Medilodge of Haggerty Road

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY This citation pertains to 1228847. Based on observation, interview and record review, the facility failed to prevent verbal abuse from staff for one resident (R39) of two residents reviewed for abuse resulting in the resident feeling upset and rights being violated. Findings include: On 07/29/2025 at 9:00 AM, R39 was observed sitting on the bed. R39 was interviewed and asked about their interaction with Certified Nursing Assistant (CNA C) on 5/19/25. R39 stated that CNA C told (R39) to shut up and called (R39) a (profanity word). R39 didn't want to take a shower and said that CNA C was in her business. A review of R39's electronic medical record revealed a re-admission to the facility on [DATE] with a diagnosis of Type 2 Diabetes, Hypertension, Major Depressive Disorder, Hyperlipidemia, Asthma, Neuromuscular Dysfunction of Bladder. R39 had a Brief Interview for Mental Status (BIMS) dated 4/25/25, which revealed a score of 15/15 (intact cognitive function). On 07/30/2025 at 11:25 AM, the Director of Nursing (DON)…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review, the facility failed to: 1. Ensure pans and lids were properly cleaned and allowed to air dry before stacking; 2. Ensure the ice machine and three-compartment sink were properly air gapped; 3. Effectively clean surfaces in the kitchen; 4. Ensure proper drainage of floor drains; 5. Ensure thermometers were available in all refrigerators and coolers; 6. Ensure moldy food items were not stored in the walk-in cooler; 7. Remove expired, undated, unlabeled food from the kitchen walk-in cooler and resident refrigerators; and 8. Properly seal food in the freezer to prevent freezer burn (a condition that occurs when frozen food has been damaged by dehydration and oxidation due to freezer air reaching the food. Findings include: On 8/27/24 at 8:50 AM, during the initial tour of the kitchen with Food Service Director (FSD) I the following was observed: 1. In the clean pot/pan area, three one-third size pans, two half-size pans, and two full-size pans, were stored wet and nestled together. Also, eight steam table lids, nestled together, and a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview, and record review, the facility failed to properly maintain the commercial dishmachine. Findings include: On 8/27/24 at 8:50 AM, during the initial tour of the kitchen the side panel of the dishmachine was not properly attached and was observed situated on top of a drainpipe leaving the mechanicals of the dishmachine exposed. Food Service Director I said the panel has been off the dish machine for over four months. Maintenance had reattached the panel, but it keeps falling off. On 8/29/24 at 1:28 PM, the Nursing Home Administrator (NHA) said the panel needs to be in place and maintenance needs to get it fixed properly. On 8/29/24 at 4:00 PM, the NHA and Director of Nursing was asked if there was any additional documentation or information that the facility would like to provide prior to the end of the survey and reported there was not.

Based on observation, interview, and record review, the facility failed to properly dispose of rubbish and ensure proper maintenance of outside disposal containers. Findings include: On 8/27/24 at 11:50 AM, during an observation of the exterior refuse area with Food Service Director (FSD) I, three dumpsters, approximately 4 to 6 cubic yards in size, were observed. The two side doors of one of the dumpsters were observed opened. The top lid on a second dumpster was completely broken off and a side door was opened. FSD I stated the broken and opened doors leaves the garbage inside exposed to pest and rodents can be attracted to the smells. On 8/28/24 beginning at 12:49 PM, the Nursing Home Administrator (NHA) said the doors of the dumpsters should be closed to avoid wind causing the garbage to fall out and to keep out rodents and pests. NHA added that it was not effective to have half the lid gone. We want to get that taken care of to avoid garbage spilling out. On 8/29/24 at 4:00 PM, the NHA and DON was asked if there was any additional documentation or information that the facility…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY This citation pertains to Intake MI00145543. Based on interview and record review, the facility failed to ensure staff to resident verbal abuse did not occur for one resident (R2), resulting in verbal abuse. Findings include: A review of the facility's incident reported to the State Agency documented on 6/25/24 at approximately 6:50 AM, Housekeeping Aide (HA) T heard CNA S use profane language towards R2 and told R2 that he was irritating and annoying. A review of the clinical record revealed R2 was admitted to the facility on [DATE]. R2's diagnoses included dementia with agitation and sensorineural hearing loss. A Minimum Data Set assessment dated [DATE] documented moderate cognitive impairment, minimal difficulty in ability to hear, and did not exhibit behaviors towards others. Further review of the abuse investigation documented that HA T informed Staffing Coordinator (SC) U that CNA S was yelling at R2. SC U heard CNA S say, You're going to make me clock the (expletive) out. You're getting on my (expletive)…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, and record review, the facility failed to ensure the Preadmission Screening/ Annual Resident Review (PASARR) forms for Mental Illness/ Intellectual Disability/ Related Conditions Identification (DCH-3877) documents were reviewed, revised, and sent to the local state agency for annual evaluation for a Level II determination for one (R46) of three residents reviewed for PASSARs, resulting in the potential for unmet psychosocial care needs. Findings include: A review of R46's electronic medical record (EMR) did not reveal a Level ll evaluation. There was not a Mental Illness/Intellectual/Developmental Disability/Related condition exemption Criteria Certification (DCH-3878) form. (The DCH-3878 is a State of Michigan Department of Health and Human Services (MDHHS) form used to claim exemption for level ll screening). R46 was admitted to facility on 11/24/2022 with most recent readmission on [DATE] with pertinent diagnoses of schizophrenia, visual hallucinations and bipolar disorder. Review of a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to implement an individualized comprehensive seizure disorder care plan for one resident (R25) Findings include: A review of the admission Record for Resident #25 (R25) documented an initial admission date of 2/24/20 and readmission date of 5/14/24. R25's diagnoses on 2/27/2020 included unspecified convulsions. A Minimum Data Set assessment dated [DATE] documented severe cognitive impairment. Current physician's orders for R25 documented Levetiracetam (medication used to treat seizure disorders) oral tablet 750 mg. Give 2 tablets by mouth two times a day for anticonvulsant. Order date 5/14/24. R25's clinical record documented in part the following: - R25 was discharged to the hospital on 5/6/24 and returned to the facility on 5/14/24. - Nursing progress note dated 5/6/24 documented the following: The CENA (Certified Nurse Aids) yelled for help, when entering the room the patient was having a seizure. The seizure lasted 1 minute and 45 seconds. The patient…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based of observation, interview, and record review, the facility failed to document the application of a WHFO (wrist, hand, finger orthotic) as ordered for one resident (R44). Findings include: On 8/28/24 at 8:30 AM, R44 was observed sitting in a wheelchair. R44 did not have a splint on his right hand. A review of the admission Record for R44 documented an original admission date of 7/17/19 and readmission date of 3/28/23. R44's diagnoses included atherosclerotic heart disease, anoxic brain damage, and aphasia. A Minimum Data Set assessment dated [DATE] documented severe cognitive impairment. A current physician's order documented: Splint: type R (right) WHFO location: Right wrist wear schedule patient to wear up to 4 hours daily, monitoring for skin breakdown, to position and protect R hand. Ordered 4/3/24. On 8/29/24 at 11:32 AM, Certified Nurse Aide (CNA) P said she was unaware R44 wore a splint. CNA P located R44's splint in his closet drawer. CNA P said she would chart the application of R44's splint as…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, interview and record review, the facility failed to ensure a clean, comfortable and homelike environment, resulting in excessively worn and soiled furniture, increased risk for infections. This deficient practice had the potential to affect the 90 residents who reside within the facility. Findings include: During a dining room observation during lunch on 8/07/23 at 12:03 PM on the C level floor, a resident was observed sitting in a chair that was not a dining chair, the table was positioned above elbow level for the resident. Two residents were observed sitting in dining chairs at the same table and at an appropriate height for eating. All residents that were served lunch were served on cafeteria type trays. The living area in the same dining room was observed with a couch and loveseat that were heavily soiled with water stains, what appeared to be milk stains, and dirt on the seat cushions and arm rests. One resident was observed sitting on the sofa eating his lunch on an over-the-bed table. Two light brown vinyl covered chairs were excessively worn through…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to implement effective individualized interventions to prevent falls, in four of four residents reviewed for falls (R36, R47, R51, and R69), resulting in fractures (Resident #36) and injuries (Resident #47, #51 and #69). Findings Include: Resident #36 (R36) On 08/07/23 at approximately 10:15 AM R35 was observed lying in bed with swelling, a laceration and multiple bruised areas on her face; R35 was observed with a cast on her right wrist. R35 stated in an interview that she fell the day prior and had fallen multiple times at the facility. R36's Minimum Data Set (MDS) assessment dated [DATE] revealed she was admitted to the facility on [DATE], had a Brief Interview for Mental Status (BIMS), a short cognitive screener, score of 15 (13-15 Cognitively Intact). The same MDS assessment revealed R36 had functional range of motion limitations on one side of her lower extremity (hip, knee, ankle, foot); she used a walker and a wheelchair for…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interview, observation and record review the facility failed to provide sufficient staff to meet 5 of 8 residents' needs, as voiced during a confidential Resident Council meeting, , resulting in unmet needs and frustration. Findings include: During a resident council meeting on 08/07/23 at 01:54 PM, residents voiced concerns with staffing. CNAs told us to just pee in the bed and they would have to change us. 3 out of 8 residents stated that they are neglected by staff disappearing on their shift and not providing care as needed. 5 out of 8 residents stated they were told CNA was not their aide, or that not my job. 3 out of 8 residents stated they have waited over an hour for someone to answer their call light, when the CNA comes in, if the resident fell asleep waiting, staff will turn off the call light and leave the room. 1 out of 8 residents stated the CNA will come in to see what they need and then say they cannot help the resident because they have a bad back or sore wrist. 4 out of 8 residents stated they have only had one CNA working on their floor and they are a 2…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to immediately investigate and report allegations of abuse for one resident ( R72) of 21 residents reviewed for abuse, resulting in an incomplete investigation, an unreported allegation of abuse to the State Agency timely, and the potential for further allegations of abuse to go unreported and not thoroughly investigated. Findings include: Review of the medical record reflected R72 was an initial admission to the facility on [DATE], readmission on [DATE]. Diagnoses of Malignant Neoplasm of Oropharynx, Neurogenic Bowel, spinal cord injury, functioning quadriplegic, Neuromuscular Dysfunction of Bladder. The most recent Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 05/12/2023, revealed R72 had a Brief Interview of Mental Status (BIMS) of 15 out of 15 (cognitively intact) and requires 2-person assistance for transfer, toileting and showers. During an interview on 08/07/23 at 03:26 PM, R72 stated he was in the shower, the CNA took a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, observation and record review, the facility failed to ensure that resident's care plan included the collaboration of the hospice plan of care, description of the services furnished by hospice, and failed to ensure hospice orders were implemented for one of one resident (R4) who received hospice services resulting in the potential of care not being provided to resident. Findings Include: Resident #4 (R4) Review of the medical record reflected R4 was an initial admission to the facility on [DATE]. admission to hospice program on 01/27/23. Diagnoses include Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, Rheumatoid Arthritis and history of falls. The most recent Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 07/28/2023, revealed R4 had a Brief Interview of Mental Status (BIMS) of 5 out of 15 (severely impaired cognition) and was dependent of all care. During an interview on 08/07/23 at 04:45 PM, family of R4 stated they have sat in the room for more than 4…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.