NORTHERN LIGHTS HCC
706 BRATLEY DR
WASHBURN, WI, 54891
7153735621
CCN: 525567
3
Overall2
Health4
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
OIG Federal Exclusion Matches (1)
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.
TRUSTED CARE SERVICES, INC
1128b8
Excluded 2003-12-18
Ownership
| Name | Role | % |
|---|---|---|
| COX, YVONNE | CORPORATE DIRECTOR | NOT APPLICABLE |
| AIKEN, SUSAN | CORPORATE DIRECTOR | NOT APPLICABLE |
| AVOL LAW, ELLEN | CORPORATE DIRECTOR | NOT APPLICABLE |
| BOUTON, DICK | CORPORATE DIRECTOR | NOT APPLICABLE |
| EHLERS, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| JACOBSON, AMY | CORPORATE DIRECTOR | NOT APPLICABLE |
| RASPOTNIK, SANDRA | CORPORATE DIRECTOR | NOT APPLICABLE |
| STRZOK, DIANA | CORPORATE DIRECTOR | NOT APPLICABLE |
| SHVETZOFF, SERGEI | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SHVETZOFF, TAMI | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HEALTH DIMENSIONS CONSULTING INC | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| BRISCOE, DAVID | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| BRISCOE, PATRICIA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| OGLE, KIM | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ROGOTZKE, AMBER | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SANTIKKO, NOLAN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SHVETZOFF HENNESSEY, ERIN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Penalties (1)
| Date | Type | Amount |
|---|---|---|
| 2025-01-29 | Fine | $16K |
Health Deficiencies (33)
2025-11-12 · Health
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
G
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
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.
2025-07-30 · Health
F
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
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.
D
F697 · Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
D
F693 · Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
D
F688 · Quality of Life and Care Deficiencies
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
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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.
C
F628 · Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
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.
E
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2025-01-29 · Health
J
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2024-05-22 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
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.
D
F758 · Pharmacy Service Deficiencies
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.
E
F725 · Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
E
F688 · Quality of Life and Care Deficiencies
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
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F677 · Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
D
F625 · Resident Rights Deficiencies
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.
2023-05-10 · Health
E
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
D
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
E
F688 · Quality of Life and Care Deficiencies
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
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
D
F655 · Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
D
F637 · Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.05
RN Hrs/Resident/Day0.54
0.84
LPN Hrs/Resident/Day0.81
0.54
CNA Hrs/Resident/Day2.33
2.68
PT Hrs/Resident/Day0.12
0.04
Data as of 2026-03-01