Maple Manor Rehab Center of Novi Inc

Inspectors wroteBased on observation, interview and record review the facility failed to implement an effective water management program, appropriately initiate Enhanced Barrier Precautions and provide infection control practices with medication administration, this had the ability to affect all the resident's residing in the facility including six [R27, R85, R86, R87, R88 and R89] residents identified.

Inspectors wroteThis citation pertains to intake# 2788480 Based on observation, interview and record review, the facility failed to maintain a clean and homelike environment for two residents (R57 and R65) of five residents reviewed for environmental concerns, as well as the residents that utilized the central shower room, resulting in unclean floors and shower/resident rooms in disrepair.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure professional standards of practice for medication administration for one resident (R83) of three residents reviewed for medication administration.

Inspectors wroteBased on observation, interview and record reviews the facility failed to ensure preventive interventions were implemented as noted in the plan of care, for two residents at risk for development of pressure injuries (R's 3 & 65) of five residents reviewed for pressure injury.

Inspectors wroteThis citation pertains to intake # 2714575Based on observation, interview, and record review, the facility failed to implement proper safety interventions to prevent falls for one resident (R501) of three residents reviewed for falls, resulting in a fall with injuries requiring a transfer to the hospital for skin tears and sutures to R501's forehead.

Inspectors wroteBased on observation, interview, and record reviews the facility failed to ensure infection control standards and practices were consistently implemented by the facility staff and failed to implement an effective infection control surveillance program for 47 or 47 (including Resident R14, R19, R5, R35, R2,R342 ad R24) residents residing at the facility during the time of the survey.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the facility's 'wireless' call light communication system was fully operational and had adequate alternate interventions for residents to summons help. This deficient practice has the potential to effect all residents, including R142, R144, R143, R344, and one anonymous resident (AR).

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure appropriate assessments and physician orders with medical symptoms were completed for audible position change alarms for two (R6 and R342) of two Residents reviewed for restraints resulting in the potential to restrict body movements due to the fear of sounding the alarm with physical discomfort and psychological distress utilizing a reasonable person concept.

Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure a positioning device (hand splints) were implemented for one (R16) of one resident reviewed for positioning and range of motion services resulting in the potential for contracture progression (hardening of the muscles, tendons, and other soft tissues) with further decline in range of motion and compromise with skin integrity.

Inspectors wroteBased on observation, interview and record reviews the facility failed to ensure oxygen therapy was consistently administered as ordered by the Physician for one (R14) of two residents reviewed for respiratory care.

Inspectors wroteBased on observation, interview, and record reviews the facility failed to ensure physician ordered medications had an indication for use and failed to transcribe physician orders per the facility policy for two (R's 5 and 7) of two residents reviewed for unnecessary medications.

Inspectors wroteBased on interview and record review, the facility failed to ensure that there was a stop/end date for PRN (as needed) psychotropic medication and failed to ensure that resident specific non-pharmacologic interventions were attempted prior to the administration of PRN psychotropic medication (anxiolytic) for two (R5 and R12) of five residents reviewed for unnecessary medications with potential for adverse side effects and decreased quality of life. Findings inlude: R12 R12 was admitted to facility on 2/5/25 after hospitalization. R12's admitting diagnoses included: stroke, diabetic neuropathy, history of falls, heart failure, kidney failure, generalized anxiety disorder, restlessness and agitation. Based on the Minimum Data Set (MDS) assessment dated [DATE], R12 had Brief Interview for Mental Status (BIMS) score of 13/15, indicative of intact cognition. [...]

Inspectors wroteBased on interview and record review the facility failed to consistently maintain a system that monitored antibiotic use, this had the ability to affect any resident prescribed an antibiotic in the facility of the 47 residents that resided in the facility at the time of the survey.

Inspectors wroteBased on observation, interviews, and record reviews the facility failed to ensure consistent dialysis communication documentation and assessments were maintained in the clinical record for one (R40) of one resident reviewed for dialysis.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide a privacy cover over an indwelling catheter bag for one Resident (R2) of two residents reviewed for catheters.

Inspectors wroteBased on interview and record review, the facility failed to ensure three (R46, R48, and R108) of four residents reviewed for advance directives had their code status/treatment preferences clearly documented in their clinical record.

Inspectors wroteBased on interview and record review, the facility failed to develop and implement a care plan for hearing loss for one Resident (R19) hearing loss or one resident reviewed for hearing loss/communication.

Inspectors wroteBased on observation, interview, and record review, the facility failed to thoroughly assess and document a pressure ulcer for one (R30) of two residents reviewed for pressure ulcers.

Inspectors wroteBased on interview and record review, the facility failed to document urinary output consistently for one Resident (R2) of two residents reviewed for catheters.

Inspectors wroteBased on interview and record review the facility failed to implement an effective antibiotic stewardship program that included consistent implementation of protocols for appropriate antibiotic use for two (R's 159& 160), this deficient practice had the ability to affect multiple residents who were prescribed antibiotics during their inpatient care at the facility.