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Facility profile · CCN 085033

Pike Creek Nursing & Rehabilitation Center

97 federal citations on record , including 3 at the Immediate Jeopardy level, and 4 federal enforcement actions totaling $484,596.

Special Focus Status 3 Immediate Jeopardy

Record summary

Federal record · Q1 2026
97
Total citations
87
Last 3 years
6
Actual harm+
4
Federal penalties
$484,596
Total fines
1
Overall ★ rating

Most common violation categories here

Most common F-tags at this facility

Citation history

97 on record
SurveyF-TagViolationSeveritySource
Aug 13, 2025F732Post nurse staffing information every day.CComplaint
Aug 13, 2025F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DComplaint
Aug 13, 2025F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Aug 13, 2025F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.EComplaint
Sep 10, 2024F947Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.DComplaint
Sep 10, 2024F941Develop, implement, and/or maintain an effective training program that includes effective communications for direct care staff members.EComplaint
Sep 10, 2024F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.DComplaint
Sep 10, 2024F761Ensure 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.DComplaint
Sep 10, 2024F686Provide appropriate pressure ulcer care and prevent new ulcers from developing.DComplaint
Sep 10, 2024F677Provide care and assistance to perform activities of daily living for any resident who is unable.DComplaint
Sep 10, 2024F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.DComplaint
Sep 10, 2024F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.DComplaint
Sep 10, 2024F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DComplaint
Sep 10, 2024F552Ensure that residents are fully informed and understand their health status, care and treatments.DComplaint
Sep 10, 2024F949Provide behavior health training consistent with the requirements and as determined by a facility assessment.EComplaint
Sep 10, 2024F946Provide training in compliance and ethics.EComplaint
Sep 10, 2024F944Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.EComplaint
Sep 10, 2024F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.DComplaint
Sep 10, 2024F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.EComplaint
Sep 10, 2024F760Ensure that residents are free from significant medication errors.JComplaint
Sep 10, 2024F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.JComplaint
Sep 10, 2024F691Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.DComplaint
Sep 10, 2024F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DComplaint
Sep 10, 2024F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DComplaint
Sep 10, 2024F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DComplaint
Sep 10, 2024F943Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.DStandard
Sep 10, 2024F887Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.DStandard
Sep 10, 2024F883Develop and implement policies and procedures for flu and pneumonia vaccinations.DStandard
Sep 10, 2024F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EStandard
Sep 10, 2024F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.DStandard
Sep 10, 2024F800Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.EStandard
Sep 10, 2024F791Provide or obtain dental services for each resident.DStandard
Sep 10, 2024F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.DStandard
Sep 10, 2024F730Observe each nurse aide's job performance and give regular training.DStandard
Sep 10, 2024F697Provide safe, appropriate pain management for a resident who requires such services.DStandard
Sep 10, 2024F695Provide safe and appropriate respiratory care for a resident when needed.DStandard
Sep 10, 2024F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.EStandard
Sep 10, 2024F688Provide 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.DStandard
Sep 10, 2024F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.EStandard
Sep 10, 2024F550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.DStandard
Sep 25, 2023F760Ensure that residents are free from significant medication errors.DComplaint
Sep 25, 2023F679Provide activities to meet all resident's needs.DComplaint
Sep 25, 2023F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DComplaint
Sep 25, 2023F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.DComplaint
Sep 25, 2023F835Administer the facility in a manner that enables it to use its resources effectively and efficiently.FComplaint
Sep 25, 2023F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FComplaint
Sep 25, 2023F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.EComplaint
Sep 25, 2023F803Ensure 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.CComplaint
Sep 25, 2023F773Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.DComplaint
Sep 25, 2023F761Ensure 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.DComplaint
Sep 25, 2023F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.FComplaint
Sep 25, 2023F732Post nurse staffing information every day.CComplaint
Sep 25, 2023F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.EComplaint
Sep 25, 2023F710Obtain a doctor's order to admit a resident and ensure the resident is under a doctor's care.DComplaint
Sep 25, 2023F697Provide safe, appropriate pain management for a resident who requires such services.GComplaint
Sep 25, 2023F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.DComplaint
Sep 25, 2023F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.GComplaint
Sep 25, 2023F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.HComplaint
Sep 25, 2023F677Provide care and assistance to perform activities of daily living for any resident who is unable.EComplaint
Sep 25, 2023F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.EComplaint
Sep 25, 2023F656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.DComplaint
Sep 25, 2023F655Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admittedDComplaint
Sep 25, 2023F641Ensure each resident receives an accurate assessment.DComplaint
Sep 25, 2023F610Respond appropriately to all alleged violations.DComplaint
Sep 25, 2023F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DComplaint
Sep 25, 2023F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.CComplaint
Sep 25, 2023F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.DComplaint
Sep 25, 2023F944Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.FStandard
Sep 25, 2023F943Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.FStandard
Sep 25, 2023F887Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.DStandard
Sep 25, 2023F880Provide and implement an infection prevention and control program.JStandard
Sep 25, 2023F868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyEStandard
Sep 25, 2023F867Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.FStandard
Sep 25, 2023F849Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.EStandard
Sep 25, 2023F843Have an agreement with at least one or more hospitals certified by Medicare or Medicaid to make sure residents can be moved quickly to the hospital when they need medical care.EStandard
Sep 25, 2023F758Implement 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.DStandard
Sep 25, 2023F730Observe each nurse aide's job performance and give regular training.EStandard
Sep 25, 2023F725Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.EStandard
Sep 25, 2023F698Provide safe, appropriate dialysis care/services for a resident who requires such services.DStandard
Sep 25, 2023F695Provide safe and appropriate respiratory care for a resident when needed.DStandard
Sep 25, 2023F692Provide enough food/fluids to maintain a resident's health.DStandard
Sep 25, 2023F645PASARR screening for Mental disorders or Intellectual DisabilitiesDStandard
Sep 25, 2023F644Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.DStandard
Sep 25, 2023F623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.DStandard
Sep 25, 2023F585Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.FStandard
Sep 25, 2023F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.EStandard
Sep 25, 2023F577Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.CStandard
Apr 13, 2023F745Provide medically-related social services to help each resident achieve the highest possible quality of life.DComplaint
Apr 13, 2023F561Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.EComplaint
May 12, 2022F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.BStandard
May 12, 2022F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EStandard
May 12, 2022F810Provide special eating equipment and utensils for residents who need them and appropriate assistance.DStandard
May 12, 2022F806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.DStandard
May 12, 2022F761Ensure 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.DStandard
May 12, 2022F684Provide appropriate treatment and care according to orders, resident’s preferences and goals.DStandard
May 12, 2022F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DStandard
May 12, 2022F558Reasonably accommodate the needs and preferences of each resident.DStandard

Federal enforcement history

Federal regulators have imposed 4 enforcement actions against this facility, including 2 civil money penalties totaling $484,596 and 2 payment-denial actions spanning 178 days.

DateTypeFinePayment denial
Sep 10, 2024Fine$221,208
Sep 10, 2024Payment DenialOct 17, 2024 · 64 days
Sep 25, 2023Fine$263,388
Sep 25, 2023Payment DenialNov 14, 2023 · 114 days
About this record A citation is a finding by a state survey team working under federal contract. It is not a court judgment. The description above is drawn verbatim from federal public datasets. Facilities have the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.

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