01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-31 | 5 | 2026-03-31 | 9 |
| Cycle 2 | 2025-01-13 | 7 | 2025-01-13 | 0 |
| Cycle 3 | 2024-02-09 | 11 | 2024-02-09 | 0 |
CMS CCN 1557842026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Creekside Village
1420 E Douglas Rd · Mishawaka, IN 46545 · St. Joseph County
Certified beds100CMS provider file
Recent citation rows32current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
32 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-31 · FIREE0037Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish staff and initial training requirements.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREE0041Severity C · widespread; potential for minimal harm
Emergency Preparedness Deficiencies
Implement emergency and standby power systems.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2026-04-302026-03-31 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2026-04-302026-03-31 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-04-302026-03-31 · HEALTHF0757Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Correction field: Deficient, Provider has date of correction · 2026-04-302026-03-31 · HEALTHF0790Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide routine and 24-hour emergency dental care for each resident.
Correction field: Deficient, Provider has date of correction · 2026-04-302026-03-31 · FIREK0293Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Have properly located and lighted "Exit" signs.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREK0341Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREK0351Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREK0511Severity E · pattern; potential for more than minimal harm
Services Deficiencies
Have properly installed electrical wiring and gas equipment.
Correction field: Deficient, Provider has date of correction · 2026-06-162026-03-31 · FIREK0741Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Correction field: Deficient, Provider has date of correction · 2026-06-302026-03-31 · FIREK0918Severity C · widespread; potential for minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2026-06-162025-03-21 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-04-10 · complaint2025-01-13 · HEALTHF0679Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2025-02-132025-01-13 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-02-132025-01-13 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-02-132025-01-13 · HEALTHF0693Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-02-132025-01-13 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-02-132025-01-13 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2025-02-132024-07-02 · HEALTHF0609Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Past Non-Compliance · 2024-06-24 · complaint2024-02-09 · HEALTHF0655Severity D · isolated; potential for more than minimal harm
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
Correction field: Deficient, Provider has date of correction · 2024-03-102024-02-09 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-03-1003 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- CHIES, STEVENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/17/2016
- JACKSON, BLAKEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/01/2015
- JACKSON, ETHANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/01/2015
- JACKSON, MARKIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/01/2015
- JACKSON, MICHAELIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/14/2024
- JACKSON, WESSLEYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/01/2015
- JUSTICE, DAVIDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 04/01/2015
- KELSEY, DONNAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/18/2024
- STITLE, STEPHENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/16/2016
- WRIGHT, THERESSAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/21/2021
- DRUMMER, CARLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2017
- HANIFY, THOMASIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- HORN, BRENDAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 12/01/2023
- LAZARD, ROBERTIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/29/2021
- MANTRAVADI, GEETAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 07/21/2021
- PAYNE, MONICAIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/09/2021
- BABCOCK, PAULIndividual · CORPORATE OFFICERNOT APPLICABLE · since 09/30/2020
- CAINE, VIRGINIAIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/10/1994
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.68per resident day
RN hours0.33per resident day
Weekend nurse hours3.04per resident day
Staff turnover35.3%CMS reported field