ENSIGN CLOVERDALE LLC

NPI 1245225176, organization, Cloverdale, CA, Skilled Nursing Facility

Evidence tier

network structure with a list link

Part of provider network D1-00041, ranked 41 nationally.
Medicaid dollars per patient on code 99304 ($293 per patient-month) sit in the top 5% of every provider billing that code.

score 64 of 100, rank 1538, $0 at stake

Provider networks

D1-00041 ranked 41

77 providers around Riverside, CA: 10 hospices, 29 home health agencies, 38 nursing facilities.

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	ENSIGN CLOVERDALE LLC (also CLOVERDALE HEALTHCARE CENTER)
Type	Organization
Status	Active
NPI issued	September 16, 2005, last updated February 17, 2021
Practice location	300 CHERRY CREEK ROAD, Cloverdale, CA 95425-3811, 707-894-5201
Authorized official	SOON BURNAM (Authorized Agent)
Specialties	Skilled Nursing Facility (314000000X, primary, license 010000157 CA)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
99304	Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	$125K	100%	$293	$14 (top 5% from $148)	98th percentile

In this area

17 providers in Sonoma County, CA carry an indicator in the public record, with $11.7M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by part of a provider network on 8.

tier	provider	at stake	why
3	SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Santa Rosa, CA, ranked 826	$41K	Part of provider network D1-00071, ranked 71 nationally. Medicaid dollars per patient on code G0155 ($196 per patient-month) sit in the top 5% of every provider billing that code.
3	ENSIGN SONOMA LLC Sonoma, CA, ranked 874	$5K	Part of provider network D1-00041, ranked 41 nationally. Medicaid dollars per patient on code 99304 ($296 per patient-month) sit in the top 5% of every provider billing that code.
3	ENSIGN MONTGOMERY LLC Santa Rosa, CA, ranked 883	$3K	Part of provider network D1-00041, ranked 41 nationally. Medicaid dollars per patient on code 99304 ($219 per patient-month) sit in the top 5% of every provider billing that code.
3	SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Santa Rosa, CA, ranked 1261	$244K	Part of provider network D1-00071, ranked 71 nationally.
3	GUARDIAN ANGEL HOME CARE OF SANTA ROSA Santa Rosa, CA, ranked 2301	$0	Part of provider network D1-00045, ranked 45 nationally.
3	A.V.C.H., INC. Sebastopol, CA, ranked 2728	$0	Part of provider network D1-00041, ranked 41 nationally.
3	SANTA ROSA POSTACUTE CARE LLC Santa Rosa, CA, ranked 4108	$0	Part of provider network D1-00138, ranked 138 nationally.
3	ENSIGN SANTA ROSA LLC Santa Rosa, CA, ranked 4476	$0	Part of provider network D1-00041, ranked 41 nationally.

All 17 in CA

Recent enforcement in CA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJPleaded guiltyAug 27, 2026

Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare

Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit

Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit

Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

Referral packet

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Ask this case

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