Evergreen Health and Rehabilitation Center
380 Millwood Avenue, Winchester, VA 22601
Evergreen Health and Rehabilitation Center, a 176-bed for profit - limited liability company nursing facility in Winchester, VA, holds a 2-star CMS overall rating - below the 3.0-star national average, ranking #180 of 286 rated homes in VA on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing below the national norm. No recent finding reached the actual-harm level.
CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating, read the components below; they often tell a sharper story than the headline.
Phone: 5406677010
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- 2 / 5
- Below average · CMS overall · nat'l 3.0
- #180 of 286
- In-state rank among rated VA homes
- 3.16
- Well below average · nurse hrs/day · nat'l 3.86
- 50
- Inspection findings
The verdict
Evergreen Health and Rehabilitation Center, a 176-bed for profit - limited liability company nursing facility in Winchester, VA, holds a 2-star CMS overall rating - below the 3.0-star national average, ranking #180 of 286 rated homes in VA on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing below the national norm. No recent finding reached the actual-harm level.
- 2 / 5
- CMS overall · national 3.0
- #180 of 286
- In-state rank among rated VA homes
- 3.16
- Nurse hrs/resident-day · national 3.86
- 50
- Inspection findings on file
CMS force-curves overall stars within each state; read health, staffing, and quality sub-ratings alongside the headline.
In-state ownership mix · peer inventory
How 289 VA nursing homes split by ownership sector
This facility is recorded as For profit - Limited Liability company. Sector buckets collapse CMS ownership_type into For-profit, Nonprofit, and Government, orthogonal to the RN/LPN/CNA hour bar below.
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 495142
- Ownership
- For profit - Limited Liability company
- Provider Type
- Medicare and Medicaid
- Beds
- 176
- Residents
- 172
- In Hospital
- No
- County
- Winchester City
- Last Inspection
- Jan 10, 2024
Staffing Data
How the 3.16 total nursing hours per resident-day are staffed:
- RN Hours
- 0.81 (nat'l avg: 0.69)
- LPN Hours
- 0.63
- CNA Hours
- 1.71
- Total Nursing Hours
- 3.16 (nat'l avg: 3.86)
- PT Hours
- 0.05
- Nursing Turnover
- 49.7%
- RN Turnover
- 54.8%
What the CMS Record Reveals About Evergreen Health and Rehabilitation Center
According to CMS Nursing Home Compare, Evergreen Health and Rehabilitation Center ranks #180 of 286 rated nursing homes in VA on overall stars (tie-broken by health+staffing+quality, then fewer fines). Evergreen Health and Rehabilitation Center operates 176 certified beds in Winchester, VA with approximately 172 residents currently in care, and carries a CMS overall rating of 2 out of 5 stars (health inspection 2★ · staffing 2★ · quality 4★).
The inspection file contains 50 deficiency records from recent surveys, all falling in the no-harm or minimal-harm bands of the CMS scope-and-severity grid. This provider's enforcement record shows no fines or payment denials to date. Staffing is reported at 3.16 total nursing hours per resident day (national average 3.86), with RN coverage at 0.81 per resident day.
Classified as "For profit - Limited Liability company" ownership and operating as a "Medicare and Medicaid" provider, Evergreen Health and Rehabilitation Center falls into a category where comparative context matters. Reported nursing staff turnover at this facility is 49.7% (CMS payroll-based measure).
Why sub-scores and the CMS methodology matter
The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results, staffing levels, and quality measures. Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone, a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes, ratings and fines are lagging indicators of those upstream choices. The staffing metric in particular is the one most strongly tied to resident outcomes in peer-reviewed literature.
For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report, the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify the same record on Medicare.gov Care Compare and with the facility or your state survey agency before making placement decisions.
Deficiency History (50 most recent)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jun 1, 2026
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Category: Quality of Life and Care Deficiencies
Corrected: Jun 1, 2026
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Category: Quality of Life and Care Deficiencies
Corrected: Jun 1, 2026
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jun 1, 2026
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jun 1, 2026
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jun 1, 2026
Post nurse staffing information every day.
Category: Nursing and Physician Services Deficiencies
Corrected: Feb 19, 2024
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 19, 2024
Ensure medication error rates are not 5 percent or greater.
Category: Pharmacy Service Deficiencies
Corrected: Feb 19, 2024
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: Feb 19, 2024
Observe each nurse aide's job performance and give regular training.
Category: Nursing and Physician Services Deficiencies
Corrected: Feb 19, 2024
Provide safe and appropriate respiratory care for a resident when needed.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 19, 2024
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.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 19, 2024
Provide appropriate foot care.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 19, 2024
Ensure services provided by the nursing facility meet professional standards of quality.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 19, 2024
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 19, 2024
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 19, 2024
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Category: Resident Rights Deficiencies
Corrected: Feb 19, 2024
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Category: Resident Rights Deficiencies
Corrected: Feb 19, 2024
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Category: Resident Rights Deficiencies
Corrected: Feb 19, 2024
Allow residents to self-administer drugs if determined clinically appropriate.
