West Bloomfield Health and Rehabilitation Center

Inspectors wroteThis citation pertains to intake 3002054Based on interview and record review, the facility failed to ensure interventions to prevent falls were completed and in place for one resident (R801) of two residents reviewed for falls.

Inspectors wroteThis citation pertains to intake 2696425 .Based on interview and record review, the facility failed to ensure medication was available for administration per Physician's order, utilize the reserve supply of medication for administration and accurately document administration of medication in the medical record for one resident (R903) of two residents reviewed for medication administration.

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

Inspectors wroteBased on observation, interview and record review the facility failed to ensure timely and accurate advanced directive documentation were in place for four (R29, R47, R48 and R71) out of eight reviewed for advanced directives.

Inspectors wroteBased on observation, interview and record review, the facility failed to maintain the confidentiality of medical information for one (R110) of four residents reviewed for dignity.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure two (R273 and R272) of four residents reviewed for dietary services, received meals according to their preferences.

Inspectors wroteThis citation pertains to intake #'s MI00147219 and MI00149909 Based on observation, interview and record review, the facility failed to ensure multiple allegations of verbal and physical employee to resident abuse were reported to the State Agency (SA) for two (R404 and R401) of three residents reviewed for abuse.

Inspectors wroteThis citation pertains to Intake MI00146824 Based on interview and record review, the facility failed to report an allegation of abuse (from R902) to the State Agency within the required timeframe for one (R905) of one residents reviewed for abuse, resulting in the potential for unidentified or continued abuse.

Inspectors wroteThis citation pertains to Intake MI00146824. Based on interview and record review, the facility failed to ensure additional and revised interventions were in place for one (R902) of one reviewed for behavior, resulting in the potential to exacerbate and further disrupt other residents (including R903, R904).

Inspectors wroteThis citation pertains to Intake MI00146824 Based on interview and record review, the facility failed to maintain and provide complete clinical records for one (R902) reviewed of one, resulting in the facility staff and providers not having access to all pertinent information to care for the resident.

Inspectors wroteThis citaiton pertains to intake #MI00144557. Based on interview and record review, the facility failed to ensure appropriate consents for treatment were made for one resident (R801) of three residents reviewed for consents, resulting in feelings of frustration.

Inspectors wroteThis citation pertains to intake #MI00144557. Based on interview and record review, the facility failed to ensure notification of changes for one resident (R801) of three residents reviewed for notification of changes, resulting in feelings of frustration.

Inspectors wroteThis citation pertains to intake: MI00143972. Based on interviews and record reviews the facility failed to ensure the required assistance level for care was provided for one (R404) of two residents reviewed for falls, resulting in the resident to have fell from their bed, required a transfer to the hospital due to pain, and admitted with a lateral angulated fracture of the right femoral neck and multiple left rib fractures.

Inspectors wroteBased on observation, interview and record review the facility failed to maintain sanitary conditions in the kitchen. This deficient practice had the potential to affect all residents that consume food from the kitchen:

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow protocols for residents on contact/droplet precautions and utilize correct infection control practices and protocols for disposing of contaminated Personal Protective Equipment (PPE) (R15, R83, R50, R5, R54) residents reviewed for COVID-19 (Coronavirus Disease 2019). This had the potential to affect all 130 residents who resided in the facility.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure coordination of care for hospice services for two residents (R#'s 22 and 105) of three residents reviewed for hospice services resulting in the potential for unmet care needs at the end of life.

Inspectors wroteBased on interview, and record review, the facility failed to ensure an authorized person consented to vaccinations for one resident (R97) of five residents reviewed for consents resulting in the potential the inappropriate initiation of treatments and services.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications were administered according to professional standards of practice for one (R6).

Inspectors wroteThis citation has two deficient practices. Deficient Practice #1 Based on observation, interview and record review the facility failed to ensure a Doppler diagnostic and medication order to treat (Deep-Vein thrombosis) were initiated in a timely manner for one resident (R12) of one residents reviewed for Swelling/Edema.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide appropriate medical services to prevent the development of a pressure ulcer injury for one resident (R30) out of one reviewed for pressure ulcers resulting in the development of two stage two sacral (area on lower back where the spine and pelvis meet) pressure ulcers.

Inspectors wroteBased on observation, interview, and record review, the facility failed to provide social services that included competency assessment and obtaining services for legal representation for residents without a decision maker for two (R15 and R97) of five residents reviewed for advance directives.

Inspectors wroteBased on observation, interview and record review the facility failed to properly store and dispose of outdated medications in one medication storage room and properly secure two treatment carts, of two storage rooms and five medication carts reviewed for labeling and storage.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure the daily nurse staff postings were updated daily and reflected the staffing at the facility potentially affecting all residents and visitors at the facility.

Inspectors wroteThis citation pertains to intake #MI00139289. Based on interview and record review, the facility failed to ensure a proper transfer for one resident, (R802) of three residents reviewed for accidents resulting in a 7.5 centimeter skin tear.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure potentially hazardous food items were cooled to 41 degrees Fahrenheit or less within 6 hours, failed to ensure food items were stored covered, failed to date food items when opened, and failed to store wiping cloths in chemical sanitizer. This deficient practice had the potential to affect all residents that consume food from the kitchen.

Inspectors wroteBased on observation, interview and record review, the facility failed to obtain an assessment and physician's order for self-administration of medications for one resident (R84) of one resident reviewed for self-administration of medications.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications were administered according to professional standards of practice for one (R16).

Inspectors wroteBased on interview and record review, the facility failed to ensure adequate coordination of care and maintain timely documented communication with the resident's hospice provider for one (R20) of three residents reviewed for hospice services.

Inspectors wroteBased on observation, interview and record review the facility failed to ensure the safety of a resident from possible burns/fire from a heating pad for one (R329) out of seven residents reviewed for accidents.

Inspectors wroteBased on observation, interview, and record review, the facility failed to follow their policy regarding monitoring temperature and proper functioning of refrigerators for one (R111) of one resident reviewed for having a personal refrigerator. This deficient practice may result in potentially hazardous food being held outside of the proper temperature and the increased risk of contamination and food-borne illness.