EVERGREEN HEALTH CARE CENTER - SHAWANO, WI
United States hospital / nursing home:
EVERGREEN HEALTH CARE CENTER - SHAWANO, WI
EVERGREEN HEALTH CARE CENTER
1250 EVERGREEN ST
SHAWANO, WI 54166
RELIGIOUS NONMEDICAL HEALTH CARE INSTITUTIONS SNF/NF (DUALLY CERTIFIED)
Services provided by EVERGREEN HEALTH CARE CENTER:
- Activities services are provided onsite to residents
- Administration and storage of blood services are provided offsite to residents
- Clinical laboratory services are provided offsite to residents
- Dental services are provided offsite to residents
- Dental services are provided onsite to residents
- Dietary services are provided onsite to residents
- Housekeeping services are provided onsite to residents
- Nursing services are provided onsite to residents
- Occupational therapy services are provided onsite to non residents
- Occupational therapy services are provided onsite to residents
- Field 1 - Indicates other activity services provided by staff onsite to residents
- Pharmacy services are provided onsite to residents
- Physical therapy services are provided onsite to non residents
- Physical therapy services are provided onsite to residents
- Physician services are provided onsite to residents
- Podiatry services are provided offsite to residents
- Podiatry services are provided onsite to residents
- Social work services are provided onsite to residents
- Speech/language pathology services are provided onsite to non residents
- Speech/language pathology services are provided onsite to residents
- Diagnostic xray services are provided offsite to residents
- Diagnostic xray services are provided onsite to residents
Beds - Total (Total number of beds in a facility, including those in non-Participating or non-licensed areas): 91
Beds - Total certified (Number of beds in Medicare and/or Medicaid certified areas within a facility): 91
Registered nurse - Full time (The number of full-time equivalent registered nurses employed by a facility on a full time basis): 2.33
Change of ownership counter (The number of times a change of ownership (chow) has taken place for a particular provider): 2
Prior change of ownership (The date of a prior change of ownership): Jan 1986
Compliance: life safety code (Indicates if a waiver of the life safety code has been recommended for a provider): WAIVER RECOMMENDED
Program participation (Indicates if the provider participates in Medicare, Medicaid, or both programs): MEDICARE AND MEDICAID
Regional override #1 (number beds) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes
Regional override #2 (staffing) (This field is set to "y" when the regional office has to ok a pending record in the special fields screen. this field only applies to categories in the odie data entry system): Yes
Activity professional - Full time (The number of full-time equivalent activities professionals employed full time by a facility): 1.14
Administrator - Full time (The number of full-time equivalent administrative staff employed on a full time basis by a facility): 2.29
Administrator - Part time (The number of full-time equivalent administrative staff employed on a part-time basis by a facility): 2.20
Beds - Snf/nf (Number of beds certified for both Medicare and Medicaid skilled nursing care in a long term care facility): 91
Cert nurse aides - Full time (The number of full-time equivalent certified nurse aides employed by a facility on a full time basis): 3.34
Cert nurse aides - Part time (The number of full-time equivalent certified nurse aides employed by a facility on a part time basis): 17.04
Dietitians - Part time (The number of full-time equivalent dietitians employed by a facility on a part time basis): 0.11
Food service - Full time (The number of full-time equivalent food service personnel employed by a facility on a full time basis): 2.03
Food service - Part time (The number of full-time equivalent food service personnel employed by a facility on a part time basis): 4.03
Housekeeping - Full time (The number of full-time equivalent housekeeping personnel employed by a facility on a full time basis): 2.21
Housekeeping - Part time (The number of full-time equivalent housekeeping personnel employed by a facility on a part time basis): 0.81
Lpn/lvn - Part time (The number of full-time equivalent licensed practical/ vocational nurses employed by a facility on a part time basis): 6.43
Multi-Facility organization name (The name of the multi-Facility organization that owns the facility): HMU INC
Multi-Facility organization owned (Indicates if a facility is owned by an organization that owns (or leases) two or more nursing facilities): Yes
Nurses with admin duties-Full time (The number of full-time equivalent nurses with administrative duties employed by a facility on a full time basis): 1.10
Nurses with admin duties-Part time (Number of full-time equivalent nurses with administrative duties employed by a facility on a part time basis): 0.77
Occup therapy asst - Contract (The number of full time equivalent occupational therapy assistants under contrcat to a facility): 0.06
Occupational therapist - Contract (The number of full-time equivalent occupational therapists under contract to a facility): 0.46
Organized resident group (Indicates if the facility has an organized residents group): Yes
Other - Part time (The number of full-time equivalent persons not included in any other categories employed by the facility on a part-time basis): 2.50
Other activities staff-Part time (Number of part time staff hours provided by other activ ities staff): 1.93
Phys ther asst - Contract (Number of contract staff hours for physical therapy ass istants): 0.43
Physical therapists - Contract (The number of full-time equivalent physical therapists under contract to a facility): 0.51
Physical therapy aide - Full time (The number of full-time equivalent physical therapy aide employed by a facility on a full time basis): 1.11
Physical therapy aide - Part time (The number of full-time equivalent physical therapy aide employed by a facility on a part time basis): 1.33
Registered nurse - Part time (The number of full-time equivalent registered nurses employed by a facility on a part time basis): 0.63
Rn director of nursing - Full time (The number of full-time equivalent rn director of nursing employed by a facility on a full time basis): 1.03
Social worker - Full time (The number of full-time equivalent social workers employed by a facility on a full time basis): 1.14
Speech pathologist - Contract (The number of full-time equivalent speech pathologists under contract to a facility): 0.43
Compliance: plan of correction (Indicates if a provider is in compliance with program requirements based on an acceptable plan for correction of deficiencies): COMPLIANCE BASED ON ACCEPTABLE POC
Compliance: status (Indicates if a provider or supplier is in compliance with program requirements): IN COMPLIANCE
Current survey date (The date of the health or life safety code survey, whichever is later. the "official" survey date for the provider): Mar 2002
Eligibility code (Indicates if a facility is eligible to participate in the Medicare and/or Medicaid programs): ELIGIBLE TO PARTICIPATE