Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Pine Creek Manor Skilled Nursing & Rehab Center

Wayne, MI · 49 certified beds · Last Life Safety survey April 30, 2026

CMS Certification Number 235559 · first certified August 1994

Ownership

Operated by PIONEER HEALTHCARE MANAGEMENT · For profit - Limited Liability company

No change of ownership on CMS record since January 1, 2016, when the records begin.

32
Citations on file
CMS's current file
3
Life Safety surveys
CMS's current file
8
Tags cited more than once
Across separate surveys
15
Inspection & testing records
Of the citations on file

Position within MI

32 citations — more than 94% of the 422 certified nursing homes in MI. Compared within MI 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

Improvingfewer citations at the latest survey than at its earlier surveys in CMS's current file.

The latest survey found 8 citations; the earlier surveys on file averaged 12. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens April 2027 — about 5 months from now. This facility’s last Life Safety survey was April 2026. Facilities in MI are typically surveyed 12–14 months after the last one (median 13), measured over 731 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 about three years in Virginia. How the window is measured

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Which alerts

4 inspection-and-testing tags have 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 cited for sprinkler inspection and testing in CMS’s current file are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

6 of the 32 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)

5 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 32 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

How that compares

Citations in CMS's current file

Compared with the median facility in MI, and nationally. Surveyors differ markedly between states, so the MI figure is the meaningful one.

This facility32MI median13National median11
Citations in CMS's current file, compared
MeasureCitations
This facility32
Median facility in MI13
Median facility nationally11

Survey history

Citations at each Life Safety survey
162024-0182025-0382026-04
Citations at each Life Safety survey
Survey dateCitations
January 9, 202416
March 13, 20258
April 30, 20268

Most-cited tags

Most-cited tags at this facility
K-09233K-03553K-09203K-03242K-03532E-00392K-02112K-07112
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0923Have proper medical gas storage and administration areas.32026-04-30
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.32026-04-30
K-0920Ensure proper usage of power strips and extension cords.32026-04-30
K-0324Provide properly protected cooking facilities.22026-04-30
K-0353Inspect, test, and maintain automatic sprinkler systems.22025-03-13
E-0039Conduct testing and exercise requirements.22026-04-30
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.22025-03-13
K-0711Provide a written emergency evacuation plan.22025-03-13

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 11
  • Gas, Vacuum, and Electrical Systems Deficiencies 7
  • Emergency Preparedness Deficiencies 6
  • Egress Deficiencies 4
  • Other 4
Citations by CMS category
CategoryCitations
Smoke Deficiencies11
Gas, Vacuum, and Electrical Systems Deficiencies7
Emergency Preparedness Deficiencies6
Egress Deficiencies4
Miscellaneous Deficiencies3
Services Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

April 30, 2026 — 8 citations

Citations issued on April 30, 2026
TagWhat the surveyor checksStatus
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (June 12, 2026)
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (June 26, 2026)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (June 12, 2026)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (June 26, 2026)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 12, 2026)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (June 12, 2026)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (June 12, 2026)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (June 12, 2026)

March 13, 2025 — 8 citations

Citations issued on March 13, 2025
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (April 18, 2025)
K-0223Provide 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 (April 18, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 18, 2025)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (April 18, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (April 18, 2025)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (April 18, 2025)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (April 18, 2025)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (April 18, 2025)

January 9, 2024 — 16 citations

Citations issued on January 9, 2024
TagWhat the surveyor checksStatus
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (February 19, 2024)
E-0007Address patient/client population and determine types of services needed.Deficient, Provider has date of correction (February 19, 2024)
E-0015Address subsistence needs for staff and patients.Deficient, Provider has date of correction (February 19, 2024)
E-0018Establish procedures for tracking staff and patients during an emergency.Deficient, Provider has date of correction (February 19, 2024)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (February 19, 2024)
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 19, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (February 19, 2024)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (February 19, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (February 19, 2024)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (February 19, 2024)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 19, 2024)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (February 19, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 19, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 19, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (February 19, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (February 19, 2024)

Reflects the CMS posting of October 1, 2026. Surveys conducted in the last few months may not appear yet.