Pike Creek Nursing: Staffing Transparency Gaps - DE
The hospice binder that was supposed to contain the care plan sat empty at the nurses' station on August 6. No one could explain where the documents had gone.
Resident 110 was receiving hospice services for chronic heart failure with no expectation of improvement. The facility's own care plan acknowledged the resident was dying, stating the goal was to keep them "as comfortable as possible through review period." For specific interventions, it simply referred staff to "See Hospice plan of care."
But when inspectors requested that hospice plan, nurses couldn't produce it.
Licensed practical nurse E32 told inspectors that nursing staff were supposed to access the hospice care plan through the resident's hospice binder. At 11:24 that morning, inspectors asked to see it.
Staff said the binder housed the hospice plan of care. They couldn't find it at the nurses' station.
When they finally located the binder, it was empty.
Licensed social worker E10 seemed surprised during a 12:25 interview. "That is usually found in the hospice binder," she said as she and the inspector reviewed the empty binder together.
Finding nothing, E10 offered an explanation: "We use our own facility care plan, which should include the hospice care plan."
It didn't.
Inspectors reviewed Resident 110's comprehensive care plan generated by the facility. They found no evidence the hospice plan had been incorporated. No evidence the facility had collaborated with hospice staff to ensure the resident's end-of-life needs were being addressed.
The dying patient's specific comfort measures, pain management protocols, and other hospice interventions were nowhere to be found in the facility's records.
Director of nursing E3 confirmed during a 12:40 interview that the hospice plan was supposed to be "kept current and available in the hospice binder for staff reference." She explained the usual process: "The hospice nurses usually update the binder, and then we make changes as needed."
Then she acknowledged the obvious problem.
"I see the binder is missing information, so that should have been addressed."
The missing documents meant nursing staff had no access to current goals and interventions for Resident 110's hospice care. The facility's own care plan offered no guidance beyond referring staff to the hospice plan they couldn't find.
Federal regulations require nursing homes to ensure that residents receiving hospice services have their care coordinated between facility staff and hospice providers. The facility must maintain current care plans that address the resident's specific needs.
For Resident 110, that coordination had broken down completely.
The hospice binder that was supposed to guide the resident's end-of-life care sat empty while the patient remained in the facility's care. Staff responsible for providing comfort measures and managing symptoms had no access to the specialized hospice protocols designed for the dying resident.
The facility's comprehensive care plan, which should have integrated hospice services, contained no evidence of collaboration with the hospice team. No specific interventions for managing the resident's heart failure symptoms in the final stages of life. No protocols for ensuring comfort as the condition progressed.
When federal inspectors completed their review on August 13, they found the facility had failed to ensure hospice care plans were available to staff. The violation affected few residents but represented a fundamental breakdown in end-of-life care coordination.
Resident 110 remained at the facility, receiving care from nursing staff who lacked access to the hospice plan designed to guide their final days of life.
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.
The hospice binder that was supposed to contain the care plan sat empty at the nurses' station on August 6.
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.