Regency at Livonia

Inspectors wroteThis citation pertains to intake #3094316Based on observation, interview and record review, the facility failed to monitor blood glucose levels and follow hospital discharge medication (insulin) orders for one resident (R700) of three reviewed for medication orders.

Inspectors wroteBased on observation, interview, and record review, the facility failed to prepare food in accordance with professional standards for food service safety, resulting in the potential to spread food borne illness among all residents that consume food from the kitchen.

Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a safe, homelike environment affecting two residents (R31 and R78) of two reviewed for environment.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop a current vision care plan for one resident (R22) out of five residents reviewed for comprehensive care plans.

Inspectors wroteBased on observation, interview, and record review, the facility failed to apply heel protection boots for one resident (R53) out of three reviewed for care interventions.

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement pressure ulcer interventions for one resident (R11) out of three reviewed for pressure ulcers.

Inspectors wroteBased on interview and record review, the facility failed to adequately monitor an intravenous (IV) medication for one resident (R1) of one resident reviewed for medication monitoring.

Inspectors wroteThis citation pertains to the Complaint Intake # 272114. Based on observation, interview and record review the facility failed to ensure proper diagnosis or clinical indication to support the insertion of an indwelling catheter for three (3) residents: Resident #501 (R501), Resident #502 (R502), and Resident #504 (R504) of 4 residents reviewed for indwelling catheter resulting in improper catheter management leading to a potential recurrent catheter-associated urinary tract infection (CAUTI), sepsis and hospitalization.

Inspectors wroteThis citation pertains to Intake MI00152501. Based on observation, interview, and record review, the facility failed to ensure resident showers were provided as scheduled for one resident (R701) of three reviewed for acitivites of daily (ADL) care.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure timely assessment and monitoring following an identified weight loss for one resident (R56) of two reviewed for nutrition resulting in, weight loss and unmet nutritional needs.

Inspectors wroteBased on observation and interview, the facility failed to provide a homelike environment throughout residential common areas and rehabilitation area.

Inspectors wroteBased on observation, interview, and record review, the facility failed to initiate an activities care plan for one resident (R94) of one reviewed for care plans.

Inspectors wroteBased on interview and record review, the facility failed to ensure medication was administered as orders for one resident (R93) of one reviewed for medication administration.

Inspectors wroteBased on observation, interview, and record review, the facility failed to document and provide activities for one resident (R94) of one reviewed for activities.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure hand splint and elbow brace were applied for one (R38) of one resident reviewed for range of motion.

Inspectors wroteBased observation, interview, and record review the facility failed to ensure proper storage of medication in two of two medication carts and one resdent's room (R38) reviewed for medication storage.

Inspectors wroteThis citation pertains to intake MI00147311. Based on observation, interview, and record review, the facility failed to initiate a facility wide elopement code (notification for a missing resident) in a timely manner for one sampled resident (R902) of three reviewed for accidents.

Inspectors wroteThis citation pertains to Intake MI00144815. Based on interview and record review, the facility failed to provide Notice of Medicare Non-Coverage (NOMNC) to one resident (R700) out of one reviewed for discharge from the facility. Findings Include: A review of an Intake called into the State Agency noted the following, The family appealed the discharge and received a telephone call . the appeal went in patient's favor due to not informing the patient in ample time. A review of the medical record revealed R700 admitted into the facility on [DATE] with the following medical diagnoses, Muscle Weakness and End Stage Renal Disease. A review of the Minimum Data Set (MDS) assessment revealed a Brief Interview for Mental Status score of 15/15 indicating an intact cognition. R700 also required assistance with bed mobility and transfers. [...]

Inspectors wroteThis citation is related to Intake M1001445014. Based on observation, interview and record review, the facility failed to properly care for pressure ulcers for one of one resident (R702). A review of an Intake called into the State Agency noted a resident had a bedsore for so long that she got a bad infection which she was hospitalzied for. On 6/20/2024, record review revealed R702 was admitted on [DATE] with following relevant diagnoses: Sepsis, Quadraplegia C5-7 Complete, Neuromuscular Dysfunction of Bladder, Muscle Weakness, Chronic Iron Deficiency, Depression, Anxiety Disorder, Essential Hypertension, Gastro-esophageal Reflux Disease, Acute Kidney Failure. R702 is alert and oriented to person, place, time and situation. R702 is physically dependent for all activities of daily living. [...]

Inspectors wroteThis citation pertains to Intake M100144133. Based on observation, interview and record review, the facility failed to ensure orders for catheter care was provided for one (R906) of four residents reviewed for catheter care.

Inspectors wroteBased on observation and interview the facility failed to maintain sanitary conditions in the kitchen resulting in an increased potential for cross contamination of food and foodborne illness, potentially affecting 98 residents who receive meal services (3 nothing by mouth residents, or NPO) out of the facility's total census of 101 residents.

Inspectors wroteThis citation pertains to Intake MI00138590. Based on observation, interview, and record review, the facility failed to ensure sufficient staff were available to provide a timely response to call lights and resident requests/needs, affecting four residents (R10, R27, R35, R86 and R2) of nine reviewed for staffing, resulting in resident frustration and unmet care requests and needs.

Inspectors wroteThis citation pertains to Intake: MI00138590. Based on observation, interview, and record review the facility failed to serve food in a palatable manner and at the preferred temperature for three residents (R3, R246, and R249) and seven confidential group residents of fifteen residents reviewed for food palatability, resulting in dissatisfaction during meals.

Inspectors wroteBased on observation and interview, the facility failed to provide a safe, functional, and sanitary, environment for the facilities census of 101 residents and its staff resulting in an increased chance of harm.

Inspectors wroteBased on observation, interview, and record review the facility failed to implement a restorative nursing plan (RNP) for one resident (R3) of five residents reviewed for range of motion (ROM), resulting in the potential for a decline in ROM .

Inspectors wroteThis citation pertains to Intake MI00138666. Based on observation, interview, and record review, the facility to provide showers/bathing and/or assistance with shaving per the plan of care, affecting three residents (R38, R42, and R250) of eight reviewed for activities of daily living (ADLs), resulting in resident frustration and unmet care needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to follow-up on a neurology referral for one resident (R45) of one reviewed for quality of care resulting in, a delay in testing, and the potential for unmet care needs.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure timely podiatry services for one resident (R51) of one reviewed for foot care, resulting in delayed treatment, long toenails and the potential for discomfort.

Inspectors wroteBased on observation, interview, and record review, the facility failed to effectively identify an environmental hazard (broken glass), potentially affecting one of one resident (R57), in which created the potential for injury and/or skin laceration.

Inspectors wroteBased on observation, interview and record review the facility failed to label and date three eye dropper vials with the name and or date in one of four medication carts resulting in the potential for lost/misdirected medications or expired medication use.

Inspectors wroteBased on observation, interview, and record review, the facility failed to accurately document in the resident medical record, affecting two (R38 and R42) of two residents reviewed, resulting in falsified documentation and the potential for unmet care needs and/or inaccurate assessments.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure hand hygiene was completed prior to entry and upon exit from a resident room during care for one of four staff reviewed during medication pass, resulting in the potential for the spread of infection.