Pike Creek Nursing: Care Quality Deficiencies - DE
Federal inspectors discovered the problem during an August complaint investigation when they asked to review hospice documentation for Resident 110, who was receiving end-of-life care for chronic heart failure.
The facility's own care plan acknowledged the resident "is receiving hospice services and is not expected to improve in condition." Staff were supposed to follow hospice protocols to keep the resident "as comfortable as possible."
But when inspectors requested the hospice binder that supposedly contained the care plan, nurses couldn't find it at their station.
Once located, the binder was completely empty.
Licensed practical nurse E32 had told inspectors at 11:00 AM that nursing staff could access hospice care plans in the resident's hospice binder. Twenty-four minutes later, when surveyors asked to see it, the binder contained no hospice care documents whatsoever.
Licensed social worker E10 seemed surprised by the missing documents. "That is usually found in the hospice binder," she told inspectors while reviewing the empty folder together.
Scrambling for an explanation, E10 then claimed the facility used its own care plan instead. "We use our own facility care plan, which should include the hospice care plan," she said.
It didn't.
Inspectors reviewed Resident 110's comprehensive facility care plan and found no evidence that hospice protocols had been incorporated. The facility had failed to collaborate with hospice staff to ensure the resident's end-of-life needs were properly addressed.
Director of Nursing E3 confirmed that hospice care plans were supposed to be kept current and available in the binder for staff reference. "The hospice nurses usually update the binder, and then we make changes as needed," she explained.
But she acknowledged the obvious problem. "I see the binder is missing information, so that should have been addressed."
The missing documentation meant nursing staff lacked access to current goals and interventions specifically designed for Resident 110's hospice care. Without these protocols, workers couldn't ensure they were following proper end-of-life procedures.
Hospice care requires detailed coordination between facility staff and hospice providers. Residents receiving such services typically have specific comfort measures, medication schedules, and symptom management protocols that differ from standard nursing home care.
The facility's hospice care plan for Resident 110 was supposed to outline these specialized interventions. Instead, staff found themselves with a generic facility care plan that simply stated "See Hospice plan of care" - a plan that didn't exist in their documentation.
The breakdown represents more than missing paperwork. Hospice patients and their families rely on coordinated care teams to manage pain, provide emotional support, and ensure dignity during final days or weeks of life.
When Pike Creek staff couldn't produce the hospice care plan, they couldn't demonstrate they understood what specific comfort measures Resident 110 needed. They couldn't show inspectors how they were coordinating with hospice nurses or what protocols they followed for medication management.
Federal regulators cited the facility for failing to ensure hospice care plans were available and integrated into comprehensive care planning. The violation affected multiple residents, though inspectors classified the immediate harm as minimal.
The citation suggests systemic problems with hospice coordination at Pike Creek. If staff couldn't locate care plans during a federal inspection, the documentation gaps likely existed during routine care shifts when residents needed specific hospice interventions.
Nursing home residents enter hospice care when their life expectancy drops to six months or less. These patients deserve specialized attention focused on comfort rather than cure. Missing care plans undermine that fundamental promise.
Resident 110 remained at Pike Creek receiving hospice services while federal inspectors documented the facility's failure to maintain proper documentation for end-of-life care.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Pike Creek Nursing & Rehabilitation Center from 2025-08-13 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
PIKE CREEK NURSING & REHABILITATION CENTER in WILMINGTON, DE was cited for violations during a health inspection on August 13, 2025.
Once located, the binder was completely empty.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.