Creekside Center for Rehabilitation and Healing
306 W Due West Avenue, Madison, TN 37115
Creekside Center for Rehabilitation and Healing, a 139-bed for profit - limited liability company nursing facility in Madison, TN, holds a 4-star CMS overall rating - well above the 3.0-star national average, with nurse staffing below the national norm. No recent finding reached the actual-harm level.
CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating, read the components below; they often tell a sharper story than the headline.
Phone: 6156124499
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- 4 / 5
- Above average · CMS overall · nat'l 3.0
- 3.87
- About average · nurse hrs/day · nat'l 3.89
- 8
- Inspection findings
- $0
- Federal penalties (0)
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 445516
- Ownership
- For profit - Limited Liability company
- Provider Type
- Medicare and Medicaid
- Beds
- 139
- Residents
- 129
- In Hospital
- No
- County
- Davidson
- Last Inspection
- Jul 12, 2023
Staffing Data
How the 3.87 total nursing hours per resident-day are staffed:
- RN Hours
- 0.66 (nat'l avg: 0.68)
- LPN Hours
- 1.12
- CNA Hours
- 2.10
- Total Nursing Hours
- 3.87 (nat'l avg: 3.89)
- PT Hours
- 0.09
- Nursing Turnover
- 55.4%
- RN Turnover
- 55.0%
What the CMS Record Reveals About Creekside Center for Rehabilitation and Healing
Creekside Center for Rehabilitation and Healing operates 139 certified beds in Madison, TN with approximately 129 residents currently in care, and carries a CMS overall rating of 4 out of 5 stars (health inspection 4★ · staffing 1★ · quality 5★).
The inspection file contains 8 deficiency records from recent surveys, all falling in the no-harm or minimal-harm bands of the CMS scope-and-severity grid. This provider's enforcement record shows no fines or payment denials to date. Reported nurse staffing runs 3.87 total hours per resident day (national average 3.89); RN hours specifically are 0.66 per resident day.
Classified as "For profit - Limited Liability company" ownership and operating as a "Medicare and Medicaid" provider, Creekside Center for Rehabilitation and Healing falls into a category where comparative context matters. Reported nursing turnover at this facility is 55.4%, above the level where continuity of care typically begins to suffer.
Why sub-scores and the CMS methodology matter
The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results, staffing levels, and quality measures. Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone, a 3-star facility with weak inspection history reads differently from one held back by thin staffing.
National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes, ratings and fines are lagging indicators of those upstream choices. The staffing metric in particular is the one most strongly tied to resident outcomes in peer-reviewed literature.
For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report, the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.
Deficiency History (8 most recent)
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Aug 17, 2023
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.
Category: Resident Rights Deficiencies
Corrected: Aug 17, 2023
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Category: Resident Rights Deficiencies
Corrected: Aug 17, 2023
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: May 23, 2019
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: May 25, 2018
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.
Category: Pharmacy Service Deficiencies
Corrected: May 25, 2018
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: May 25, 2018
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: May 16, 2018
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 0.4% | Yes |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.0% | Yes |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 3.1% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 3.3% | Yes |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.0% | Yes |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 11.3% | Yes |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.4% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 4.8% | No |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 2.0% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 77.8% | No |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 24.9% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 92.0% | No |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 18.8% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 68.8% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | 72.1% | No |
Penalty History
No penalties on record.
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Understanding Nursing Home Data
Frequently Asked Questions
What is the overall CMS rating for Creekside Center for Rehabilitation and Healing?
What are the staffing levels at Creekside Center for Rehabilitation and Healing?
How many beds does Creekside Center for Rehabilitation and Healing have?
Does Creekside Center for Rehabilitation and Healing have any deficiencies on record?
Has Creekside Center for Rehabilitation and Healing received any fines or penalties?
Who owns Creekside Center for Rehabilitation and Healing?
When was Creekside Center for Rehabilitation and Healing last inspected?
What quality measures are tracked for Creekside Center for Rehabilitation and Healing?
Data Sources
Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.
Read our methodology - how this data is sourced, computed, and verified.
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