Federal inspection record · CMS data as of October 1, 2026
Windsor Health And Rehabilitation
820 Cottage Street Ne, Salem, OR · (503) 399-1135
- Certified beds
- 100
- Residents per day
- 47
- Ownership
- For-Profit
- Chain
- Evergreen Healthcare Group
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 3, 1991
1
How this home got 1 star
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Oregon.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Oregon homes
Windsor Health And Rehabilitation carries 125 inspection points. That is fewer than 12% of Oregon's 126 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Oregon: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–14 pts
- 4★ 14–41 pts
- 3★ 41–65 pts
- 2★ 65–95.25 pts
- 1★ over 95.25 pts
Bars show every rated home in Oregon by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
36 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
G
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Everything else, by area of care
Quality of Life and Care10E
- E
Provide activities to meet all resident's needs.
- E
Provide or obtain dental services for each resident.
- D
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.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
- D
Provide safe, appropriate pain management for a resident who requires such services.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Freedom from Abuse, Neglect, and Exploitation6D
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Respond appropriately to all alleged violations.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
Resident Rights5D
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
- D
Honor the resident's right to organize and participate in resident/family groups in the facility.
- D
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- D
Reasonably accommodate the needs and preferences of each resident.
Infection Control4E
- E
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- E
Provide and implement an infection prevention and control program.
Nursing and Physician Services3F
- F
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Observe each nurse aide's job performance and give regular training.
Resident Assessment and Care Planning3D
- D
Assess the resident when there is a significant change in condition
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Pharmacy Service2D
- D
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.
- D
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Administration1E
- E
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
Nutrition and Dietary1F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspection history
2026-07-13
25 health deficiencies · 2 fire-safety deficiencies
Top issue: Quality of Life and Care (8 deficiencies)
2025-03-14
10 health deficiencies · 6 fire-safety deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
2023-11-16
1 health deficiencies · 0 fire-safety deficiencies
Top issue: Infection Control (1 deficiency)
4
Nursing time per resident, per day
Each resident here gets about 5 h 20 min of nursing staff time a day, 15 min of it from a registered nurse.
This home
5 h 20 min
Oregon average
5 h 8 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 46% of nursing staff and 83% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$13,592 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2026-07-13 | Fine | $13,592 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine25.1 pts worse | 70.2% | 95.3% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine3 pts better | 97.0% | 94.0% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injuryAbout the same | 2.4% | 2.4% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms3.1 pts better | 1.8% | 4.9% | 13.5% |
| Percentage of long-stay residents who lose too much weightAbout the same | 4.6% | 4.6% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication1.1 pts worse | 13.3% | 12.2% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication13.1 pts better | 1.2% | 14.3% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.1 pts better | 0.0% | 0.1% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened22.7 pts worse | 41.3% | 18.6% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased6.3 pts worse | 20.5% | 14.2% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.1 pts better | 1.2% | 1.3% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection3 pts worse | 5.0% | 2.0% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8.4 pts worse | 29.2% | 20.8% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.3 pts better | 5.3% | 5.6% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine26 pts worse | 59.8% | 85.8% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit13.2 pts worse | 29.2% | 16.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.2 pts worse | 1.6% | 1.4% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine4.2 pts worse | 76.7% | 80.9% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission2.9 pts worse | 24.8% | 21.9% | 23.4% |
·
Who owns and runs it
36 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Cabaneros, Cecille | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Cabaneros, Cecille | Adp Of The SNF · Individual | 0% | 1 facilities |
| Cepeda, Mylene | Managing Control - Governing Body · Individual | 0% | 4 facilities |
| Cepeda, Mylene | Operational/Managerial Control · Individual | 0% | 4 facilities |
| Cepeda, Mylene | Adp Of The SNF · Individual | 0% | 4 facilities |
| Ch Pacific Northwest Holdings LLC | Indirect Ownership Interest · Organization | 0% | 22 facilities |
| Ch Pacific Northwest Holdings LLC | Adp Of The SNF · Organization | 0% | 22 facilities |
| Couve Financial Services LLC | Operational/Managerial Control · Organization | 0% | 41 facilities |
| Couve Financial Services LLC | Adp Of The SNF · Organization | 0% | 41 facilities |
| Couve Healthcare Consulting LLC | Operational/Managerial Control · Organization | 0% | 50 facilities |
| Couve Healthcare Consulting LLC | Adp Of The SNF · Organization | 0% | 50 facilities |
| Henning, Tracey | Operational/Managerial Control · Individual | 0% | 2 facilities |
| Henning, Tracey | Adp Of The SNF · Individual | 0% | 2 facilities |
| Herzka, Yisroel | Indirect Ownership Interest · Individual | 0% | 75 facilities |
| Herzka, Yisroel | Adp Of The SNF · Individual | 0% | 75 facilities |
| Morris, Christopher | Operational/Managerial Control · Individual | 0% | 18 facilities |
| Morris, Christopher | Adp Of The SNF · Individual | 0% | 18 facilities |
| Odenthal, Jason | Managing Control - Governing Body · Individual | 0% | 18 facilities |
| Odenthal, Jason | Operational/Managerial Control · Individual | 0% | 18 facilities |
| Odenthal, Jason | Adp Of The SNF · Individual | 0% | 18 facilities |
| Oregon SNF Consulting LLC (De) | Operational/Managerial Control · Organization | 0% | 4 facilities |
| Oregon SNF Consulting LLC (De) | Adp Of The SNF · Organization | 0% | 4 facilities |
| Pacific Northwest Opco Management LLC | Operational/Managerial Control · Organization | 0% | 29 facilities |
| Pacific Northwest Opco Management LLC | Adp Of The SNF · Organization | 0% | 29 facilities |
| Pacific Northwest SNF Operations Holdings (Or) LLC | Direct Ownership Interest · Organization | 0% | 4 facilities |
| Pacific Northwest SNF Operations Holdings LLC | Indirect Ownership Interest · Organization | 0% | 16 facilities |
| Spielman, Shimon | Operational/Managerial Control · Individual | 0% | 48 facilities |
| Spielman, Shimon | Adp Of The SNF · Individual | 0% | 48 facilities |
| Windsor SNF Operations LLC | Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Windsor SNF Operations LLC | Operational/Managerial Control · Organization | 0% | 1 facilities |
| Windsor SNF Operations LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Witzcorp Global LLC | Indirect Ownership Interest · Organization | 0% | 21 facilities |
| Witzcorp Global LLC | Adp Of The SNF · Organization | 0% | 21 facilities |
| Yenowitz, Yitzchok | Indirect Ownership Interest · Individual | 0% | 50 facilities |
| Yenowitz, Yitzchok | Operational/Managerial Control · Individual | 0% | 50 facilities |
| Yenowitz, Yitzchok | Adp Of The SNF · Individual | 0% | 50 facilities |
·
Fire safety
8 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Miscellaneous3F
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Emergency Preparedness3F
- D
Establish policies and procedures for volunteers.
- F
Develop Emergency Preparedness policies and procedures.
- F
Establish policies and procedures including evacuation.
Smoke2F
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- D
Provide properly protected cooking facilities.
·
Other homes nearby
-
Tierra Rose Care Center
Salem, OR
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 5 h 9 min
- Fines
- $0
-
Keizer Nursing And Rehabilitation
Keizer, OR · Volare Health
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- —
- Fines
- $0
-
Avamere Court At Keizer
Keizer, OR · Avamere
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 4 h 49 min
- Fines
- $0