01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-02-18 | 20 | 2025-02-18 | 9 |
| Cycle 2 | 2023-10-23 | 10 | 2023-10-23 | 2 |
| Cycle 3 | 2022-08-15 | 11 | 2022-08-15 | 1 |
CMS CCN 3852582026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Evergreen Post Acute
8643 Ne Beech Street · Portland, OR 97220 · Multnomah County
Certified beds55CMS provider file
Recent citation rows53current CMS citation release
Penalty rows1current 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
53 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 14 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-14 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2026-06-01 · complaint2025-11-17 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-12-08 · complaint2025-11-17 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2025-12-08 · complaint2025-02-18 · FIREE0013Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop Emergency Preparedness policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-04-022025-02-18 · FIREE0020Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish policies and procedures including evacuation.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0561Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-03-21 · complaint2025-02-18 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0676Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0679Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0699Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care or services that was trauma informed and/or culturally competent.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0740Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0804Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0806Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · HEALTHF0812Severity E · pattern; 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 · 2025-03-212025-02-18 · HEALTHF0825Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or get specialized rehabilitative services as required for a resident.
Correction field: Deficient, Provider has date of correction · 2025-03-212025-02-18 · 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 · 2025-03-212025-02-18 · FIREK0222Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-03-2103 / 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 |
|---|---|---|---|
| 2023-12-11 | Fine | $4,194 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- TRUIST BANKOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 09/01/2024
- APT, FREDERICKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/10/2024
- BRZYCKI, TRACYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2024
- CARNAGIE, RUSSELLIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/03/2024
- JERGENSEN, JOSHUAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/10/2024
- LARSON, DAVIDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2024
- MITCHELL, JOHNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 05/10/2024
- PORTLAND 8643 REALTY LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/01/2024
- PROVIDENCE ADMINISTRATIVE CONSULTING SERVICES INCOrganization · ADP OF THE SNFNOT APPLICABLE · since 09/01/2024
- CARNAGIE, RUSSELLIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/30/2025
- LARSON, DAVIDIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/30/2025
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 hours4.94per resident day
RN hours0.36per resident day
Weekend nurse hours4.44per resident day
Staff turnover63.3%CMS reported field
06 / LOCAL RECORDS
Open the Portland ledger →Other published facilities nearby
Avalon Care Center - Portland40 beds · CMS overall 3/545 citation rowsAvamere Crestview Of Portland127 beds · CMS overall 4/560 citation rowsBelmont Care And Rehabilitation41 beds · CMS overall 1/560 citation rowsCascade Terrace Post Acute105 beds · CMS overall 1/564 citation rowsCedar Crossings89 beds · CMS overall 3/588 citation rowsFernhill Rehabilitation And Care63 beds · CMS overall 2/574 citation rowsFernwood Supportive Living At Madrona Grove16 beds · CMS overall 4/532 citation rowsGateway Care And Retirement59 beds · CMS overall 3/554 citation rows