EVERGREEN HEALTH SERVICES
1250 EVERGREEN ST, SHAWANO, WI 54166 · CCN 525343
Ratings
- Overall
- ★★☆☆☆ 2
- Health inspection
- ★★☆☆☆ 2
- Quality measures
- ★★★★☆ 4
- Staffing
- ★★★☆☆ 3
Facility
- Ownership type
- For profit - Limited Liability company
- Certified beds
- 50
- Avg residents/day
- 38.6
- Phone
- 7155263107
Inspection history vs Wisconsin & national averages
Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.
| Cycle | Inspection date | This facility | Wisconsin avg | National avg | vs state |
|---|---|---|---|---|---|
| 1 | 2025-05-29 | 10 | 9.8 | 9.5 | +0.2 worse |
| 2 | 2024-05-22 | 6 | 9.2 | 9.8 | -3.2 better |
| 3 | 2023-05-10 | 4 | 8.3 | 9.3 | -4.3 better |
Cycle 1 deficiencies by category
| Category | Deficiencies |
|---|---|
| Quality of life and care | 6 |
| Nutrition and dietary | 1 |
| Pharmacy service | 1 |
| Infection control | 2 |
Staffing (hours per resident per day)
| Metric | This facility | Turnover |
|---|---|---|
| Total nurse staffing (reported) | 3.40 | 54.3% |
| RN staffing (reported) | 0.76 | 50.0% |
| Total nurse staffing (adjusted) | 3.48 | — |
Fines & penalties
- Total fines
- $0
- Number of fines
- 0
- Number of penalties
- 0
- Payment denials
- 0
Chain
- Chain
- NORTH SHORE HEALTHCARE
- Facilities in chain
- 58
- Chain avg overall
- 2.80 / 5
Inspection citations (20)1 immediate jeopardy1 actual harm
- EF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2025-09-16 · Health · corrected 2025-10-09
Potential for more than minimal harm
- JF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-09-16 · Health · corrected 2025-10-09
Immediate jeopardy
- EF0880Provide and implement an infection prevention and control program.2025-09-16 · Health · corrected 2025-10-09
Potential for more than minimal harm
- DF0693Ensure 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.2025-08-20 · Health · corrected 2025-09-11
Potential for more than minimal harm
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-05-29 · Health · corrected 2025-06-19
Potential for more than minimal harm
- DF0695Provide safe and appropriate respiratory care for a resident when needed.2025-05-29 · Health · corrected 2025-06-19
Potential for more than minimal harm
- DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2025-05-29 · Health · corrected 2025-06-19
Potential for more than minimal harm
- EF0809Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.2025-05-29 · Health · corrected 2025-06-19
Potential for more than minimal harm
- DF0880Provide and implement an infection prevention and control program.2025-05-29 · Health · corrected 2025-06-19
Potential for more than minimal harm
- GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2025-03-19 · Health · corrected 2025-05-02
Actual harm
- DF0761Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.2024-08-07 · Health · corrected 2024-08-19
Potential for more than minimal harm
- DF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2024-05-22 · Health · corrected 2024-06-20
Potential for more than minimal harm
- DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2024-05-22 · Health · corrected 2024-06-20
Potential for more than minimal harm
- DF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.2024-05-22 · Health · corrected 2024-06-20
Potential for more than minimal harm
- DF0849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.2024-05-22 · Health · corrected 2024-06-20
Potential for more than minimal harm
- DF0883Develop and implement policies and procedures for flu and pneumonia vaccinations.2024-05-22 · Health · corrected 2024-06-20
Potential for more than minimal harm
- DF0580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.2024-01-29 · Health · corrected 2024-02-29
Potential for more than minimal harm
- DF0686Provide appropriate pressure ulcer care and prevent new ulcers from developing.2024-01-29 · Health · corrected 2024-02-29
Potential for more than minimal harm
- DF0757Ensure each resident’s drug regimen must be free from unnecessary drugs.2023-05-10 · Health · corrected 2023-06-08
Potential for more than minimal harm
- FF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2023-05-10 · Health · corrected 2023-05-31
Potential for more than minimal harm
Ownership
| Owner | Type | Role | Percent | Since |
|---|---|---|---|---|
| NSHR OPERATIONS LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | 2019-10-01 |
| ARROWHEAD 123 LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-10-01 |
| THE LANE MORRELL BOWEN TRUST | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-10-01 |
| BAUMANN, TROY | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-10-01 |
| HOEHN, JEFFREY | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-10-01 |
| MILLS, DAVID | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | — | 2019-10-01 |
| CIBC BANK USA | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-12-01 |
| CLIFTONLARSONALLEN LLP | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-12-01 |
| CONTINUUM THERAPY PARTNERS | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-03-01 |
| NORTH SHORE HEALTHCARE LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-12-01 |
| NSH REHAB LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-03-01 |
| WIPFLI LLP | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | 2025-02-01 |
| BAUMANN, TROY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-01 |
| BELONGIA, CHRISTINA | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-11-01 |
| CHERUKULA, MADHAVI REDDY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-02-01 |
| GEE, DARREN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2021-11-30 |
| GOSSEN, JENNIFER | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2026-01-05 |
| GREER, LAUREN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-11-29 |
| HOEHN, JEFFREY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-01 |
| PATZER, COLLEEN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-02-14 |
| PURTELL, BRIAN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-10-01 |
| BAUMANN, TROY | Individual | CORPORATE DIRECTOR | — | 2019-10-01 |
| HOEHN, JEFFREY | Individual | CORPORATE DIRECTOR | — | 2019-10-01 |
| CIBC BANK USA | Organization | 5% OR GREATER SECURITY INTEREST | — | 2024-12-31 |
| CIBC BANK USA | Organization | 5% OR GREATER MORTGAGE INTEREST | — | 2024-12-31 |
Other facilities in SHAWANO
| Name | Overall | Beds |
|---|---|---|
| SHAWANO HEALTH SERVICES | ★★★★★ | 100 |
Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.