The Laurels of Fulton

Inspectors wroteBased on interview and record review, the facility failed to provide medication according to professional standards of practice for 1 resident (R2) of 12 residents reviewed.

Inspectors wroteBased on observations, interviews and record review, the facility failed to provide meaningful activities for 2 Residents (R2 and R6) of 12 residents sampled.

Inspectors wroteBased on interview and record review, the facility failed to inform the responsible party of the initiation of a psychotropic medication for one cognitively impaired Resident (R3) of six residents reviewed for psychotropic medications.

Inspectors wroteBased on interview and record review, the facility failed to timely inform the party responsible of a fall sustained by a cognitively impaired (R3) of five residents reviewed for accidents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to implement their abuse policy and have a policy for reporting and investigating abuse for 2 Residents (Resident #2 and #24) out of 12 sampled residents.

Inspectors wroteBased on observation, interview, and record review the facility failed to investigate and report an allegation of abuse to the State Agency for 2 Residents (R2 and R24) of 12 residents sampled.

Inspectors wroteBased on interview and record review, the facility failed to complete and maintain an Acute Transfer Log and provide this log to the Ombudsman in a timely manner.

Inspectors wroteBased on observation, interview, and record review, the facility failed to develop, implement, and update individualized care plans for 2 residents (R8 and R6) of 12 residents reviewed.

Inspectors wroteBased on interview and record review, the facility failed to revise the Care Plan for one cognitively impaired Resident (R3) with behaviors and who was prescribed psychoactive medications without documented Care Plan revisions to attempt to prevent or minimize the use of psychoactive medications of five residents reviewed for Care Plan revisions.

Inspectors wroteBased on observations, interview and record review, the facility failed to ensure one resident (R24) of 12 residents sampled was receiving all her activities of daily living to maintain her ability to walk.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide adequate supervision to prevent the fall of 1 resident (R45) of 4 residents reviewed for falls.

Inspectors wroteBased on interview and record review, the facility failed to evaluate one cognitively impaired resident and document the rationale for use of an antipsychotic, define target behaviors, and establish goals for treatment in accordance with regulatory requirements and facility policy for one Resident (R3) of five residents reviewed for the use of psychotropic medication.

Inspectors wroteBased on interview and record review, the facility failed to maintain an accurate Electronic Health Record (EHR) for 1 resident (R45) of 12 residents reviewed for accuracy of medical records.

Inspectors wroteThis citation pertains to intake 2636578Based on interview and record review, the facility failed to implement measures to prevent the elopement from the facility for one resident known to be at risk for elopement (R101) of four residents reviewed resulting in an Immediate Jeopardy that began on 9/21/25 when R101 left the facility unbeknownst to staff which created a high likelihood for serious harm, injury, and/or death.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the comprehensive care plan was reviewed and revised for one resident (Resident #8) out of 13 residents reviewed for quality care, resulting in hospitalization for a fracture sustained after a fall from staff use of the incorrect lift device.

Inspectors wroteBased on observation, interview, and record review, the facility failed to 1.) implement the facility policy for pressure injury/wound management, 2.) ensure pressure injury/wound assessments were comprehensive and accurate, and 3.) ensure treatments were promptly ordered and completed, for 2 of 13 residents (Resident #17 and #1) reviewed for alterations in skin integrity, resulting the development of preventable pressure injuries and the worsening of wounds.

Inspectors wroteThis citation pertains to intake #MI00148210 Based on interview and record review, the facility failed to provide enhanced supervision and assistance to residents with acute medical changes and significant medication changes, for two of five residents (Resident #32 and Resident #16) reviewed, resulting in a fractured left arm and a brain bleed for Resident #32 and a fractured right arm for Resident #16.

Inspectors wroteBased on interview and record review, the facility failed to implement an effective and current system of surveillance for staff illnesses to identify possible communicable diseases and infections to prevent the spread of an illness/outbreak, resulting in the potential for an outbreak to go undetected.

Inspectors wroteBased on interview and record review, the facility failed to ensure Medication Regimen Reviews were maintained in the resident's clinical record with documentation of the physician's response for 1 resident (R1) of 5 residents reviewed for medication regimen reviews.

Inspectors wroteBased on interview and record review, the facility failed to 1.) implement and operationalize an antibiotic stewardship program and 2.) ensure accurate monitoring and documentation of infections for 3 residents (Resident #23, #30, and #192) out of 6 residents reviewed for antibiotic use and treatment.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure that residents' rooms (#' 1) had the required square footage, resulting in the potential for resident discomfort and crowding.

Inspectors wroteBased on interview and record review, the facility failed to develop and/or implement policies and procedures for ensuring the reporting of a reasonable suspicion of a crime in accordance with section 1150B of the Act and for ensuring abuse allegations were reported timely to the State Agency for one resident (R211) of three residents reviewed.

Inspectors wroteBased on observation, interview, and record review, the facility failed to prevent facility acquired pressure injuries and provide pressure injury preventative care consistent with professional standards of practice for 3 residents (Resident #94, #37, and #193) reviewed for the risk of and/or the development of pressure injuries, resulting in the development of an avoidable pressure injury, the worsening of a pressure injury, and the potential for skin breakdown and overall deterioration in health status.

Inspectors wroteBased on observation, interview, and record review, the facility failed to 1.) ensure facility staff were educated on and implemented transmission based precautions for Resident #94, and #5, 2.) ensure wound care was completed following infection control standards of practice for Resident #37, and 3.) implement an effective and current system of surveillance of staff and resident illnesses to identify possible communicable diseases and infections to prevent the spread of an illness/outbreak for Resident #193. This deficient practice placed all residents residing in the facility at risk for the potential of the development and spread of disease and infection and the potential for an outbreak to go undetected.

Inspectors wroteBased on interview and record review, the facility failed to ensure residents who experienced a change in condition were assessed timely with adequate follow-up and physician notification for 2 residents (Resident #193 and Resident #14) out of 11 residents reviewed for quality of care, resulting in a delay in care and hospitalization and the potential for serious harm from misdiagnosed and unmanaged changes in condition.