Evergreen Health Center - Oshkosh Nursing Home
General Information
UPDATEFederal Provider Number
525647
Provider Name
EVERGREEN HEALTH CENTER
Provider Address
1130 N WESTFIELD ST
OSHKOSH, WI 54902
OSHKOSH, WI 54902
Provider Phone Number
9202332340
Provider SSA County
690
Provider County Name
Winnebago
Ownership Type
Non profit - Corporation
Number of Certified Beds
80
Number of Residents in Certified Beds
71
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
EVERGREEN RETIREMENT COMMUNITY
Date First Approved to Provide Medicare and Medicaid services
1999-04-01
Continuing Care Retirement Community
Y
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
3
Health Inspection Rating Footnote
QM Rating
2
QM Rating Footnote
Staffing Rating
5
Staffing Rating Footnote
RN Staffing Rating
5
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
3.43310
Reported LPN Staffing Hours per Resident per Day
0.30986
Reported RN Staffing Hours per Resident per Day
1.01197
Reported Licensed Staffing Hours per Resident per Day
1.32183
Reported Total Nurse Staffing Hours per Resident per Day
4.75493
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07746
Expected CNA Staffing Hours per Resident per Day
2.57729
Expected LPN Staffing Hours per Resident per Day
0.65803
Expected RN Staffing Hours per Resident per Day
1.05368
Expected Total Nurse Staffing Hours per Resident per Day
4.28899
Adjusted CNA Staffing Hours per Resident per Day
3.26848
Adjusted LPN Staffing Hours per Resident per Day
0.39084
Adjusted RN Staffing Hours per Resident per Day
0.71762
Adjusted Total Nurse Staffing Hours per Resident per Day
4.46880
Cycle 1 Total Number of Health Deficiencies
5
Cycle 1 Number of Standard Health Deficiencies
5
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
36
Cycle 1 Standard Survey Health Date
2014-07-02
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
36
Cycle 2 Total Number of Health Deficiencies
4
Cycle 2 Number of Standard Health Deficiencies
4
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
32
Cycle 2 Standard Health Survey Date
2013-04-03
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
0
Cycle 3 Total Number of Health Deficiencies
10
Cycle 3 Number of Standard Health Deficiencies
9
Cycle 3 Number of Complaint Health Deficiencies
1
Cycle 3 Health Deficiency Score
68
Cycle 3 Standard Health Survey Date
2012-03-23
Cycle 3 Number of Health Revisits
1
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
68
Total Weighted Health Survey Score
40.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
1
Number of Fines
0
Total Amount of Fines in Dollars
0
Number of Payment Denials
0
Total Number of Penalties
0
Location
Processing Date
2015-06-01
Nursiong Homes Nearby
Bethel Home
225 N Eagle St |
OSHKOSH WI 54902 | 0.7 mile away
Eden Rehab Suites And Green House Homes
3151 Eden Ct |
OSHKOSH WI 54904 | 2 miles away
Northpoint Medical And Rehab Ctr
1850 Bowen St |
OSHKOSH WI 54901 | 2.4 miles away
Park View Health Center
725 Butler Ave |
OSHKOSH WI 54901 | 3.8 miles away
Omro Care Center
500 Grant Ave |
OMRO WI 54963 | 8.8 miles away
Bridgewood Nursing And Rehab Center
125 Byrd Ave |
NEENAH WI 54956 | 10.7 miles away
Oakridge Gardens Nur Ctr, Inc
1700 Midway Rd |
MENASHA WI 54952 | 16 miles away
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