Milton Freewater Health and Rehabilitation

Name: Milton Freewater Health and Rehabilitation
Address: 120 ELZORA STREET, Milton Freewater, OR, 97862, US
Telephone: 5419383318

120 Elzora Street, Milton Freewater, OR 97862 · Umatilla County · 70 certified beds · avg 32 residents/day · certified since Jan 20, 1984

Part of chain: EVERGREEN HEALTHCARE GROUP (44 facilities, chain avg rating 2.5★)

4/5

Health inspection rating (on-site)

Serious findings on record

$8,278

Fines, last 3 years

5.63

Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

Health inspection rating: ★★★★☆4/5 · CMS overall rating: 5/5

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)

▲ Actual harm, one-off · Aug 7, 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: Aug 28, 2025 (Deficient, Provider has date of correction)

All citations in the current public record (26)

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
Jan 15, 2026	D · Potential for harm, one-off	The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds. · from a complaint
Jan 15, 2026	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
Jan 15, 2026	D · Potential for harm, one-off	The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections.
Jan 15, 2026	D · Potential for harm, one-off	The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care.
Jan 15, 2026	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.
Aug 7, 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, 2025	D · Potential for harm, one-off	The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint
Aug 7, 2025	D · Potential for harm, one-off	The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint
Aug 7, 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
Jun 28, 2024	E · Potential for harm, repeated	The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint
Jun 28, 2024	D · Potential for harm, one-off	The facility did not let a resident help develop and carry out their own plan of care — the written roadmap of the services and support they'll receive, built around their personal goals and preferences.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not help a resident get vision and hearing services — such as eye exams, glasses, hearing tests, or hearing aids.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Jun 28, 2024	D · Potential for harm, one-off	The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint
Apr 7, 2023	E · Potential for harm, repeated	The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards.
Apr 7, 2023	D · Potential for harm, one-off	The facility did not let a resident help develop and carry out their own plan of care — the written roadmap of the services and support they'll receive, built around their personal goals and preferences.
Apr 7, 2023	D · Potential for harm, one-off	The facility did not protect residents from misuse of their belongings or money — this is called misappropriation, and it includes theft or improper use of a resident's property or funds.
Apr 7, 2023	D · Potential for harm, one-off	The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives.
Apr 7, 2023	D · Potential for harm, one-off	The facility did not create and follow a basic care plan covering a new resident's most immediate needs within 48 hours of admission. The first days are when a new resident is most vulnerable.
Apr 7, 2023	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.
Apr 7, 2023	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.
Apr 7, 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.
Apr 7, 2023	D · Potential for harm, one-off	The facility did not provide or arrange dental services for its residents. Nursing homes are responsible for making sure residents can get dental care.

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (7 → 5).

Year	Citations	Serious (G–L)	Worst severity that year
2023	9	0	E
2024	8	0	E
2025	4	1	G ▲
2026	5	0	D

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 $8,278.

Date	Type	Amount / length
Aug 7, 2025	Fine	$8,278

Nurse staffing (from payroll records, adjusted for how much care residents need)

Measure	This facility	Oregon avg	U.S. avg	Where it stands
Total nurse staffing (hours per resident per day)	5.63	5.42	3.95	top 30% in Oregon; top 6% in the U.S.
Registered Nurse hours	1.23	0.78	0.69	top 9% in Oregon; top 9% in the U.S.
Weekend total nurse staffing	4.95	4.85	3.50	top 37% in Oregon; top 7% in the U.S.
Weekend RN hours (not acuity-adjusted)	0.79	0.48	0.48	top 11% in Oregon; top 12% in the U.S.
Total nursing staff turnover (%)	34.1	47.4	45.8	top 15% in Oregon; top 22% in the U.S.
RN turnover (%)	45.5	51.6	42.9	top 34% in Oregon; bottom 43% 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 5.34, RN 1.16, weekend 4.69. Staffing rating: 5/5.

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: 2/5 · long-stay residents: 3/5 · short-stay residents: 1/5

Who owns this facility

For profit - Corporation

Owner / manager	Type	Role	Stake	Since
Ashby, William	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
CH PNW 12 Holdings LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Chambers, Randy	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Couve Financial Services LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Couve Healthcare Consulting LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Freewater Oregon LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Herzka, Yisroel	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Hyde, Deidre	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Milton Freewater SNF Operations, LLC	Organization	Direct Ownership Interest	NOT APPLICABLE	08/31/2023
Odenthal, Jason	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Pacific Northwest 12 Leased Operations Holdings LLC	Organization	Direct Ownership Interest	NOT APPLICABLE	08/31/2023
PNW 12 Opco Management LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
PNW 12 SNF Consulting LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Spielman, Shimon	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Witzcorp PNW 12 LLC	Organization	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Yenowitz, Yitzchok	Individual	Indirect Ownership Interest	NOT APPLICABLE	08/31/2023
Ashby, William	Individual	Operational/Managerial Control	NOT APPLICABLE	08/31/2023
Ashby, William	Individual	ADP of the SNF	NOT APPLICABLE	08/31/2023
Chambers, Randy	Individual	Operational/Managerial Control	NOT APPLICABLE	08/31/2023
Chambers, Randy	Individual	ADP of the SNF	NOT APPLICABLE	08/31/2023

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?"
"What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
"How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
"How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
"What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
"How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
"Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
"When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
"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
Regency at the Park	7.4 mi	College Place, WA	★★★★★	4/5
Park Manor Rehabilitation Ctr	7.8 mi	Walla Walla, WA	★★★★★	5/5
Washington State Walla Walla Veterans Home	8.4 mi	Walla Walla, WA	★★★★☆	3/5
Washington Odd Fellows Home	9.6 mi	Walla Walla, WA	★★★★☆	3/5

Compare this facility with the 3 closest →

All facilities in Milton Freewater →

Facility data as of CMS processing date 2026-08-01. CCN 385161.

The Care File

Visit checklist — Milton Freewater Health and Rehabilitation

120 Elzora Street, Milton Freewater, OR 97862 · 5419383318

Health inspection rating 4/5 · CMS overall 5/5· Fines (3y): $8,278

Most serious findings on record:

▲ Aug 7, 2025 (F-0689, 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.

Questions for the administrator:

☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "What safeguards do you have to protect residents' money and belongings, and what happens when something goes missing?"
☐ "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
☐ "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
☐ "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
☐ "How often is each resident's medication list reviewed, and who decides when a drug can be reduced or stopped?"
☐ "Tell me about this abuse or neglect citation — what happened, and what specific changes did you make afterward?"
☐ "When abuse or theft is suspected, who do you notify, how fast, and how do you inform the family?"
☐ "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?"

While you're there, notice:

☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)

Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 385161 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)