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NATIONAL NURSING HOME WATCH LIST |
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EVERGREEN CARE CTR: Actual Harm and/or Immediate Jeopardy |
1250 EVERGREEN ST |
SHAWANO WI |
TELEPHONE: 7155263107 |
TYPE OF OWNERSHIP: For profit - Corporation |
NUMBER OF BEDS / PERCENT OCCUPIED: 65 / 86 |
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| Based on the annual and complaint survey data reported by CMS as of 02/06/10 , this home is listed because in at least one area they caused actual harm to a patient and/or subjected the patients to immediate jeopardy. More recent reports/corrections may be available. Check with the nursing home administrator. Actual harm is indicated by a score of G, H, I, while J, K, L indicate immediate jeopardy. The color coding scheme is below: |
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| RATING | DEFINITION |
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 | actual harm and/or immediate jeopardy: score= G,H,I,J,K,L |
 | potential for more than minimal harm: score= D, E, F |
 | potential for minimal harm: score= A, B, C |
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| NOTE: THIS HOME ALSO FOUND TO HAVE CAUSED ACTUAL HARM OR PLACED |
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| PATIENTS IN IMMEDIATE JEOPARDY ON AT LEAST: 2 ADDITIONAL SURVEY(S) |
| RESULTS LISTED BASED ON MOST RECENT ANNUAL SURVEY DATED: 01/27/2009 |
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| RATING | VIOLATION | SCOPE/SEVERITY CODE |
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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. | D |
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Develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured. | D |
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Give professional services that follow each resident's written care plan. | D |
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Make sure that each resident who enters the nursing home without a catheter is not given a catheter, unless it is necessary. | D |
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Have drugs and other similar products available, which are needed every day and in emergencies, and give them out properly. | C |
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Make sure that the nursing home area is free of dangers that cause accidents. | G |
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Properly mark drugs and other similar products. | E |
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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. | D |
COMPLAINT SURVEY RESULTS: SUBSTANTIATED |
| DATE | RATING | COMPLAINT VIOLATION CONFIRMED | SCOPE/SEVERITY CODE |
|---|---|---|---|
| 09/27/2006 |
| Immediately tell the resident, doctor, and a family member if: the resident is injured, there is a major change in resident's physical/mental health, there is a need to alter treatment significantly, or the resident must be transf | D |
| 09/27/2006 |
| 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. | D |
| 09/27/2006 |
| Give professional services that meet a professional standard of quality. | D |
| 09/27/2006 |
| Make sure that the nursing home area is free of dangers that cause accidents. | D |
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