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Nursing HomeMedicaid Investigative

Rock Creek of Ottawa

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

1100 W 15th Street, Ottawa, KS 6606775 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Rock Creek of Ottawa Nursing Home in Ottawa, KS — Street View
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4/ 10
moderate Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Above-median deficiencies (16 vs median 9.0)
  • High staff turnover (60%)

Below average in KS · Meets national RN staffing standard · Below chain average · No penalties on record

Source: Medicare data

What this means for your family

This facility has areas of concern that warrant careful consideration. Registered Nurse hours are only 82% of the national benchmark, which can affect medication management and response times. The facility has 16 deficiencies, which is above the state average. We recommend asking the administrator directly: "How are you addressing recent staffing shortfalls?" These are not reasons to panic, but they are reasons to ask tough questions and visit in person.

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.61hrs
82%
Registered nurses for medical care
Total Nursing
3.46hrs
84%
All nurses + aides combined
Staff Turnover
65%
Lower is better (< 30% = good)
RN Turnover
60%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
5/ 5
Better Than Avg

10

measures

Worse Than Avg

4

measures

Mixed Results

3

measures

Long-Stay Residents
😔

Residents with depression symptoms

↓ Lower is better
This Facility41.7%
Worse than Avg
Here
41.7%
US
12.1%
KS
6.0%
Franklin
11.4%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility33.7%
Worse than Avg
Here
33.7%
US
19.4%
KS
22.9%
Franklin
19.4%
💊

Residents on antipsychotic medication

↓ Lower is better
This Facility3.8%
Better than Avg
Here
3.8%
US
15.5%
KS
18.1%
Franklin
17.3%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility8.2%
Better than Avg
Here
8.2%
US
15.3%
KS
17.5%
Franklin
16.2%
💉

Residents vaccinated for pneumonia

↑ Higher is better
This Facility99.1%
Better than Avg
Here
99.1%
US
93.4%
KS
91.7%
Franklin
95.6%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility11.8%
Better than Avg
Here
11.8%
US
14.4%
KS
18.4%
Franklin
14.4%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility98.0%
Better than Avg
Here
98.0%
US
81.8%
KS
75.6%
Franklin
85.4%
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility88.7%
Better than Avg
Here
88.7%
US
79.8%
KS
73.8%
Franklin
78.3%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.8%
Better than Avg
Here
0.8%
US
1.6%
KS
2.1%
Franklin
1.5%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

16deficiencies
1penalties
Well above state avg (10.1)
17 complaint-triggered

Rock Creek of Ottawa shows a concerning pattern of complaint-triggered deficiencies, with families filing 17 reports leading to inspection issues. The facility has recurring problems with accident prevention and safety, fire safety systems, and medication management that persist across multiple surveys from 2021 through 2025. While all deficiencies show correction dates, the repeated nature of safety violations suggests ongoing operational challenges that families should carefully consider.

Jan 27, 2026Complaint
1
0689Actual harm · IsolatedResolved (past non-compliance)

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Jan 30, 2025Complaint
15
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0761Potential for harm · PatternCorrected

Pharmacy Service Deficiencies

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.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

0558Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

0623Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0690Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

0726Potential for harm · IsolatedCorrected

Nursing and Physician Services Deficiencies

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

0744Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

0757Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure each resident’s drug regimen must be free from unnecessary drugs.

0758Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

Jan 30, 2025Routine
5
0161Potential for harm · WidespreadCorrected

Construction Deficiencies

Use approved construction type or materials.

0321Potential for harm · WidespreadCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0753Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have restrictions on the use of highly flammable decorations.

0920Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0324Potential for harm · IsolatedCorrected

Smoke Deficiencies

Provide properly protected cooking facilities.

Dec 20, 2023Complaint
1
0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Mar 29, 2023Routine
11
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0372Potential for harm · WidespreadCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0712Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0920Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0636Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0511Potential for harm · IsolatedCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

Aug 9, 2021Routine
15
0727Potential for harm · WidespreadCorrected

Nursing and Physician Services Deficiencies

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0347Potential for harm · WidespreadCorrected

Smoke Deficiencies

Properly provide smoke detection systems in areas open to corridors.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0920Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0677Potential for harm · PatternCorrected

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

0222Potential for harm · PatternCorrected

Egress Deficiencies

Add 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.

0293Potential for harm · PatternCorrected

Egress Deficiencies

Have properly located and lighted "Exit" signs.

0372Potential for harm · PatternCorrected

Smoke Deficiencies

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

0930Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper storage of liquid oxygen.

0657Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

0679Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

0684Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

0686Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

0741Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Federal Penalties

Fine

Jan 27, 2026

$12,735

Ownership & Operations

Who Operates This Facility

Owner / Operator

Rock Creek of Ottawa

Organization Type

for profit

Chain Affiliation

Chain Name

The Ensign Group

Chain Size

342 facilities nationwide

Chain avg rating: 3.2/5 · Rank 277 of 328

Ownership & Management

Key personnel

Bohrer, TracyW-2 Managing EmployeeBunker, DerekOfficer / DirectorBurnam, SoonOfficer / DirectorGuschl, JamesOfficer / DirectorBohrer, TracyManager
Source: Medicare provider data

Contact

Get in Touch

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References & Resources

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