All citations for The Pavilion at Creekwood

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to The Pavilion at Creekwood

Last standard health inspection on record

April 14, 2026

Showing 1 to 25 of 36 citations

  1. Immediate jeopardy to resident health or safety

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    Isolated (one or a few residents). CMS level J.

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of January 5, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 6, 2025).

  2. Immediate jeopardy to resident health or safety

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Isolated (one or a few residents). CMS level J.

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of January 5, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 6, 2025).

  3. Immediate jeopardy to resident health or safety

    Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.

    Isolated (one or a few residents). CMS level J.

    Health citation F-0742, Quality of Life and Care Deficiencies. Inspection of January 5, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 6, 2025).

  4. Immediate jeopardy to resident health or safety

    Honor 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.

    Isolated (one or a few residents). CMS level J.

    Health citation F-0578, Resident Rights Deficiencies. Inspection of August 27, 2024. Found during a complaint inspection.

    The home gave a date the problem would be corrected (August 28, 2024).

  5. No harm, with potential for more than minimal harm

    Include a process for Emergency Preparedness collaboration.

    Widespread (many residents). CMS level F.

    Emergency preparedness citation E-0009, Emergency Preparedness Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 7, 2026).

  6. No harm, with potential for more than minimal harm

    Provide properly protected cooking facilities.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0324, Smoke Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 22, 2026).

  7. No harm, with potential for more than minimal harm

    Inspect, test, and maintain automatic sprinkler systems.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0353, Smoke Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2026).

  8. No harm, with potential for more than minimal harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0521, Services Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 4, 2026).

  9. No harm, with potential for more than minimal harm

    Have generator or other power source capable of supplying service within 10 seconds.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 24, 2026).

  10. No harm, with potential for more than minimal harm

    Have generator or other power source capable of supplying service within 10 seconds.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of February 26, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (March 17, 2025).

  11. No harm, with potential for more than minimal harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Widespread (many residents). CMS level F.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of January 25, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 27, 2024).

  12. No harm, with potential for more than minimal harm

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0755, Pharmacy Service Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2026).

  13. No harm, with potential for more than minimal harm

    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.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0761, Pharmacy Service Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2026).

  14. No harm, with potential for more than minimal harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2026).

  15. No harm, with potential for more than minimal harm

    Properly select, install, inspect, or maintain portable fire extinguishes.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0355, Smoke Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 4, 2026).

  16. No harm, with potential for more than minimal harm

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0686, Quality of Life and Care Deficiencies. Inspection of August 6, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (August 7, 2025).

  17. No harm, with potential for more than minimal harm

    Ensure medication error rates are not 5 percent or greater.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0759, Pharmacy Service Deficiencies. Inspection of February 26, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (February 27, 2025).

  18. No harm, with potential for more than minimal harm

    Keep aisles, corridors, and exits free of obstruction in case of emergency.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0211, Egress Deficiencies. Inspection of February 26, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (February 27, 2025).

  19. No harm, with potential for more than minimal harm

    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0321, Smoke Deficiencies. Inspection of February 26, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (February 27, 2025).

  20. No harm, with potential for more than minimal harm

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0755, Pharmacy Service Deficiencies. Inspection of May 20, 2024. Found during a complaint inspection.

    The home gave a date the problem would be corrected (May 21, 2024).

  21. No harm, with potential for more than minimal harm

    Install corridor and hallway doors that block smoke.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0363, Smoke Deficiencies. Inspection of January 25, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (February 26, 2024).

  22. No harm, with potential for more than minimal harm

    Install smoke barrier doors that can resist smoke for at least 20 minutes.

    Pattern (more than a few residents). CMS level E.

    Fire safety citation K-0374, Smoke Deficiencies. Inspection of January 25, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (February 26, 2024).

  23. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of November 21, 2023. Found during a complaint inspection.

    The home gave a date the problem would be corrected (December 18, 2023).

  24. No harm, with potential for more than minimal harm

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of June 1, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (June 2, 2026).

  25. No harm, with potential for more than minimal harm

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Isolated (one or a few residents). CMS level D.

    Health citation F-0550, Resident Rights Deficiencies. Inspection of April 14, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 15, 2026).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.