EVERGREEN HEALTHCARE GROUP
Ownership rollup across 44 nursing homes in 6 states: Montana, Nevada, Oregon, South Dakota, Washington, Wyoming. The "follow the money" view of an operator’s whole portfolio — the pattern a single facility page can’t show.
The chain’s homes average 2.5 of 5 stars on the CMS overall rating — about 0.6 stars below the ~3.0 average of the 6 states it operates in. A whole portfolio rating below its own states’ norm is a pattern worth researching, not a single-home fluke. It is also moving the wrong way: across the same 44 homes rated throughout, the average fell 0.20 stars between 2025-02 and 2026-06. We benchmark against its own states because CMS ranks the health-inspection star within each state, so a national comparison (national average ~3.0) partly measures where a chain operates rather than how it operates.
Where the rating comes from
The CMS overall star blends three different things. Split apart across the whole portfolio, they say different things about an operator: thin staffing is a budget decision made above the building, while a weak inspection score is what surveyors actually found inside it.
| Component | Chain average | Basis | |
|---|---|---|---|
| Health inspection | 2.4 of 5 | 43 rated homes | state surveyors’ findings, ranked within each state |
| Staffing | 3.3 of 5 | 43 rated homes | from payroll (PBJ) hours |
| Quality measures | 3.0 of 5 | 43 rated homes | largely self-reported clinical data |
Averaged across this chain’s rated homes. Health-inspection stars are assigned within each state’s own distribution, so for a chain spanning several states this component mixes distributions and is best read alongside each home’s actual citations.
Portfolio red flags
How many of this chain’s homes carry the most serious CMS markers. One flagged home can be local; a pattern across the portfolio is an operator-level signal worth researching.
2 of this chain’s 44 homes are tied to a real-estate investment trust (REIT) in CMS ownership records. Private-equity and REIT operators are the focus of most research into how money is moved out of nursing homes — often through the related-party payments shown below. CMS under-reports these ties, so read this as a floor.
Follow the money — chain finances
Aggregated from each home’s CMS Medicare cost report (HCRIS). Related-party payments are dollars a home sends to landlords or management companies under common ownership — the main channel through which private-equity and REIT owners can pull money out of a home while its own books still show a thin margin.
Only homes with a cost report on file are included, so the related-party total is a floor. Cost reports are self-filed, unaudited, and a year or two behind.
Weighted by each home’s average daily census, across the all 44 homes that report both a usable payer mix and a census. Homes whose cost report fails the same validity check the facility pages apply are left out of this figure entirely rather than counted as zero.
Every home in this chain
Lowest-rated first, so the homes most worth a closer look sit at the top. Each links to its full inspection, staffing, fines, and ownership record.
| Home | CMS rating | Flags |
|---|---|---|
| Laurel Health & Rehabilitation CenterLaurel, MT | 1 of 5 | $7,163 fined |
| Livingston Health & Rehabilitation CenterLivingston, MT | 1 of 5 | $17,404 fined |
| El Jen Skilled CareLas Vegas, NV | 1 of 5 | Abuse flag $52,466 fined |
| Gardnerville Health & Rehabilitation CenterGardnerville, NV | 1 of 5 | Abuse flag |
| Portland Health And RehabilitationPortland, OR | 1 of 5 | $24,827 fined |
