| Hickory Creek at Peru | |
| 390 W Boulevard, Peru, Indiana 46970 | |
| (765) 473-4900 | |
| Name | Hickory Creek at Peru |
|---|---|
| Location | 390 W Boulevard, Peru, Indiana |
| Certified By | Medicare and Medicaid |
| No. of Certified Beds | 36 |
| Occupancy Rate | 70.83% |
| Medicare ID (CCN) | 155406 |
| Legal Business Name | Henry County Memorial Hospital |
| Ownership Type | For Profit - Corporation |
| Chain | American Senior Communities (90 nursing homes) |
| Chain Average Overall Rating | 3.9 out of 5 |
| NPI Number | 1164451944 |
| Match | Confirmed listed in Medicare enrollment records |
| Organization Name | Henry County Memorial Hospital |
| Doing Business As | Hickory Creek at Peru |
| Address | 390 Boulevard, Peru, IN 46970 |
| Phone Number | 765-473-4900 |
| Ratings from Surveys (Inspections): | |
| Ratings from Quality Measures: | |
| Ratings from Staffing Data: | |
| Overall Rating: |
|---|
| Staffing Measure | Provider | National Avg. |
|---|---|---|
| Total nurse staff hours per resident per day | 3.58 | 3.86 |
| Registered nurse (RN) hours per resident per day | 0.62 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 1.09 | 0.86 |
| Nurse aide hours per resident per day | 1.87 | 2.32 |
| Total nurse staff hours per resident per day on the weekend | 3.2 | 3.42 |
| RN hours per resident per day on the weekend | 0.39 | 0.48 |
| Physical therapist hours per resident per day | 0.02 | 0.07 |
| Total nursing staff turnover | 61.3% | 45.8% |
| Registered nurse turnover | Not available: the staffing data did not meet CMS's criteria for this measure | 42.9% |
| Number of administrators who have left the nursing home | 0 | 0.5 |
| Cited for abuse, neglect or exploitation of residents (Care Compare abuse icon) | No |
| Number of Fines | 0 |
| Total Amount of Fines in Dollars | $0 |
| Number of Payment Denials | 0 |
| Total Number of Penalties | 0 |
| Date | Deficiency | Harm Level | Status |
|---|---|---|---|
| Dec 23, 2025 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. F0755, Pharmacy Service, Standard inspection | Potential for harm, pattern | Corrected by Jan 5, 2026 |
| Dec 23, 2025 | Ensure services provided by the nursing facility meet professional standards of quality. F0658, Resident Assessment and Care Planning, Standard inspection | Potential for harm, isolated | Corrected by Jan 5, 2026 |
| Dec 23, 2025 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. F0689, Quality of Life and Care, Standard inspection | Potential for harm, isolated | Corrected by Jan 5, 2026 |
| Dec 23, 2025 | Ensure each resident’s drug regimen must be free from unnecessary drugs. F0757, Pharmacy Service, Standard inspection | Potential for harm, isolated | Corrected by Jan 5, 2026 |
| Sep 30, 2024 | Assure the security of all personal funds of residents deposited with the facility. F0570, Resident Rights, Standard inspection | Potential for harm, pattern | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656, Resident Assessment and Care Planning, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. F0657, Resident Assessment and Care Planning, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Provide enough food/fluids to maintain a resident's health. F0692, Quality of Life and Care, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Post nurse staffing information every day. F0732, Nursing and Physician Services, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. F0761, Pharmacy Service, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Sep 30, 2024 | Provide and implement an infection prevention and control program. F0880, Infection Control, Standard inspection | Potential for harm, isolated | Corrected by Oct 18, 2024 |
| Oct 10, 2023 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. F0812, Nutrition and Dietary, Standard inspection | Potential for harm, widespread | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. F0580, Resident Rights, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. F0656, Resident Assessment and Care Planning, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. F0657, Resident Assessment and Care Planning, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. F0684, Quality of Life and Care, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. F0690, Quality of Life and Care, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Oct 10, 2023 | Provide safe and appropriate respiratory care for a resident when needed. F0695, Quality of Life and Care, Standard inspection | Potential for harm, isolated | Past non-compliance (already corrected) |
| Oct 10, 2023 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. F0756, Pharmacy Service, Standard inspection | Potential for harm, isolated | Corrected by Nov 4, 2023 |
| Quality Measure | Provider | National Avg. |
|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | 1.43 | 13.87 |
| Percentage of long-stay residents who lose too much weight | 4.44 | 5.19 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0 | 0.82 |
| Percentage of long-stay residents with a urinary tract infection | 1.05 | 1.59 |
| Percentage of long-stay residents who have depressive symptoms | 67.78 | 12.8 |
| Percentage of long-stay residents who were physically restrained | 0 | 0.13 |
| Percentage of long-stay residents experiencing one or more falls with major injury | 1.04 | 3.23 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 97.92 | 93.55 |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 91.43 | 82.04 |
| Percentage of short-stay residents who newly received an antipsychotic medication | Not Available | 1.56 |
| Percentage of long-stay residents whose ability to walk independently worsened | 3.12 | 14.07 |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 17.58 | 19.52 |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100 | 95.46 |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Not Available | 79.75 |
| Percentage of long-stay residents with pressure ulcers | 4.21 | 4.62 |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 22.23 | 19.01 |
| Percentage of long-stay residents who received an antipsychotic medication | 15.15 | 15.38 |
Waters of Peru Skilled Nursing Facility, the Location: 317 Blair Pike, Peru, Indiana 46970 Phone: (765) 473-4426 |