01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-03-19 | 9 | 2024-12-06 | 1 |
| Cycle 2 | 2024-12-06 | 8 | 2023-11-30 | 0 |
| Cycle 3 | 2023-11-30 | 7 | 2022-11-18 | 0 |
CMS CCN 3451132026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Willow Creek Nursing And Rehabilitation Center
2401 Wayne Memorial Drive · Goldsboro, NC 27534 · Wayne County
Certified beds200CMS provider file
Recent citation rows25current CMS citation release
Penalty rows3current 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
25 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-11 · 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 · 2026-06-30 · complaint2026-06-11 · 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 · 2026-06-30 · complaint2026-06-11 · 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 · 2026-06-30 · complaint2026-06-11 · 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 · 2026-06-30 · complaint2026-06-11 · HEALTHF0908Severity F · widespread; potential for more than minimal harm
Environmental Deficiencies
Keep all essential equipment working safely.
Correction field: Deficient, Provider has date of correction · 2026-06-30 · complaint2026-03-19 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2026-04-072026-03-19 · HEALTHF0584Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: No revisit needed · 2026-04-072026-03-19 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-04-072026-02-13 · HEALTHF0684Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Past Non-Compliance · complaint2026-02-13 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Past Non-Compliance · complaint2025-01-24 · 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 · 2025-01-29 · complaint2024-12-06 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2025-01-24 · complaint2024-12-06 · HEALTHF0602Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Past Non-Compliance · 2024-05-19 · complaint2024-12-06 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2025-01-242024-12-06 · 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 · 2025-01-242024-12-06 · 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 · 2025-01-242024-12-06 · HEALTHF0726Severity D · isolated; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2025-01-242024-12-06 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2025-01-24 · complaint2023-11-30 · HEALTHF0582Severity F · widespread; potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2023-12-282023-11-30 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2023-12-28 · complaint2023-11-30 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2023-12-28 · complaint2023-11-30 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide 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.
Correction field: Deficient, Provider has date of correction · 2023-12-282023-11-30 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-12-28 · complaint2023-11-30 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2023-12-2803 / 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 |
|---|---|---|---|
| 2026-02-13 | Fine | $4,394 | 0 |
| 2026-02-13 | Fine | $4,394 | 0 |
| 2024-12-06 | Fine | $6,570 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PRINCIPLE IT SERVICES, INC.Organization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2011
- PRINCIPLE LONG TERM CARE, INC.Organization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2011
- KRISHNARAJ, RAMESHIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 03/01/2023
- STROUD, WENDYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 05/24/2021
- BOICE, GALEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/05/2018
- HOOD, LYNNIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/01/2017
- JOHNSON, DIANNEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2011
- PRINCIPLE LONG TERM CARE, INC.Organization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2011
- HOOD, LYNNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/01/2017
- PRINCIPLE IT SERVICES, INC.Organization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- PRINCIPLE LONG TERM CARE, INC.Organization · ADP OF THE SNFNOT APPLICABLE · since 06/17/2025
- BOICE, GALEIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/05/2018
- HILL, RAYMONDIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- HILL, ROBERTIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- HILL, STEPHENIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2011
- KRISHNARAJ, RAMESHIndividual · ADP OF THE SNFNOT APPLICABLE · since 03/01/2023
- STROUD, WENDYIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/17/2025
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 hours3.58per resident day
RN hours0.51per resident day
Weekend nurse hours3.32per resident day
Staff turnover59.2%CMS reported field
06 / LOCAL RECORDS
Open the Goldsboro ledger →