A list of the most recent deficiencies for Evergreen Care Center. The list is based on the information provided by CMS from both standard inspections and from complaints filed by residents.
| Deficiency | Type of Deficiency | Deficiency Date | Date Corrected | Resulted from a Complaint? |
|---|---|---|---|---|
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2024-01-16 | 2024-01-28 | Y |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2023-12-01 | 2023-12-20 | Y |
| 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. | Health | 2023-12-01 | 2023-12-20 | Y |
| Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | Health | 2023-08-21 | 2023-09-01 | Y |
| Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Health | 2022-04-26 | 2022-05-05 | Y |
| Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Health | 2019-05-23 | 2019-09-07 | N |
| Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Health | 2019-05-23 | 2019-09-07 | N |
| Assess the resident when there is a significant change in condition | Health | 2019-05-23 | 2019-09-07 | N |
| Ensure each resident receives an accurate assessment. | Health | 2019-05-23 | 2019-09-07 | N |
| Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Health | 2019-05-23 | 2019-09-07 | N |
| Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Health | 2019-05-23 | 2019-09-07 | N |
| Ensure services provided by the nursing facility meet professional standards of quality. | Health | 2019-05-23 | 2019-09-07 | N |
| Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | Health | 2019-05-23 | 2019-09-07 | N |
| Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Health | 2019-05-23 | 2019-09-07 | N |
| Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. | Health | 2019-05-23 | 2019-09-07 | N |
| Conduct risk assessment and an All-Hazards approach. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Address subsistence needs for staff and patients. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Establish roles under a Waiver declared by secretary. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Establish staff and initial training requirements. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Conduct testing and exercise requirements. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Install emergency lighting that can last at least 1 1/2 hours. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Provide properly protected cooking facilities. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Have approved installation, maintenance and testing program for fire alarm systems. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Inspect, test, and maintain automatic sprinkler systems. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Properly select, install, inspect, or maintain portable fire extinguishes. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Install corridor and hallway doors that block smoke. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Meet requirements for the installation and maintenance of electrical systems. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
| Ensure proper usage of power strips and extension cords. | Fire Safety | 2019-06-27 | 2019-07-22 | N |
