NORTHBROOK HEALTHCARE CENTER
64 NORTHBROOK WAY
WILLITS, CA, 95490
7074595592
CCN: 056215
5
Overall4
Health4
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (4)
This facility's name matches one or more entities on the OIG List of Excluded Individuals/Entities (LEIE). Excluded parties are prohibited from participation in Medicare and Medicaid programs.
CENTURION HEALTHCARE, INC
1128a1
Excluded 2013-04-18
HIGHLAND PARK HEALTHCARE CENTE
1128b8
Excluded 2004-01-20
SAINT JOSEPH HEALTH CENTER
1128b8
Excluded 2000-04-20
SOUTHGATE HEALTH CENTER
1128b8
Excluded 2000-04-20
Ownership
| Name | Role | % |
|---|---|---|
| FLAGSTONE HEALTHCARE NORTH LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% |
| THE ENSIGN GROUP INC | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100% |
| WILLITS, ADAM | CORPORATE OFFICER | NOT APPLICABLE |
| BURNAM, SOON | CORPORATE OFFICER | NOT APPLICABLE |
| KEETCH, CHAD | CORPORATE OFFICER | NOT APPLICABLE |
| TWOMAGNETS LLC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| GAMBLE, SHAWNDEE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| RAO, SEEMA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Penalties (2)
| Date | Type | Amount |
|---|---|---|
| 2025-03-05 | Fine | $9K |
| 2023-03-27 | Fine | $3K |
Health Deficiencies (28)
2025-12-29 · Health
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
2025-04-10 · Health
D
F842 · Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
F759 · Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
2025-03-05 · Health
G
F604 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
2023-03-27 · Health
F
F919 · Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
F
F882 · Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F865 · Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
D
F847 · Administration Deficiencies
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
F
F803 · Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
F
F802 · Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
F
F801 · Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
F
F761 · Pharmacy Service Deficiencies
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.
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
2019-08-30 · Health
D
F925 · Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
E
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
E
F842 · Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
D
F761 · Pharmacy Service Deficiencies
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.
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
E
F755 · Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
E
F676 · Quality of Life and Care Deficiencies
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
D
F657 · Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
D
F656 · Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
D
F580 · Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
3.99
RN Hrs/Resident/Day0.54
0.44
LPN Hrs/Resident/Day0.81
1.00
CNA Hrs/Resident/Day2.33
2.55
PT Hrs/Resident/Day0.12
0.03
Data as of 2026-03-01