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Evergreenhealth Home Care Services

(425) 899-330011800 NE 128TH St Ste 200, Kirkland, WA 98034
CMS Certification Number 507079 · Proprietary · Medicare-certified since 12/04/1986
5deficiencies since 2018
0serious
2inspections
4.5CMS quality stars
Data from CMS inspection reports (Form 2567), 2018-01-02 to 2026-10-15, downloaded 2026-10-21; CMS agency list file dated 2026-09-21. What the labels mean

Inspection 2024-07-18

· Recertification · 4 deficiencies · CMS source report (PDF)
Moderate Accuracy Of Encoded Oasis Data

The agency failed to accurately complete the Outcome and Assessment Information Set (OASIS) data for M0104 that indicates the completed referral dates for 10 of 17 patients (Patients #601, #602, #603, #604, #605, #606, #608, #611, #616, and #617).

Source: CMS Form 2567, inspection 2024-07-18, tag G0374 · view on CMS
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Moderate Plan Of Care

The agency failed to notify the patient’s physician when therapy services were not provided as written in the plan of care for 3 of 17 patients (Patients #102, Patient #105, and Patient #111).

Source: CMS Form 2567, inspection 2024-07-18, tag G0572 · view on CMS
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Minor Promptly Alert Relevant Physician Of Changes

The agency failed to assess the clinical impact of missed visits and notify the patient’s physician to changes in the patient’s condition or needs that would suggest that outcomes are not being achieved and/or that the plan of care should be updated for 3 of 10 active patients (Patient #107…

Source: CMS Form 2567, inspection 2024-07-18, tag G0590 · view on CMS
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Minor Onsite Supervisory Visit Every 14 Days

The agency failed to provide documentation of Supervisory Visits every fourteen days for 2 of 6 patient records with Home Health Aide (HH Aide) orders (Patients #603 and #605).

Source: CMS Form 2567, inspection 2024-07-18, tag G0808 · view on CMS
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Inspection 2021-09-30

· Recertification · 1 deficiencies · CMS source report (PDF)
Moderate Infection Control

The agency failed to operationalize infection control policies and procedures that included an annual Tuberculosis (TB) risk assessment screening of Home Health staff consistent with State regulations for 5 of 8 Staff ( Staff #302, #303, #304, #305, and #308).

Source: CMS Form 2567, inspection 2021-09-30, tag G0684 · view on CMS
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