Wellbridge of Novi

Inspectors wroteThis citation pertains to intake 3055863 Based on observation, interview and record review, the facility failed to include resident focused and personalized interventions for incontinence care in the comprehensive plan of care for one resident (R55) of two residents reviewed for bowel and bladder programs.

Inspectors wroteThis citation pertains to intake 2990676. Based on interview and record review, the facility failed to ensure appropriate documentation of controlled substance removal, administration and accountability for one (R78) of six residents reviewed for unnecessary medications.

Inspectors wroteThis citation pertains to Intake #2634191Based on interview and record review the facility failed to ensure a resident's safety to prevent a fall and ensure x-rays pertaining to the fall were completed timely for one (R702) of one resident reviewed for falls resulting in R702 falling out of bed, sustaining a fracture to the right femur that required hospitalization, surgery and led to their death.

Inspectors wroteThis citation pertains to intake: 2634191. Based on interview and record reviews the facility failed to timely implement orders as directed by the Provider for one (R702) of one resident reviewed for a change of condition.

Inspectors wroteThis citation pertains to intake: 2634191. Based on interview and record reviews the facility failed to ensure a STAT (immediate) chest x-ray was ordered and completed as noted by the physician assistant for one (R702) of one resident reviewed for radiology services.

Inspectors wroteThis citation pertains to intake: MI00153179. Based on interview and record reviews the facility failed to adequately assess/monitor a resident with an identified change of condition, notify the Physician of continued decline and transfer the resident to a higher level of care in a timely manner, for one of six residents reviewed for a change in condition, resulting in an approximately 12 hour delay in identifying and treating the resident for an acute stroke contributing to the resident's death. The deficient practice resulted in the increased likelihood of serious harm, serious injury and/or death to occur.

Inspectors wroteThis citation pertains to Intake Number(s): MI00153132. Based on interview and record review, the facility failed to accurately reconcile and implement physician's orders from the hospital upon admission into the facility for one (R803) of two residents reviewed for admission orders, resulting in increased psychiatric symptoms including agitation, throwing objects, and combativeness.

Inspectors wroteBased on observation, interview, and record review, the facility failed to address grievances for two residents (R#'s 29 and 81) of two residents reviewed for grievances, resulting in verbalized complaints and frustration between roommates.

Inspectors wroteBased on interview, and record review, the facility failed to ensure Minimum Data Set (MDS) Assessments were completed accurately for one (R2) of 20 reviewed.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure consistent professional standards of practice were utilized by two nurses (Licensed Practical Nurse- LPN) LPN A and LPN B of four nurses reviewed for medication administration observation for one resident (R31).

Inspectors wroteBased on interview and record review, the facility failed to obtain neurology consult documentation and implement recommendations to start medication for multiple sclerosis (MS) and ensure timely follow-up evaluation was coordinated per recommendation for one (R47) of one resident reviewed for quality of care.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure an environment free from accident hazards for one (R64) of four residents reviewed for accidents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure one (R87) of one resident reviewed for bowel and bladder, who was continent of bladder and bowel, received assistance to maintain continence.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a physician documented an assessment for a competency evaluation for one resident, (R84) of one resident reviewed for competency.

Inspectors wroteBased on interview, and record review the facility failed to ensure an antibiotic medication was administered within the prescribed parameters and not in excessive dose for one (R2) of five reviewed for unnecessary medication.

Inspectors wroteBased on observation, interview and record reviews the facility failed to ensure all expired medications were removed from the residents medication storage units for one (R31) of five residents observed for the medication administration observation.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure enhanced barrier precautions (EBP) policies and protocols were followed and maintained for one (R64) of seven residents reviewed for infection control.

Inspectors wroteThis citation pertains to intake #MI00149107. Based on interview and record review the facility failed to involve a court appointed-legal guardian in the discharge process for one resident (R502) of three residents reviewed for discharge planning, resulting in R502 signing themselves out of the facility without the legal guardian's knowledge.

Inspectors wroteThis citation pertains to intake: MI00144138. Based on interviews and record review, facility failed to implement interventions and or provide adequate supervision to prevent injuries/falls for one (R901) of two Residents reviewed for falls, resulting in hospitalization for left hip fracture, preceded by emergency room visits, with subsequent decline in overall condition, pain (per the reasonable person concept) and death.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure appropriate infection control practices during medication administration observation for three residents (R284, R59, R20) of four resulting in the increased likelihood for the spread of infection.

Inspectors wroteThis citation pertains to Intake(s) MI00137603, MI00138610 and MI00138725 Based on observation, interview and record review, the facility failed to ensure resident's medications were stored securely and medication/treatment administration were followed per professional standards of practice for three residents (R2, R233 and R29).

Inspectors wroteThis citation has two deficient practice statements (DPS). DPS #1 Based on observation, interview, and record review, the facility failed to accurately assess a resident upon readmission to the facility and during subsequent skin assessments for one (R56) of two residents reviewed for an ostomy (a surgical procedure that creates an opening from an area inside of the body to the outside), resulting in the lack of monitoring and removal of stitches to the site where R56's cholecystostomy tube (a tube inserted into the gallbladder to drain fluid) was removed.

Inspectors wroteBased on observation, interview, and record review, the facility failed to evaluate and implement interventions and services for removal of a urinary catheter resulting in a Catheter Associated Urinary Tract Infection (CAUTI) for one resident (R43) reviewed for urinary catheter.

Inspectors wroteBased on interview and record review, the facility failed to ensure pharmacist recommendations were addressed during a monthly medication regimen review (MMR) for two (R71, R52) of five residents reviewed for unnecessary medications.

Inspectors wroteBased on observation, interview and record review, the facility failed to provide justification and consent for the use of antipsychotic (Quetiapine) medication for one (R52) of five residents reviewed for unnecessary medication.

Inspectors wroteThis intake pertains to Intake Number(s): MI00142258. Based on interview and record review, the facility failed to thoroughly assess and timely address a resident experiencing a change in condition and administer medications according to physician's orders for one (R802) of one resident reviewed for changes in condition, resulting in a delay in care.

Inspectors wroteThis citation pertains to Intake Number(s): MI00142602. Based on interview and record review, the facility failed to apply a thermal hot pack safety to one (R801) of one resident reviewed for burns, resulting in a burn to the right foot.