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F0580
D

Failure to Notify Family of New and Worsening Wounds

Bloomfield Hills, Michigan Survey Completed on 12-04-2025

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 consistently notify and update a resident's family regarding newly identified wounds and the worsening of existing wounds. The resident in question was admitted with significant medical conditions, including cerebral infarction and multiple myeloma, and was dependent on staff for all activities of daily living. Documentation showed that a new wound was identified on the resident's left hip, and a sacral wound progressed to a stage IV ulcer with exudate and bone exposure. Despite these developments, there was no documentation that the resident's emergency contact, their daughter, was notified about the new or worsening wounds. Progress notes indicated that the daughter was involved in care discussions and plan modifications, but specific notifications about the skin issues were not documented. The lack of communication became evident when the daughter called emergency services to have the resident transported to the hospital, where multiple wounds were identified, including a stage IV sacral ulcer and additional pressure wounds. Interviews with facility staff confirmed that family and physicians should be notified of such changes, but no evidence of notification was provided.

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