01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-04-28 | 3 | 2025-04-28 | 1 |
| Cycle 2 | 2024-04-25 | 5 | 2024-04-25 | 1 |
| Cycle 3 | 2023-07-12 | 5 | 2023-07-12 | 5 |
CMS CCN 1554172026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Hickory Creek At Scottsburg
1100 N Gardner Ave · Scottsburg, IN 47170 · Scott County
Certified beds36CMS provider file
Recent citation rows20current 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
20 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.
2025-12-04 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-01-03 · complaint2025-12-04 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2026-01-03 · complaint2025-04-28 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-05-282025-04-28 · FIREK0281Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install proper backup exit lighting.
Correction field: Deficient, Provider has date of correction · 2025-06-192024-12-06 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2025-01-06 · complaint2024-12-06 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-01-06 · complaint2024-12-06 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-01-06 · complaint2024-04-25 · HEALTHF0565Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-04-25 · HEALTHF0804Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2024-05-302024-04-25 · FIREK0355Severity B · pattern; potential for minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has plan of correction · 2024-06-192023-09-21 · 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 · 2023-10-21 · complaint2023-07-12 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2023-08-112023-07-12 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2023-08-112023-07-12 · 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 · 2023-08-112023-07-12 · HEALTHF0727Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2023-08-112023-07-12 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2023-09-092023-07-12 · 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 · 2023-09-092023-07-12 · FIREK0351Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install an approved automatic sprinkler system.
Correction field: Deficient, Provider has date of correction · 2023-09-092023-07-12 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2023-09-092023-07-12 · FIREK0712Severity C · widespread; potential for minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2023-09-0903 / 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
- HENRY COUNTY MEMORIAL HOSPITALOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 08/01/2013
- CHIES, STEVENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- DYNES, SHELDONIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- JACKSON, BLAKEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- JACKSON, ETHANIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- JACKSON, MARKIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- JACKSON, MICHAELIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/14/2024
- JACKSON, WESSLEYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- JUSTICE, DAVIDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- KELSEY, DONNAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 07/18/2024
- PIDGEON, JOHNIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- SHORE, MARIONIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2013
- STITLE, STEPHENIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2021
- WARE, DEBORAHIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/27/2021
- WRIGHT, THERESSAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/21/2021
- RING, BRIANIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/01/2022
- AMERICAN SENIOR COMMUNITIES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/01/2021
- BRUNO, NANCYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 03/17/2026
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 hours3.39per resident day
RN hours0.69per resident day
Weekend nurse hours2.96per resident day
Staff turnover44.1%CMS reported field