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F0609
D

Failure to Timely Report Allegations of Abuse and Neglect

Jackson, Michigan Survey Completed on 08-21-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to implement its policies and procedures for timely reporting of a reasonable suspicion of a crime, as required by section 1150B of the Act. A resident with multiple medical and psychiatric diagnoses, who was cognitively intact, submitted written grievances alleging that a registered nurse threatened her life and well-being, refused to listen to her wishes, and failed to process a physician's order to increase her pain medication. The resident referenced an EMS report related to a hospital transfer and expressed ongoing concerns about the nurse's conduct, including allegations of unequal treatment and threats. The nurse had previously received disciplinary action for not following through with physician orders, and documentation showed a pattern of similar issues. Despite the resident's written allegations, which were recognized by the covering Nursing Home Administrator as abuse allegations, the facility did not report the incident to the State Agency within the required two-hour timeframe. Instead, the formal report was made 20 days after the initial grievances were submitted. The delay in reporting was confirmed through interviews and record review, indicating a failure to follow mandated reporting procedures for suspected abuse or neglect.

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