01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-05-27 | 2 | 2026-05-27 | 5 |
| Cycle 2 | 2025-03-12 | 3 | 2025-03-12 | 10 |
| Cycle 3 | 2024-01-11 | 2 | 2024-01-11 | 14 |
CMS CCN 5256472026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Evergreen Health Center
1130 N Westfield St · Oshkosh, WI 54902 · Winnebago County
Certified beds80CMS provider file
Recent citation rows36current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
36 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 8 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-27 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-06-152026-05-27 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-06-152026-05-27 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-05-27 · FIREK0511Severity F · widespread; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-05-27 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-05-27 · FIREK0761Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2026-06-192026-05-27 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-06-192025-03-12 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2025-03-272025-03-12 · FIREE0041Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Implement emergency and standby power systems.
Correction field: Deficient, Provider has date of correction · 2025-04-102025-03-12 · HEALTHF0623Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Correction field: Deficient, Provider has date of correction · 2025-04-072025-03-12 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-04-072025-03-12 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-04-072025-03-12 · FIREK0291Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2025-04-072025-03-12 · FIREK0293Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2025-04-102025-03-12 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2025-03-282025-03-12 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2025-04-242025-03-12 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-03-282025-03-12 · FIREK0374Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2025-03-282025-03-12 · FIREK0511Severity D · isolated; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2025-03-152025-03-12 · FIREK0521Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Correction field: Deficient, Provider has date of correction · 2025-03-182024-01-11 · HEALTHF0582Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-02-012024-01-11 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2024-02-012024-01-11 · FIREK0211Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2024-01-312024-01-11 · FIREK0223Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2024-01-3103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- EVERGREEN RETIREMENT COMMUNITY INCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 02/26/1968
- EVERGREEN COMMUNITIES, INCOrganization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST100% · since 06/01/2022
- ARNESON, KENNETHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2006
- CHITWOOD, JAMESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/30/2018
- CHUNG, SEON YOONIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- DAVIS, DAWNIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- DEARMOND, SARAHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- DEWITT, DEIRDREIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2020
- FUNCKE, VERNAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2023
- GREY, MICHAELIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2017
- HIGGINS, BILLIE JOIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2022
- KRUCK, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/30/2020
- LYNCH, SHERRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2024
- MATHES, ANDREWIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2023
- MILLER, CHADIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 06/30/2020
- RAMSEY, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2017
- RICHESON, EMILYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/01/2021
- ROMMELFANGER, ALANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2023
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.08per resident day
RN hours1.40per resident day
Weekend nurse hours4.57per resident day
Staff turnover49.0%CMS reported field
06 / LOCAL RECORDS
Open the Oshkosh ledger →