Provider Name: EVERGREEN NURSING HOME
Address: 100 SANDERS DRIVE, EVERGREEN, AL 36401
Phone: (251) 578-3783
County: Conecuh (170)
Ownership Type: For profit - Corporation
Certified Beds: 61
Average Residents Per Day: 50.7 ()
Provider Type: Medicare and Medicaid, Resides in Hospital: No
Legal Business Name: EVERGREEN NURSING HOME, LLC
First Approved Date: October 17, 1967
Affiliated Entity: CROWNE HEALTH CARE (174)
Retirement Community: N, Special Focus Status:
Ownership Change in Last 12 Months: N
Resident Family Council: Both
Sprinkler System Status: Yes
Overall Rating: 5 ()
Health Inspection Rating: 4 ()
QM Rating: 5 ()
Long Stay QM Rating: 5 ()
Short Stay QM Rating: 4 ()
Staffing Rating: 5 ()
Staffing Report Note:
PT Staffing Note:
Nurse Aide Staff Hours Per Day, per resident: 2.72191, LPN Staff Hours Per Day: 1.2435, RN Staff Hours Per Day: 0.5984, Licensed Staff Hours Per Day: 1.8419
Total Nurse Staff Hours Per Day, per resident: 4.56385
Weekend Nurse Staff Hours: 3.66066, Weekend RN Staff Hours: 0.1787
PT Staff Hours Per Day, per resident: 0.0138
Nurse Staff Turnover: 35.8, Nurse Turnover Note:
RN Turnover: 14.3, RN Turnover Note:
Admin Left Number: 0, Admin Turnover Note:
Case Mix Nurse Aide Hours Per Day, per resident: 2.0404, Case Mix LPN Hours Per Day: 0.6453, Case Mix RN Hours Per Day: 0.2723
Adjusted Nurse Aide Hours Per Day, per resident: 2.71765, Adjusted LPN Hours Per Day: 1.4219, Adjusted RN Hours Per Day: 0.8280
Total Adjusted Nurse Hours Per Day, per resident: 4.86298
Adjusted Weekend Nurse Hours Per Day, per resident: 3.90060
Health Survey Dates and Scores: Cycle 1: 2020-03-12 (Score: 8), Cycle 2: 2019-01-17 (Score: 4), Cycle 3: 2018-02-01 (Score: 20)
Total Weighted Health Score: 8.667
Reported Incidents: 0, Substantiated Complaints: 0
Infection Control Citations: 0
Fines and Penalties: Number of Fines: 0, Total Fines in Dollars: 0.00, Payment Denials Number: 0, Total Penalties Number: 0
Location and GPS: 100 SANDERS DRIVE,EVERGREEN,AL,36401 (31.4221, -86.946)
Process Date: 2024-03-01
Each record details specific health deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Health, Deficiency: Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-04-16
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2020-04-16
Type: Health, Deficiency: Provide and implement an infection prevention and control program.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-02-21
Type: Health, Deficiency: 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.
Severity: C - Level 1: No actual harm with potential for minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-03-08
Type: Health, Deficiency: Ensure each resident receives an accurate assessment.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-03-08
Type: Health, Deficiency: Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Severity: F - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2018-03-08
Each record details specific fire safety deficiencies found during inspections, categorized by type, severity, and whether they were corrected. Below are the severity levels and their implications:
Type: Fire Safety, Tag: 0343, Version: New
Description: Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
Severity: D - Level 2: No actual harm with potential for more than minimal harm. Plan of Correction required.
Corrected: Deficient, Provider has date of correction on 2019-02-28