE, since 11/01/2019
• BELONGIA, CHRISTINA — adp of the snf, NOT APPLICABLE, since 11/01/2019
• CHERUKULA, MADHAVI — operational/managerial control, NOT APPLICABLE, since 02/01/2023
• CHERUKULA, MADHAVI — adp of the snf, NOT APPLICABLE, since 02/01/2023
• GEE, DARREN — adp of the snf, NOT APPLICABLE, since 11/30/2021
• GEE, DARREN — operational/managerial control, NOT APPLICABLE, since 11/30/2021
• GEE, DARREN — individual is an owner, partner or trustee of any adp of the snf, NOT APPLICABLE, since 02/10/2026
• GOSSEN, JENNIFER — adp of the snf, NOT APPLICABLE, since 01/05/2026
• GOSSEN, JENNIFER — operational/managerial control, NOT APPLICABLE, since 01/05/2026
• GREER, LAUREN — adp of the snf, NOT APPLICABLE, since 11/29/2023
• GREER, LAUREN — operational/managerial control, NOT APPLICABLE, since 11/29/2023
• HOEHN, JEFFREY — operational/managerial control, NOT APPLICABLE, since 10/01/2019
• HOEHN, JEFFREY — corporate director, NOT APPLICABLE, since 10/01/2019
• HOEHN, JEFFREY — adp of the snf, NOT APPLICABLE, since 10/01/2019
• MILLS, DAVID — 5% or greater indirect ownership interest, 18%, since 10/01/2019
• PATZER, COLLEEN — adp of the snf, NOT APPLICABLE, since 02/14/2023
• PATZER, COLLEEN — operational/managerial control, NOT APPLICABLE, since 02/14/2023
• PURTELL, BRIAN — operational/managerial control, NOT APPLICABLE, since 10/01/2019
• PURTELL, BRIAN — adp of the snf, NOT APPLICABLE, since 10/01/2019
• ARROWHEAD 123 LLC — 5% or greater indirect ownership interest, 10%, since 10/01/2019
• ARROWHEAD 123 LLC — adp of the snf, NOT APPLICABLE, since 12/01/2019
• CIBC BANK USA — 5% or greater mortgage interest, NOT APPLICABLE, since 12/31/2024
• CIBC BANK USA — 5% or greater security interest, NOT APPLICABLE, since 12/31/2024
• CIBC BANK USA — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• CLIFTONLARSONALLEN LLP — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• CLIFTONLARSONALLEN LLP — adp of the snf, NOT APPLICABLE, since 05/23/2025
• CONTINUUM THERAPY PARTNERS LLC — operational/managerial control, NOT APPLICABLE, since 03/01/2025
• CONTINUUM THERAPY PARTNERS LLC — adp of the snf, NOT APPLICABLE, since 05/23/2025
• NORTH SHORE HEALTHCARE LLC — operational/managerial control, NOT APPLICABLE, since 12/01/2019
• NORTH SHORE HEALTHCARE LLC — adp of the snf, NOT APPLICABLE, since 12/01/2019
• NSH 1250 EVERGREEN STREET LLC — adp of the snf, NOT APPLICABLE, since 12/01/2019
• NSH REHAB LLC — operational/managerial control, NOT APPLICABLE, since 03/01/2025
• NSH REHAB LLC — adp of the snf, NOT APPLICABLE, since 05/23/2025
• NSHR OPERATIONS LLC — 5% or greater direct ownership interest, 100%, since 10/01/2019
• THE LANE MORRELL BOWEN TRUST — 5% or greater indirect ownership interest, 10%, since 10/01/2019
• WIPFLI LLP — operational/managerial control, NOT APPLICABLE, since 02/01/2025
• WIPFLI LLP — adp of the snf, NOT APPLICABLE, since 11/10/2025