Creekside Health And Rehabilitation Center

During an interview with the MDS Coordinator on 3-26-26 at 2:19 p.m., she indicated she had worked at the facility for over 1 year and had worked in the area of MDS assessments for over 5 years.

The resident's MDS assessment under the medication sections had an error It was nothing but human error, and she had corrected the error involving the medication section on 3/26/26.

Resident D's was prescribed an anti-psychotic medication on a routine basis during the seven (7) day look-back period for the annual MDS assessment. In review of the Centers for Medicare and Medicaid Services Long Term Care Facilities Resident Assessment Instrument 3.0 User's Manual Version 1.20.1, October 2025, section N, Medications, instructions, it indicated the MDS assessment should identify, by pharmacological category, any medication received in that category in the last seven (7) days.

This citation relates to Intake 2807309. 410 IAC (Indiana Administrative Code) 16.2- 3.1-31(c)(1)410 IAC 16.2- 3.1-31(c)(6) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE