Aria Nursing and Rehabilitation

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to effectively clean and maintain the physical plant affecting 91 residents, resulting in the increased likelihood for cross-contamination and bacterial harborage.

Inspectors wroteThis citation pertains to intake 3047057. Based on observation, interview, and record review, the facility failed to provide bath/showers for one Residents (#2) of three Residents reviewed. and six out of seven residents during confidential group meeting reported not receiving regularly scheduled showers. Findings Included: [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to follow professional standards for insulin administration for R76, during medication administration observation.

Inspectors wroteBased on observation, interview and record review the facility failed to follow infection control standards during medication administration observations.

Inspectors wroteThis citation pertains to intake #2986758 Based on observation, interview, and record review, the facility failed to develop fall interventions and implement fall interventions for one (R30) out of three reviewed for fall care plans.

Inspectors wroteBased on observation, interview, and record review the facility failed to timely obtain diagnostic imaging following a residents fall in one (Resident #50) out of 3 reviewed for falls resulting in the delay in treatment for a left wrist fracture, uncontrolled pain, and loss of function.

Inspectors wroteThis citation pertains to intake 2795386 and 2803405. Based on observation, interview and record review, the facility failed to protect R2's right to be free from physical abuse by R6 and R4's right to be free from verbal abuse by staff. Findings Include:R2:Review of the medical record reflected R2 admitted to the facility on [DATE], with diagnoses that included multiple sclerosis and epilepsy (seizure disorder). The admission Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 2/2/26, reflected R2 scored 15 out of 15 (cognitively intact) on the Brief Interview for Mental Status (BIMS-a cognitive screening tool) and had upper and lower extremity (arms and legs) impairments on both sides that interfered with daily functions or placed them at risk of injury in the last seven days. On 3/25/26 at 4:25 PM, R2 was observed seated in a wheelchair, in the day room. [...]

Inspectors wroteThis citation pertains to intake: 2717790Based on observation, interview and record review the facility failed to: 1.) ensure the safety, and 2.) implement care-planned interventions during staff assisted care in 1 of 3 sampled residents (Resident #102) reviewed for falls, resulting in R102 fall from elevated bed during care, where R102 required immediate transport to the hospital related to significant leg laceration, 24 sutures, and pain. Review of the Face Sheet and Minimum Data Set (MDS) dated [DATE], reflected R102 was a [AGE] year-old female admitted to the facility on [DATE], with diagnoses that included chronic heart failure, diabetes, morbid obesity, major depression and anxiety disorder. [...]

Inspectors wroteThis citation pertains to intake: 2722185Based on observation, interview, and record review the facility failed to prevent significant medication errors for one resident (#101) out of three residents reviewed for medication errors. Review of the Face Sheet and Minimum Data Set (MDS) dated [DATE], reflected R101 was a [AGE] year-old female admitted to the facility on [DATE], with diagnoses that included insulin dependent diabetes, anxiety and depression. The MDS reflected that R101 had a BIM (assessment tool) score of 15 which indicated her ability to make daily decisions was cognitively intact. Review of the complaint submitted to the State of Michigan, dated 1/21/26, reflected the facility allegedly failed to administer insulin according to the physician orders. [...]

Inspectors wroteThis citation pertains to intake MI00152962 Based on observation, interview, and record review, the facility failed to ensure one resident (R1) was treated with dignity and respect out of five reviewed.

Inspectors wroteBased on interview and record review, the facility failed to ensure an allegation of abuse was reported timely to the State Agency for one (R1) of three reviewed.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to effectively clean and maintain the physical plant affecting 83 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, and decreased air quality.

Inspectors wroteBased on observation, interview, and record review, the facility failed to label medication in accordance with accepted professional principles, dating of open medication for one out of four medication carts reviewed and failed to ensure proper medication storage of medications for one Resident (#51) out of 83 current residents residing at the facility. Findings Included: During an observation on 05/12/25 at 10:58 AM, R51 was laying in bed with door partially open and granted this surveyor permission to enter room. R51 appeared alert and oriented and able to answer questions. A medication cup with four to five pills was located on R51's bedside table. R51 reported the nurse had brought medicaitons in about 30 minutes prior and left on bedside table while she was sleeping. [...]

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to: (1) clean and maintain food service equipment, and (2) date mark potentially hazardous ready-to-eat food products affecting 83 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, and resident foodborne illness.

Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to: (1) maintain 2 of 3 outdoor waste receptacles, and (2) clean the outdoor waste receptacle concrete pad surface affecting 83 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, and pest attraction/harborage.

Inspectors wroteBased on observation, interview, and record review the facility failed to inform one resident (46) of five residents' benefits, risks, and alternatives for the prescribing of psychotropic medication. Findings Included: Resident #46 (R46) Review of the medical record revealed R46 was admitted to the facility 10/12/2024 with diagnoses chronic kidney disease, muscle weakness, atrial fibrillation, thoracic aorta aneurysm, congestive heart failure (CHF), gastro-esophageal reflux disease, sleep disorder, restless leg syndrome, depression, anxiety, chronic pain, mitral valve insufficiency, anemia (low red blood cells count), osteoarthritis, history of myocardial infarction (heart attack), peripheral vascular disease (PVD), chronic obstructive pulmonary disease (COPD), bipolar disorder, and hyperlipidemia (high fat content in blood). [...]

Inspectors wroteBased on interview and record review, the facility failed to act promptly on grievances reported in resident council meetings and provided responses to grievances in 6 of 9 residents, as reported during a confidential resident council interview, in a total sample of 18 residents and a total census of 83 residents, resulting in unresolved resident concerns, frustration and decreased quality of life.

Inspectors wroteBased on interview and record review the facility failed to ensure three out of five residents (Resident #46, 53, and 69) reviewed for unnecessary medications had proper documentation. Findings Included: Resident #69 (R69): Per the facility face sheet R69 was admitted to the facility on [DATE]. Diagnoses included dementia without behavioral disturbance, psychotic disturbance, mood disturbance, major depression disorder, and anxiety dated 11/7/2024. Review of a progress note dated 11/9/24, for Psychological Services PSYCHOSOCIAL EVALUATION Supportive Care, revealed an initial evaluation was conducted on 11/9/2024, and revealed a documented diagnosis of, unspecified dementia without behavioral disturbance The mental health exam revealed R69 did not have delusions, hallucinations, behaviors, she was alert to herself, and oriented. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure one (Resident #17) of two residents reviewed for care plans, had a comprehensive care plan that was revised for resident care needs, resulting in the potential for additional falls and care needs not being met. Findings Include; Resident #17 (R17) Review of the medical record reflected R17 was an initial admission to the facility on [DATE], readmitted on [DATE] and on 05/10/202. Diagnoses of repeated falls, diabetes, left hip pain, bi-polar and dementia. The most recent Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 02/08/2025 revealed R17 had a Brief Interview of Mental Status (BIMS) of 13 (cognitively intact) out of 15. [...]

Inspectors wroteThis citation pertains to intake #: MI00145322 and MI00144471 Based on observation, interview, and record review, the facility failed to ensure residents with pressure injuries received necessary treatment and services, consistent with professional standards of practice, to promote healing and prevent infection for 2 of 5 residents (Resident #1 and #6) reviewed for pressure injuries, resulting in the worsening of R1's wound and subsequent hospitalization.

Inspectors wroteThis citation pertains to intake #: MI00144444 Based on interview and record review the facility failed to ensure that medications were administered following the physician ordered parameters for 3 of 8 residents (Resident #7, #8, and #10), reviewed for medication administration, resulting in medication errors.

Inspectors wroteThis citation pertains to complaint intake MI00145033. Based on observation, interview, and record review the facility failed to prevent staff to resident abuse (#10) and investigation, immediately report allegations to the state agency and thoroughly investigate allegations resulting in the potential for continued abuse of residents. Findings Include. Resident #10 (R10) Review of the medical record reflected R10 was admitted to the facility on [DATE]. Diagnoses include Orthopedic aftercare following surgical amputation, Amputation of right foot, Osteomyelitis of both ankles and feet, difficulty walking, Peripheral Vascular Disease, Pain and Malaise. The most recent Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 02/27/2024, revealed R10 had a Brief Interview of Mental Status (BIMS) of 15(cognitively intact) out of 15. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to provide prompt medical attention after a fall with multiple fractures for 1 of 3 sampled residents (R61) reviewed for falls, resulting in delay in treatment (21 hours wait prior to hospital transfer for right shoulder fractures), prolonged pain, and suffering.

Inspectors wroteThis citation pertains to intake # MI00143255 Based on observation, interview and record review, the facility failed to 1) ensure enteral feedings were provided as ordered to meet hydration and nutritional needs for one (Resident #86); 2) ensure fluids were freely accessible and provided to three (Resident #41, #43, and #86) and 3) prevent significant weight loss for one (Resident #68) of five reviewed for nutrition and hydration, resulting in weight loss, not receiving the ordered tube feeding formula, not receiving the total tube feeding volume ordered, feelings of distress, hospitalization, and the potential for unmet nutritional needs and continued weight loss. Findings Include: [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to store food product safely, maintain plumbing, and practice good hand hygiene, resulting in the potential increased risk of foodborne illness, affecting all residents that consume food from the kitchen.

Inspectors wroteBased on observation and interview, the facility failed to maintain proper backflow protection, and store equipment in a safe manner, resulting in the potential for contamination of the potable water supply and contamination of care equipment, affecting all 92 residents in the facility.

Inspectors wroteThis citation pertains to intake number MI00143255. Based on observation and record review, the facility failed to maintain the pest control program, resulting in pests throughout the building, affecting all 92 residents in the facility.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the state Ombudsman and state agency contact information was accessible, for nine out of 13 confidential residents in a group meeting, who did not know where the contact information was located. Findings Included: On 4/03/2024 at 11:03 AM, during group interviews, nine residents stated they did not know who the state Ombudsman was, how to contact the Ombudsman, nor did the nine residents know where the information was posted. The nine residents also stated they did not know where the posting was located for the contact information for the state agency. Observation on 4/3/2024 at 12:10 PM, of the third and second floors common areas, that included both the east and west sides, all dinning and activities rooms, and the chapel, revealed no postings for the state agency or Ombudsman contact information. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure there was sufficient staffing, call lights were within reach, and call lights were answered promptly for 10 out of 13 confidential group interviews, and for two out of four residents (Resident #41 and 43). Findings Included: During a confidential group meeting on 4/03/2024 at 10:21 AM, one resident stated that staffing was so bad there were several times she would not receive staff assistant getting up out of bed and would miss the activities. The same confidential resident stated that about 4-5 times she did not receive staff assistance getting out of bed to attend activities and resident council, which resulted in her missing the activities and resident council meetings entirely. The resident stated it was due to not having enough staff. [...]

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure opened medications were appropriately labeled and stored (R15, R41, R294, R297) in 3 of 5 medication carts reviewed for labeling and storage, resulting in the potential for decreased medication efficacy and adverse side effects.

Inspectors wroteBased on interview and record review, the facility failed to ensure nutritionally adequate meals were served in accordance with dietary preferences, provided a repetitive breakfast menu, and failed to provide requested dietary items for one (Resident #287) of three reviewed and 10 of 13 residents that attended the Resident Council meeting, resulting in food preferences not being honored and the potential for unmet nutritional needs.

Inspectors wroteBased on observation, interview, and record review, the facility failed to serve food that was an appetizing temperature and provide a holiday meal for two (Resident #286 and #287) of three reviewed and 10 of 13 residents that attended the Resident Council meeting resulting in food complaints, the potential for unsafe food temperatures, and weight loss.

Inspectors wroteBased on interview and record review, the facility failed to audit emergency carts, resulting in the potential for emergency carts to be ill-equipped to respond to emergency care, affecting residents on two halls in the facility.

Inspectors wroteBased on interview and record review, the facility failed to ensure the accuracy of Minimum Data Set (MDS) assessments for two (Resident #23 and #68) of 19 reviewed.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure for three out of 19 residents (Resident #41, 43 and 287) a complete comprehensive care plan was in place and/or implemented. Findings Included: Resident #41 (R41): Per the facility face sheet R41 was initially admitted to the facility on [DATE], and readmitted on [DATE]. Diagnoses included stroke. In an observation and interview on 4/02/2024 at 2:54 PM, R41 was observed in bed, and no drinking water was observed in R41's room. A sign was observed on wall which revealed Pudding Thick Liquids .) During the same observation and interview R41 asked if she could get some water. A staff member was informed of R41's request. At 3:00 PM a Styrofoam cup with a lid was observed to have been placed on a bedside table that was in the bed one area. R41 resided in bed 2. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to timely investigate a fall and revise a fall Care Plan for one (Resident #287) of 19 reviewed for Care Plans, resulting in an inaccurate Care Plan, identifying the effectiveness of implemented interventions, and the potential for more falls. Resident #287 (R287) Review of the admission Record reflected R287 was admitted to the facility on [DATE] with diagnosis which included dependence on renal dialysis, end stage renal disease, heart failure, generalized anxiety disorder, type one diabetes mellitus, acquired absence of right leg below the knee, and muscle weakness. A Social Services Note dated 3/28/23 at 4:55 PM reflected R287's Brief Interview for Mental Status (BIMS) was scored 13 out of 15, indicating cognitively intact. [...]

Inspectors wroteBased on observation, interview and record review facility failed to: 1) accurately assess, monitor, treat and prevent the development of pressure ulcers consistent with professional standards of practice to prevent avoidable pressure ulcers; and 2) implement care-planned and non-care-planned interventions for two Resident (R18 and R27) of three reviewed for pressure ulcers, resulting in facility acquired stage 3, and the increased likelihood for delayed wound healing and/or worsening of wounds and overall deterioration in health status.

Inspectors wroteThis citation pertains to intake # MI00143255 Based on interview and record review the facility failed to investigate falls and implement effective interventions to prevent falls for one (Resident #86) of three residents reviewed, resulting in the potential for falls and injury.

Inspectors wroteBased on observation, interview, and record review the facility failed to insure that two residents (R56 and R63) were free from significant medications errors out of two residents reviewed for significant medication errors resulting in the potential for adverse physical reactions/outcomes to residents. Findings Included: Resident #56(R56) Review of the Face Sheet and Minimum Data Set (MDS) dated [DATE], reflected R56 was a [AGE] year old male admitted to the facility on [DATE], with diagnoses that included alcoholism, hypertension (high blood pressure), peripheral vascular disease, osteomyelitis bilateral ankles, orthopedic amputations bilateral feet related to recent gangrene infection(septicemia), and current smoker . The MDS reflected R56 a BIM (assessment tool) score of 15 which indicated his ability to make daily decisions was cognitively intact. [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure dentures were received timely for one (Resident #68) of one reviewed for dental services.

Inspectors wroteBased on interview and record review, the facility failed to offer influenza and pneumococcal immunizations per Centers for Disease Control and Prevention (CDC) recommendations for two (Resident #6 and Resident #56) of five reviewed.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure appropriate infection control practices during medication administration for one (Resident #297) of four reviewed for medication administration, resulting in the potential for cross contamination and the spread of infection.

Inspectors wroteThis citation pertains to intake MI00140401. Based on observation, interview and record review, the facility failed to maintain professional standards of practice in ensuring activities of daily living care met resident needs in two of three residents reviewed for falls (Resident #2 & #6), resulting in a serious head injury (Resident #2) and the potential for accidents/injuries (Resident #6).

Inspectors wroteThis citation pertains to intake MI00140788 and MI00142060. Based on observation, interview and record review, the facility failed to maintain a safe, clean, comfortable and homelike environment, in a census of 91 residents, resulting in the potential for transmission of infection, decreased air quality, odors, and accidents.

Inspectors wroteThis citation pertains to intake MI00142060. Based on observation, interview and record review, the facility failed to ensure pharmacy procedures were in place for an extended leave of absence (LOA) for one (Resident #3) of one resident reviewed for LOA medication resulting in the resident not receiving medications for six days causing resident undue distress.

Inspectors wroteThis citation pertains to intake: MI00140602 Based on interview and record review the facility failed to obtain and administer anti-seizure medication, as ordered by a physician, for one resident (#1) of three residents reviewed resulting in actual harm demonstrated by resident #1 having a Grand mal seizure (a seizure that involves loss of consciousness and violent muscle contractures) and requiring hospitalization. Finding Included: [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to evaluate and revise the care plan for one (#2) of two Residents reviewed for care plan revision, of a total sample of four, resulting in a lack of care plan evaluation, revision, and implementation of appropriate interventions, and the potential for unmet care needs.

Inspectors wroteBased on interview and record review the facility failed to ensure that 1 Registered Nurse (V) and 1 Certified Nursing Assistant (S) had the required annual competency evaluations in skills and techniques necessary to care for Residents, resulting in the potential for staff to lack the necessary training to adequately meet the needs of the 87 Residents that currently reside at the facility. Findings Included: In an interview and record review on 01/17/23 at 09:02 a.m. with the Nursing Home Administrator (NHA) A and the Director of Human Resources W employee personnel files were reviewed for the completion of competencies for the nursing department employees. The Director of Human Resources W was unable to locate the annual competency for Certified Nursing Assistant (CNA) S who's hire date as the facility was 06/19/2019. [...]

Inspectors wroteBased on observation, interview and record review the facility failed to provide adequate medically related social services for 1 resident (R52) of 17 residents reviewed. Resulting in increased likelihood of resident overall psychosocial well being potentially affecting all 87 residents.

Inspectors wroteBased on observation, interview and record review the facility failed to maintain complete, accurate and readily accessible resident medical records for five residents(R1, R14, R16, R52 and R68) of 19 reviewed for medical records, resulting in the likelihood for medication errors, missed treatments, incomplete discharge instructions, incomplete recap of stay and discharge summary, and overall incomplete medical records.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure skills- assessments were done before residents were allowed to administer their own medications for one of one residents (#19) resulting in the potential for incorrect dosing, missed medications and increased difficulty breathing.

Inspectors wroteBased on observation, interview, and record the review the facility failed to ensure updated and accurate advance directive information (legal documents that allow a person to identify decisions about end-of-life care ahead of time) was in place for 1 (resident #68) out of 2 residents reviewed for advance directives, resulting in the potential for a residents preference for medical care to not be followed by the facility or other healthcare providers. Findings Include: [...]

Inspectors wroteBased on observation, interview and record review the facility failed to ensure grievance/concern forms were readily available to residents and visitors for all 87 residents living in the facility resulting in the potential for unreported concerns due to lack of anonymity and inability to access the grievance forms.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents were not subjected to staff induced mental abuse and retaliation for two of six residents (#24, #76) assessed for abuse resulting in residents feeling worried, scared or upset and the potential for further abuse.

Inspectors wroteBased on observation, interview and record review, the facility failed to report an allegation of abuse to the State Agency (SA) for one (Resident #7) of six reviewed for abuse, resulting in an allegation of abuse not being reported to the SA and the potential for further allegations going unreported.

Inspectors wroteBased on observation, interview and record review, the facility failed to thoroughly investigate an allegation of abuse for one (Resident #7) of six reviewed for abuse, resulting in an allegation of abuse not being thoroughly investigated and the potential for further allegations not being thoroughly investigated.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide a written reason for transfer/discharge for one (Resident #7) of one reviewed for hospitalization, resulting in the potential for residents and/or their responsible party not being fully informed.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide a bed hold policy for one (Resident #7) of one reviewed for hospitalization, resulting in the potential for residents and/or their responsible party not being fully informed of the facility's bed hold policy.

Inspectors wroteBased on observation, interview, and record the review the facility failed to accurately code the Minimum Data Set (MDS) Assessment for 1 (Resident #45) of 19 reviewed for MDS Assessments, from a total sample of 19, resulting in the potential for inaccurate care plans and unmet care needs. Findings Include: Resident #45 (R45) Review of the medical record revealed R45 was admitted to the facility 04/20/2020 with diagnoses that included alcoholic cirrhosis of liver, type 2 diabetes, dementia, psychotic disorder with delusions, chronic obstructive pulmonary disease (COPD), chronic viral hepatitis C, tinea unguium (nail fungus), mood disorder, major depressive disorder, anxiety, anemia (low red blood cell count), nicotine dependence, cannabis use, and alcohol abuse. [...]

Inspectors wroteBased on observation, interview and record review the facility failed to develop and implement comprehensive care plans for 1 (Resident #52) of 20 reviewed for comprehensive care planning, resulting in the potential for unmet care needs and services.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that care plans were revised for 2 residents (#25 and #55) out of 19 residents, resulting in the potential for resident unmet care needs. Finding Include: [...]

Inspectors wroteBased on observation, interview and record review, the facility failed to effectively implement discharge planning for 1 of 4 residents (R52) reviewed for discharge planning according to resident specific goals.

Inspectors wroteBased on interview, and record review, the facility failed to provide Activities of Daily Living (ADL) assistance to one (Resident #41) of two reviewed for ADLs, resulting in R41 not receiving the required supervision during care and the potential for injury.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure coordination and follow-up related to hospital discharge medication orders (Kesimpta, a prescription medicine used to treat adults with relapsing forms of multiple sclerosis) and outside medical appointments for one residents (R1) of 19 residents reviewed for quality of care, resulting in verbalized complaints and delay in care and treatment.

Inspectors wroteBased on observation, interview, and record review, the facility failed to identify use of unauthorized extension cord for 1 of 3 residents (R13) reviewed for accidents and hazards, resulting in the potential for accidents and injury.

Inspectors wroteBased on interview and record review, the facility failed to ensure the physician reviewed and acted upon identified medication regimen irregularities for one (Resident #14) of five reviewed for unnecessary medications, resulting in the potential for unnecessary medications and adverse reactions.

Inspectors wroteBased on interview and record review, the facility failed to justify the use of antibiotics for one (Resident #44) of two reviewed for antibiotics, resulting in the potential for unnecessary medications and adverse side effects.

Inspectors wroteBased on observation, interview and record review, the facility failed to 1) ensure as needed psychotropic medications were not prescribed for longer than 14 days; and 2) justify an increase in antipsychotic medication for one (Resident #14) of five reviewed for unnecessary medications, resulting in the potential for unnecessary psychotropic medications and adverse reactions.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure required postings were provided to all 87 residents living in the facility and/or their responsible parties/families resulting in misinformation and individuals not knowing whom to call with questions/concerns.