Evergreen Healthcare Center

Total Number of Beds: 60	Percent of Occupied Beds: 83%
Total Number of Residents: 50	Located Within a Hospital: No
Type of Ownership: For profit - Corporation	Multiple Nursing Homes by Same Owner: Yes
Councils the Nursing Home Participates in: Family & Resident	Medicare/Medicaid: Participating in Medicare and Medicaid
* Details Last Reported on: 01/08/2003

Nursing Home Staff Information:

Number of RN Hours per Nursing Home Resident per Day:

Number of LPN/LVN Hours per Nursing Home Resident per Day:

Number of CNA Hours per Nursing Home Resident per Day:

Number of Staff Hours per Nursing Home Resident per Day:

Nursing Home Resident Information**:

Percent of Residents Who Have Moderate to Severe Pain: 10%
Percent of Residents Who Spend Most of Their Time in Bed or in a Chair: 6%
Percent of Residents Who are More Depressed or Anxious: 23%
Percent of Residents Who Were Physically Restrained: 11%
Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder: 3%
Percent of Residents With a Urinary Tract Infection: 25%
** Details Last Reported on: 1/8/2003

Nursing Home Inspection Violations:

Date of Violation	Date Corrected	Type of Violation	Deficiency	Scope	Level of Harm
2001-02-13	2001-03-26	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Isolated	Minimal harm or potential for actual harm
2001-02-13	2001-03-26	Mistreatment Deficiencies	1) Hire only people who have no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.	Isolated	Actual harm
2001-02-13	2001-05-14	Quality Care Deficiencies	Make sure that residents who cannot care for themselves receive help with eating/drinking, grooming and hygiene.	Pattern	Minimal harm or potential for actual harm
2001-02-13	2001-05-14	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Isolated	Actual harm
2001-02-13	2001-03-26	Quality Care Deficiencies	Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary.	Isolated	Actual harm
2001-02-13	2001-03-26	Quality Care Deficiencies	Make sure that residents with loss of bladder control receive treatment or service to prevent infections and help get normal bladder control.	Isolated	Actual harm
2001-02-13	2001-03-26	Quality Care Deficiencies	Make sure each resident is being watched and has assistance devices when needed, to prevent accidents.	Isolated	Actual harm
2001-02-13	2001-05-14	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2001-02-13	2001-03-26	Pharmacy Service Deficiencies	1) Make sure that residents who take drugs are not given too many doses or for too long; 2) make sure that the use of drugs is carefully watched; or 3) stop or change drugs that cause unwanted effects.	Pattern	Minimal harm or potential for actual harm
2001-02-13	2001-03-26	Quality Care Deficiencies	Have enough nurses to care for every resident in a way that maximizes the resident's well being.	Pattern	Minimal harm or potential for actual harm
2001-02-13	2001-03-26	Environmental Deficiencies	Provide rooms that are big enough for each resident.	Pattern	Potential for minimal harm
2001-02-13	2002-03-26	Administration Deficiencies	Keep clinical information safe, so that it will not be lost, destroyed or used by the wrong person.	Widespread	Potential for minimal harm
2001-12-12	2002-01-07	Mistreatment Deficiencies	Keep each resident free from physical restraints, unless needed for medical treatment.	Pattern	Potential for minimal harm
2001-12-12	2002-01-07	Mistreatment Deficiencies	Write and use policies that forbid mistreatment, neglect and abuse of residents and theft of residents' property.	Widespread	Potential for minimal harm
2001-12-12	2002-01-07	Quality Care Deficiencies	Provide activities to meet the needs of each resident.	Widespread	Potential for minimal harm
2001-12-12	2002-02-07	Resident Assessment Deficiencies	Make sure all assessments are accurate, coordinated by an RN, done by the right professional, and are signed by the person completing them.	Pattern	Potential for minimal harm
2001-12-12	2002-01-07	Resident Assessment Deficiencies	Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.	Pattern	Potential for minimal harm
2001-12-12	2002-02-07	Resident Assessment Deficiencies	Electronically record and report resident status assessments in a timely manner as required in order to monitor resident health and progress.	Pattern	Potential for minimal harm
2001-12-12	2002-01-07	Quality Care Deficiencies	Give residents proper treatment to prevent new bed (pressure) sores or heal existing bed sores.	Pattern	Minimal harm or potential for actual harm
2001-12-12	2002-01-07	Quality Care Deficiencies	Give proper treatment to residents with feeding tubes to prevent problems (such as aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, nasal-pharyngeal ulcers) and help restore eating skills, if possible.	Isolated	Minimal harm or potential for actual harm
2001-12-12	2002-01-07	Quality Care Deficiencies	Make sure that each resident's nutritional needs were met.	Isolated	Minimal harm or potential for actual harm
2001-12-12	2002-01-07	Administration Deficiencies	Get proof that a nurse aide has the training and skills that the State requires.	Widespread	Potential for minimal harm
2001-12-12	2002-01-07	Administration Deficiencies	Give or get lab tests to meet the needs of residents.	Isolated	Minimal harm or potential for actual harm
2003-01-08	2003-02-10	Nutrition and Dietary Deficiencies	1) Provide 3 meals daily at regular times; or 2) serve breakfast within 14 hours after dinner; or 3) offer a snack at bedtime each day.	Widespread	Potential for minimal harm

*** All violations listed are based on federal government records.