Evergreen Health Services
1250 Evergreen St, Shawano, WI 54166 · Shawano County · 50 certified beds · avg 38 residents/day · certified since Dec 1, 1983
Part of chain: NORTH SHORE HEALTHCARE (59 facilities, chain avg rating 2.7★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Sep 16, 2025 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Oct 9, 2025 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Mar 19, 2025 · F-0689 · triggered by a complaint
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: May 2, 2025 (Deficient, Provider has date of correction)
All citations in the current public record (20)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Sep 16, 2025 | ▲ J · Immediate jeopardy, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Sep 16, 2025 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint |
| Sep 16, 2025 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · from a complaint |
| Aug 20, 2025 | D · Potential for harm, one-off | The facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. · from a complaint |
| May 29, 2025 | E · Potential for harm, repeated | The facility did not serve meals and snacks at times that fit residents' needs, preferences, and requests, or did not offer nourishing alternatives for residents who want to eat outside scheduled meal times. |
| May 29, 2025 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| May 29, 2025 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| May 29, 2025 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| May 29, 2025 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Mar 19, 2025 | ▲ G · Actual harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Aug 7, 2024 | D · Potential for harm, one-off | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · from a complaint |
| May 22, 2024 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| May 22, 2024 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| May 22, 2024 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| May 22, 2024 | D · Potential for harm, one-off | The facility did not arrange hospice services for a resident who needed them, or help the resident move to a facility that could arrange hospice. Hospice provides comfort-focused care for people nearing the end of life. |
| May 22, 2024 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Jan 29, 2024 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Jan 29, 2024 | D · Potential for harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint |
| May 10, 2023 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| May 10, 2023 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (5 → 4).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 2 | 0 | F |
| 2024 | 8 | 0 | D |
| 2025 | 10 | 2 | J ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
1 fine totaling $14,020.
| Date | Type | Amount / length |
|---|---|---|
| Aug 20, 2025 | Fine | $14,020 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Wisconsin avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 3.63 | 4.29 | 3.95 | bottom 31% in Wisconsin; bottom 43% in the U.S. |
| Registered Nurse hours | 0.72 | 1.01 | 0.69 | bottom 25% in Wisconsin; top 34% in the U.S. |
| Weekend total nurse staffing | 3.28 | 3.84 | 3.50 | bottom 33% in Wisconsin; bottom 46% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.41 | 0.68 | 0.48 | bottom 17% in Wisconsin; top 47% in the U.S. |
| Total nursing staff turnover (%) | 52.4 | 46.9 | 45.8 | bottom 31% in Wisconsin; bottom 31% in the U.S. |
| RN turnover (%) | 57.1 | 39.7 | 42.9 | bottom 24% in Wisconsin; bottom 26% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.58, RN 0.71, weekend 3.24. Staffing rating: 3/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 3/5 · long-stay residents: 2/5 · short-stay residents: 4/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Arrowhead 123 LLC | Organization | 5% or Greater Indirect Ownership Interest | 10% | 10/01/2019 |
| Mills, David | Individual | 5% or Greater Indirect Ownership Interest | 18% | 10/01/2019 |
| NSHR Operations LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 10/01/2019 |
| The Lane Morrell Bowen Trust | Organization | 5% or Greater Indirect Ownership Interest | 10% | 10/01/2019 |
| Arrowhead 123 LLC | Organization | ADP of the SNF | NOT APPLICABLE | 12/01/2019 |
| Baumann, Troy | Individual | Corporate Director | NOT APPLICABLE | 10/01/2019 |
| Baumann, Troy | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2019 |
| Baumann, Troy | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2019 |
| Belongia, Christina | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/01/2019 |
| Belongia, Christina | Individual | ADP of the SNF | NOT APPLICABLE | 11/01/2019 |
| Cherukula, Madhavi | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/01/2023 |
| Cherukula, Madhavi | Individual | ADP of the SNF | NOT APPLICABLE | 02/01/2023 |
| Cibc Bank USA | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 12/31/2024 |
| Cibc Bank USA | Organization | 5% or Greater Security Interest | NOT APPLICABLE | 12/31/2024 |
| Cibc Bank USA | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/01/2019 |
| Cliftonlarsonallen LLP | Organization | Operational/Managerial Control | NOT APPLICABLE | 12/01/2019 |
| Cliftonlarsonallen LLP | Organization | ADP of the SNF | NOT APPLICABLE | 05/23/2025 |
| Continuum Therapy Partners LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 03/01/2025 |
| Continuum Therapy Partners LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/23/2025 |
| Gee, Darren | Individual | Operational/Managerial Control | NOT APPLICABLE | 11/30/2021 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "How do you decide when a feeding tube is truly needed, and how do staff care for residents who have one?"
- "What happens if a resident is hungry between meals or misses a mealtime — what food options are available?"
- "How many residents here use oxygen or breathing equipment, and who checks that equipment each shift?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Shawano Health Services | 0.3 mi | Shawano, WI | ★★★★☆ | 4/5 | |
| Birch Hill Health Services | 0.5 mi | Shawano, WI | ★★☆☆☆ | 3/5 | |
| The Pines Post Acute and Memory Care | 7.4 mi | Clintonville, WI | ★★★★☆ | 3/5 | |
| Greentree Health and Rehabilitation Center | 12.0 mi | Clintonville, WI | ★★★☆☆ | 3/5 | |
| Suring Health and Rehab Center | 19.8 mi | Suring, WI | ★☆☆☆☆ | 1/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 525343.