EVERGREEN HEALTHCARE CENTER
924 CHARLIE'S WAY, MONTPELIER, OH 43543 · CCN 365495
Abuse icon
Ratings
- Overall
- ★★☆☆☆ 2
- Health inspection
- ★★☆☆☆ 2
- Quality measures
- ★★☆☆☆ 2
- Staffing
- ★★☆☆☆ 2
Facility
- Ownership type
- For profit - Corporation
- Certified beds
- 73
- Avg residents/day
- 45.3
- Phone
- 4194858307
Inspection history vs Ohio & national averages
Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.
| Cycle | Inspection date | This facility | Ohio avg | National avg | vs state |
|---|---|---|---|---|---|
| 1 | 2023-01-18 | 11 | 10.2 | 9.5 | +0.8 worse |
| 2 | 2021-12-21 | 7 | 10.7 | 9.8 | -3.7 better |
| 3 | 2019-06-26 | 0 | 9.9 | 9.3 | -9.9 better |
Cycle 1 deficiencies by category
| Category | Deficiencies |
|---|---|
| Abuse, neglect, exploitation | 2 |
| Quality of life and care | 3 |
| Resident rights | 1 |
| Pharmacy service | 2 |
| Administration | 1 |
| Infection control | 2 |
Staffing (hours per resident per day)
| Metric | This facility | Turnover |
|---|---|---|
| Total nurse staffing (reported) | 3.18 | 37.5% |
| RN staffing (reported) | 0.53 | — |
| Total nurse staffing (adjusted) | 2.99 | — |
Fines & penalties
- Total fines
- $0
- Number of fines
- 0
- Number of penalties
- 0
- Payment denials
- 0
Chain
- Chain
- COMMUNICARE HEALTH
- Facilities in chain
- 122
- Chain avg overall
- 2.80 / 5
Inspection citations (18)1 immediate jeopardy1 actual harm
- DF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- JF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.2023-01-18 · Health · corrected 2023-02-14
Immediate jeopardy
- DF0610Respond appropriately to all alleged violations.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2023-01-18 · Health · corrected 2023-02-14
Actual harm
- DF0692Provide enough food/fluids to maintain a resident's health.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0760Ensure that residents are free from significant medication errors.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0835Administer the facility in a manner that enables it to use its resources effectively and efficiently.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0880Provide and implement an infection prevention and control program.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0881Implement a program that monitors antibiotic use.2023-01-18 · Health · corrected 2023-02-14
Potential for more than minimal harm
- DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0625Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0698Provide safe, appropriate dialysis care/services for a resident who requires such services.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0759Ensure medication error rates are not 5 percent or greater.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
- DF0880Provide and implement an infection prevention and control program.2021-12-21 · Health · corrected 2022-01-21
Potential for more than minimal harm
Ownership
| Owner | Type | Role | Percent | Since |
|---|---|---|---|---|
| SXCY MSTR LSCO, LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2022-01-01 |
| C.R. STOLTZ FAMILY INVESTMENT COMPANY INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| C.R. STOLTZ IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| HEALTH CARE LEASE FACILITIES, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| I. ROSEDALE IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| R.S. WILHEIM IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| RONALD S WILHEIM 2012 SPOUSAL TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| ROSEDALE FAMILY INVESTMENT COMPANY, INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| RRW, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| S.L. ROSEDALE IRREVOCABLE TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| SKILLED HC HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| SXCY HOLDINGS, LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2022-01-01 |
| WILHEIM FAMILY INVESTMENT COMPANY, INC. | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2018-03-01 |
| ROBINAIR MGT CO., LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2018-03-01 |
| GROVES, DONNA | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-04-14 |
| GUTIERREZ, YVETTE | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-04-05 |
| PARK, KEVIN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-10-01 |
| ROMEO, DOMINIC | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-04-01 |
| ROMEO, DOMINIC | Individual | CORPORATE OFFICER | — | 2023-04-01 |
| STOLTZ, CHARLES | Individual | CORPORATE OFFICER | — | 2018-03-01 |
| WILHEIM, RONALD | Individual | CORPORATE OFFICER | — | 2018-03-01 |
Other facilities in MONTPELIER
| Name | Overall | Beds |
|---|
Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.