Above average — CMS composite of the measures below.
A standard survey is most likely before around March 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Creekside during CMS and state inspections, most recent first.
A resident with severe cognitive impairment and an elopement risk left a unit after a door failed to latch completely shut, which disengaged the alarm. Staff later found the resident outside the building near a hallway exit door that did not lock or alarm. Interviews showed the ELPAS system sent alerts only when the resident neared an exit door, not when the resident actually exited, and staff on different channels did not all receive the same notification.
The facility failed to implement EBP for two residents with indwelling medical devices and wounds. One resident had kidney failure, Stage 5 kidney disease, hemodialysis access, and a neck wound, while another resident had an indwelling urinary catheter. Staff reported both residents declined EBP and had signed forms or negotiated risk agreements, and observations showed no EBP signage or gown use during care.
Malfunctioning Exit Door Allowed Resident Elopement
Penalty
Summary
The facility failed to identify a malfunctioning unit door that did not latch completely shut, allowing a resident with severe cognitive impairment to elope from the unit and then from the building. The resident’s MDS showed a BIMS score of 7, with diagnoses of Alzheimer’s disease and dementia, and the care plan identified the resident as an elopement risk due to aimless wandering. Interventions in the care plan included a picture on the resident’s door and wander-alert identification to help staff locate the room. The incident report and timeline showed that staff last saw the resident eating in the dining room, and later an ELPAS wander alert triggered when the resident neared the unit’s east exit door. Staff later found the resident sitting outside a hallway exit door and assisted the resident back inside. A head-to-toe assessment found no injuries. The facility documented that the resident exited the unit because the door did not latch completely shut, which caused the door alarm to disengage. Facility interviews showed that once the resident left the unit, the resident got outside the building through a hallway exit door approximately 20 feet away that did not lock or alarm. Staff stated the ELPAS system sent text alerts when a wander-alert resident neared a unit exit door, but it did not track exits, and staff on different channels did not all receive the same alerts. The DON and Administrator acknowledged the unit door did not function properly that morning, and the policy required daily testing of security doors and checking that fully locked unit doors remained securely closed and locked.
Failure to Implement Enhanced Barrier Precautions
Penalty
Summary
The facility failed to implement Enhanced Barrier Precautions (EBP) for 2 residents reviewed for infection control. Resident #40 had intact cognition, kidney failure, Stage 5 kidney disease, and received hemodialysis with a right jugular dialysis catheter and a surgical wound to the right anterior neck. The care plan noted the resident refused EBP because of not wanting extra clutter, and the ETAR documented EBP tasks were completed on all 3 shifts on 12/16/25 before the physician’s order discontinuing EBP on 12/17/25. Staff later documented that the resident requested to be removed from EBP and the precaution materials were removed from the room. During observation, the resident had an external catheter to the right upper chest for hemodialysis, but the room lacked an EBP sign and PPE supplies. Staff interviews stated the resident was not in EBP because the port was covered, that she had signed something to not have EBP, and that she would have the dialysis shunt for life. Resident #2 also had intact cognition and an indwelling urinary catheter. The care plan documented the catheter and noted the resident declined EBP and signed a negotiated risk agreement. During observation, staff emptied the catheter without wearing a gown per EBP policy, and the resident’s room did not have an EBP sign outside the door. Staff stated EBP was not used per the resident’s request for dignity and that he had signed a negotiated risk form. The facility policy on Transmission Based Precautions Isolation and PPE Use did not include documentation about resident refusal of EBP and signing a waiver, while CDC guidance and CMS QSO-22-08-NH identified EBP use for residents with wounds or indwelling medical devices.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Grundy Center
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Grundy Care Center | 0.4 mi | ★★★★★ | 15 | 0 |
| Parkview Manor Care Center | 8 mi | ★★★★★ | 1 | 0 |
| Oakview Nursing Home | 10.8 mi | ★★★★★ | 8 | 0 |
| Westbrook Acres | 12.2 mi | ★★★★★ | 9 | 0 |
| Maple Manor Village | 16.6 mi | ★★★★★ | 7 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release October 2026) and official state health department websites.