| Firesteel Healthcare CenterMitchell, SD | 1 of 5 | $153,308 fined |
| Palisade Healthcare CenterGarretson, SD | 1 of 5 | 1 immediate-jeopardy Abuse flag $154,946 fined |
| Riverview Healthcare CenterFlandreau, SD | 1 of 5 | 4 immediate-jeopardy SFF candidate Abuse flag $176,867 fined |
| Alaska Gardens Health and RehabilitationTacoma, WA | 1 of 5 | 2 immediate-jeopardy $170,372 fined |
| Shepherd of the Valley Rehabilitation and WellnessCasper, WY | 1 of 5 | $97,031 fined |
| Worland Health and RehabilitationWorland, WY | 1 of 5 | 1 immediate-jeopardy SFF candidate Abuse flag $41,746 fined REIT-owned |
| Aspen Meadows Health And Rehabilitation CenterBillings, MT | 2 of 5 | $115,183 fined |
| Mountain View Health And RehabilitationCarson City, NV | 2 of 5 | Abuse flag $25,675 fined |
| Independence Health And RehabilitationIndependence, OR | 2 of 5 | $69,876 fined |
| Village Health CareGresham, OR | 2 of 5 | $22,695 fined |
| Canterbury HouseAuburn, WA | 2 of 5 | $68,159 fined |
| Enumclaw Health and RehabilitationEnumclaw, WA | 2 of 5 | $23,203 fined |
| North Cascades Health and RehabilitationBellingham, WA | 2 of 5 | 2 immediate-jeopardy Abuse flag $295,969 fined |
| Seattle Medical Post Acute CareSeattle, WA | 2 of 5 | Abuse flag $73,318 fined |
| Shelton Health and RehabilitationShelton, WA | 2 of 5 | 1 immediate-jeopardy $65,213 fined |
| Granite Rehabilitation and WellnessCheyenne, WY | 2 of 5 | $15,548 fined |
| Laramie Health and RehabilitationLaramie, WY | 2 of 5 | Abuse flag $35,880 fined REIT-owned |
| Wind River Rehabilitation and WellnessRiverton, WY | 2 of 5 | $25,984 fined |
| Pahrump Health And RehabilitationPahrump, NV | 3 of 5 | $40,427 fined |
| La Grande Post Acute RehabLa Grande, OR | 3 of 5 | — |
| Windsor Health And RehabilitationSalem, OR | 3 of 5 | $20,910 fined |
| Fountain Springs HealthcareRapid City, SD | 3 of 5 | $22,526 fined |
| Prairie View Healthcare CenterWoonsocket, SD | 3 of 5 | $8,512 fined |
| Wheatcrest Hills Healthcare CenterBritton, SD | 3 of 5 | $37,553 fined |
| Royal Park Health and RehabilitationSpokane, WA | 3 of 5 | $111,830 fined |
| Rawlins Rehabilitation and WellnessRawlins, WY | 3 of 5 | 2 immediate-jeopardy $14,433 fined |
| Sage View Care CenterRock Springs, WY | 3 of 5 | $8,278 fined |
| Thermopolis Rehabilitation and WellnessThermopolis, WY | 3 of 5 | 1 immediate-jeopardy $27,072 fined |
| Hot Springs Health & Rehabilitation CenterHot Springs, MT | 4 of 5 | $22,614 fined |
| Missoula Health & Rehabilitation CenterMissoula, MT | 4 of 5 | — |
| Polson Health & Rehabilitation CenterPolson, MT | 4 of 5 | $17,404 fined |
| Hillsboro Health And RehabilitationHillsboro, OR | 4 of 5 | — |
| The Dalles Health And RehabilitationThe Dalles, OR | 4 of 5 | $14,380 fined |
| Americana Health and RehabilitationLongview, WA | 4 of 5 | — |
| Buena Vista HealthcareColville, WA | 4 of 5 | $13,104 fined |
| Frontier Rehabilitation and Extended CareLongview, WA | 4 of 5 | — |
| Transitional Care Of SeattleSeattle, WA | 4 of 5 | — |
| Milton Freewater Health And RehabilitationMilton Freewater, OR | 5 of 5 | $8,278 fined |
| Ormsby Post Acute RehabilitationCarson City, NV | Not rated | 1 immediate-jeopardy Special Focus Abuse flag $60,464 fined |
Source: CMS Provider Data Catalog (nursing-home ratings, deficiencies, penalties, and ownership) and the CMS Medicare cost report (HCRIS) for finances. Chain membership is as reported to CMS. CMS extracts retrieved 30 August 2026; CMS refreshes them monthly, so counts here are as of that date. Verify with the facility and your state regulator.