Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record
HICKORY CREEK AT ROCHESTER
ROCHESTER, IN · 36 certified beds · Last Life Safety survey June 11, 2025
CMS Certification Number 155430 · first certified March 1992
Ownership
Operated by AMERICAN SENIOR COMMUNITIES · Non profit - Corporation
- Ownership changed April 1, 2023 (change of ownership)from HENRY COUNTY MEMORIAL HOSPITAL
Position within IN
21 citations — more than 68% of the 507 certified nursing homes in IN. Compared within IN rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated
The latest survey found 5 citations; the earlier surveys in the window averaged 8. With 3 surveys on file this is a direction of travel, not a conclusion.
When is the next survey likely?
Well past the typical window (May 2026 to August 2026), and past the point by which nine in ten IN facilities have been surveyed. This facility’s last Life Safety survey was June 2025. Facilities in IN are typically surveyed 11–14 months after the last one (median 13), measured over 883 consecutive surveys in the last two years of CMS records.
A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured
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1 inspection-and-testing tag has been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.
Emergency preparedness
8 of the 21 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index
Physical environment (health survey)
2 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 21 Life Safety citations above. The Physical Environment Index
How that compares
Compared with the median facility in IN, and nationally. Surveyors differ markedly between states, so the IN figure is the meaningful one.
| Measure | Citations |
|---|---|
| This facility | 21 |
| Median facility in IN | 15 |
| Median facility nationally | 11 |
Survey history
| Survey date | Citations |
|---|---|
| April 21, 2023 | 6 |
| June 10, 2024 | 10 |
| June 11, 2025 | 5 |
Most-cited tags
| Tag | What the surveyor checks | Times cited | Last cited |
|---|---|---|---|
| K-0511 | Have properly installed electrical wiring and gas equipment. | 2 | 2025-06-11 |
| K-0331 | Construct fire resistant interior walls. | 1 | 2024-06-10 |
| E-0025 | Create arrangements with other facilities to receive patients. | 1 | 2024-06-10 |
| E-0006 | Conduct risk assessment and an All-Hazards approach. | 1 | 2024-06-10 |
| E-0007 | Address patient/client population and determine types of services needed. | 1 | 2024-06-10 |
| K-0712 | Have simulated fire drills held at unexpected times. | 1 | 2025-06-11 |
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | 1 | 2025-06-11 |
| E-0029 | Develop a communication plan. | 1 | 2023-04-21 |
What the citations cover
- Emergency Preparedness Deficiencies 8
- Smoke Deficiencies 6
- Egress Deficiencies 2
- Services Deficiencies 2
- Other 3
| Category | Citations |
|---|---|
| Emergency Preparedness Deficiencies | 8 |
| Smoke Deficiencies | 6 |
| Egress Deficiencies | 2 |
| Services Deficiencies | 2 |
| Miscellaneous Deficiencies | 2 |
| Gas, Vacuum, and Electrical Systems Deficiencies | 1 |
Every citation on file
As published by CMS, newest survey first. Descriptions are CMS’s own wording.
June 11, 2025 — 5 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| K-0353 | Inspect, test, and maintain automatic sprinkler systems. | Deficient, Provider has date of correction (September 8, 2025) |
| K-0372 | Ensure smoke barriers are constructed to a 1 hour fire resistance rating. | Deficient, Provider has date of correction (July 10, 2025) |
| K-0511 | Have properly installed electrical wiring and gas equipment. | Deficient, Provider has date of correction (July 10, 2025) |
| K-0712 | Have simulated fire drills held at unexpected times. | Deficient, Provider has date of correction (July 10, 2025) |
| K-0741 | Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed. | Deficient, Provider has date of correction (July 11, 2025) |
June 10, 2024 — 10 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0006 | Conduct risk assessment and an All-Hazards approach. | Deficient, Provider has date of correction (July 17, 2024) |
| E-0007 | Address patient/client population and determine types of services needed. | Deficient, Provider has date of correction (July 17, 2024) |
| E-0025 | Create arrangements with other facilities to receive patients. | Deficient, Provider has date of correction (July 17, 2024) |
| K-0281 | Install proper backup exit lighting. | Deficient, Provider has date of correction (July 1, 2024) |
| K-0331 | Construct fire resistant interior walls. | Deficient, Provider has date of correction (July 18, 2024) |
| K-0341 | Install a fire alarm system that can be heard throughout the facility. | Deficient, Provider has date of correction (July 2, 2024) |
| K-0351 | Install an approved automatic sprinkler system. | Deficient, Provider has date of correction (July 2, 2024) |
| K-0363 | Install corridor and hallway doors that block smoke. | Deficient, Provider has date of correction (July 18, 2024) |
| K-0511 | Have properly installed electrical wiring and gas equipment. | Deficient, Provider has date of correction (July 18, 2024) |
| K-0906 | Ensure gas cylinders are properly stored. | Deficient, Provider has date of correction (July 18, 2024) |
April 21, 2023 — 6 citations
| Tag | What the surveyor checks | Status |
|---|---|---|
| E-0004 | Develop and maintain an Emergency Preparedness Program (EP). | Deficient, Provider has date of correction (June 29, 2023) |
| E-0013 | Develop Emergency Preparedness policies and procedures. | Deficient, Provider has date of correction (June 29, 2023) |
| E-0024 | Establish policies and procedures for volunteers. | Deficient, Provider has date of correction (June 29, 2023) |
| E-0029 | Develop a communication plan. | Deficient, Provider has date of correction (June 29, 2023) |
| E-0039 | Conduct testing and exercise requirements. | Deficient, Provider has date of correction (June 29, 2023) |
| K-0223 | Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector. | Deficient, Provider has date of correction (June 29, 2023) |
Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.