Category: Resident Rights Deficiencies
Corrected: Feb 19, 2024
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Category: Infection Control Deficiencies
Corrected: Feb 19, 2024
Employ or obtain outside professional resources to provide services in the nursing home when the facility does not employ a qualified professional to furnish a required service.
Category: Administration Deficiencies
Corrected: Feb 19, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: Feb 19, 2024
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 19, 2024
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Category: Resident Rights Deficiencies
Corrected: Feb 19, 2024
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Feb 19, 2024
Have a plan that describes the process for conducting QAPI and QAA activities.
Category: Administration Deficiencies
Corrected: Feb 19, 2024
Post nurse staffing information every day.
Category: Nursing and Physician Services Deficiencies
Corrected: May 16, 2022
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Category: Nursing and Physician Services Deficiencies
Corrected: May 16, 2022
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: May 16, 2022
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 16, 2022
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Category: Quality of Life and Care Deficiencies
Corrected: May 16, 2022
Provide safe and appropriate respiratory care for a resident when needed.
Category: Quality of Life and Care Deficiencies
Corrected: May 16, 2022
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Category: Quality of Life and Care Deficiencies
Corrected: May 16, 2022
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 16, 2022
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 16, 2022
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Category: Resident Rights Deficiencies
Corrected: May 16, 2022
Observe each nurse aide's job performance and give regular training.
Category: Nursing and Physician Services Deficiencies
Corrected: May 16, 2022
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 16, 2022
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Category: Resident Rights Deficiencies
Corrected: May 16, 2022
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Category: Resident Rights Deficiencies
Corrected: May 16, 2022
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Category: Resident Rights Deficiencies
Corrected: May 16, 2022
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Category: Resident Rights Deficiencies
Corrected: May 16, 2022
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: May 16, 2022
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jun 21, 2019
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Category: Nutrition and Dietary Deficiencies
Corrected: May 28, 2019
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Category: Pharmacy Service Deficiencies
Corrected: May 28, 2019
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Category: Pharmacy Service Deficiencies
Corrected: May 28, 2019
Provide safe, appropriate pain management for a resident who requires such services.
Category: Quality of Life and Care Deficiencies
Corrected: May 28, 2019
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 12.0% | Yes |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.9% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 1.0% | Yes |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 3.8% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 13.2% | Yes |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 1.6% | Yes |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 10.6% | Yes |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.6% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 3.9% | No |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 37.5% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 99.7% | No |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 20.5% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 98.7% | No |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 27.5% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 87.7% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | 89.3% | No |
Penalty History
No penalties on record.
Nationwide facilities with similar scale or staffing
Two data-derived peer sets for Evergreen Health and Rehabilitation Center, both outside VA so the neighborhoods are not the same-state geography list below.
Similar bed count
Nearest CMS certified bed counts outside VA (176 beds here).
Similar staffing hours
Nearest CMS adjusted total nurse hours per resident day outside VA (2.69 here).
Nearby Nursing Homes in VA
288 other nursing homes are on record in VA; 6 are shown here.
Abingdon Health & Rehab Center
Abingdon, VA
Albemarle Health & Rehabilitation Center
Charlottesville, VA
Alexandria Rehabilitation and Healthcare Center
Alexandria, VA
Alleghany Health and Rehab
Clifton Forge, VA
Amelia Rehabilitation and Healthcare Center
Amelia, VA
Annandale Healthcare Center
Annandale, VA
Understanding Nursing Home Data
What the CMS records show for Evergreen Health and Rehabilitation Center
The health, staffing, and quality sub-ratings above often diverge from the CMS overall headline. Use those components and the inspection findings to read the full file, not the overall star alone.
- The VA registry aggregates state averages and the highest-rated homes in this cohort. View VA registry
- Peer homes near 176 beds show how CMS stars vary at a similar scale in VA. Compare a similar-size peer
- CMS publishes separate fields for inspections, nurse staffing hours, and quality measures; the guide explains how each star is computed. How CMS ratings work
CMS refreshes Nursing Home Compare quarterly (current extract: August 2026). PlainNursing describes published records; it does not establish suitability, availability, admissions, or individual outcomes.
Frequently Asked Questions
What is the overall CMS rating for Evergreen Health and Rehabilitation Center?
Where does Evergreen Health and Rehabilitation Center rank among nursing homes in VA?
What are the staffing levels at Evergreen Health and Rehabilitation Center?
How many beds does Evergreen Health and Rehabilitation Center have?
Does Evergreen Health and Rehabilitation Center have any deficiencies on record?
Has Evergreen Health and Rehabilitation Center received any fines or penalties?
Who owns Evergreen Health and Rehabilitation Center?
When was Evergreen Health and Rehabilitation Center last inspected?
What quality measures are tracked for Evergreen Health and Rehabilitation Center?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Verify the same CCN on Medicare.gov Care Compare and with the facility or your state health department.
Read our methodology - how this data is sourced, computed, and verified.
