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

Jacob's Creek Nursing and Rehabilitation Center

Madison, NC · 170 certified beds · Last Life Safety survey December 18, 2025

CMS Certification Number 345050 · first certified May 1968

Ownership

Operated by PRINCIPLE LONG TERM CARE · For profit - Limited Liability company

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

10
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
3
Tags cited more than once
Across separate surveys
6
Inspection & testing records
Of the citations on file

Position within NC

10 citations — more than 51% of the 419 certified nursing homes in NC. Compared within NC 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 the window.

The latest survey found 2 citations; the earlier surveys in the window averaged 4. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens February 2027 — about 4 months from now. This facility’s last Life Safety survey was December 2025. Facilities in NC are typically surveyed 14–16 months after the last one (median 15), measured over 412 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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Which alerts

2 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 ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

How that compares

Citations on file over three years

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

This facility10NC median9National median11
Citations on file over three years, compared
MeasureCitations
This facility10
Median facility in NC9
Median facility nationally11

Survey history

Citations at each Life Safety survey
42023-0442024-0922025-12
Citations at each Life Safety survey
Survey dateCitations
April 27, 20234
September 18, 20244
December 18, 20252

Most-cited tags

Most-cited tags at this facility
K-05112K-02112K-03242K-03411K-03631K-03211K-03721
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0511Have properly installed electrical wiring and gas equipment.22025-12-18
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.22025-12-18
K-0324Provide properly protected cooking facilities.22024-09-18
K-0341Install a fire alarm system that can be heard throughout the facility.12023-04-27
K-0363Install corridor and hallway doors that block smoke.12024-09-18
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.12024-09-18
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.12024-09-18

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 6
  • Egress Deficiencies 2
  • Services Deficiencies 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies6
Egress Deficiencies2
Services Deficiencies2

Every citation on file

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

December 18, 2025 — 2 citations

Citations issued on December 18, 2025
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (February 27, 2026)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (February 27, 2026)

September 18, 2024 — 4 citations

Citations issued on September 18, 2024
TagWhat the surveyor checksStatus
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 (January 20, 2025)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (January 20, 2025)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (January 20, 2025)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (January 20, 2025)

April 27, 2023 — 4 citations

Citations issued on April 27, 2023
TagWhat the surveyor checksStatus
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (July 5, 2023)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (July 5, 2023)
K-0341Install a fire alarm system that can be heard throughout the facility.Deficient, Provider has date of correction (July 5, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (July 5, 2023)

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