Average — CMS composite of the measures below.
A standard survey is most likely before around August 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Boulevard Temple Care Center, Llc during CMS and state inspections, most recent first.
A resident who had been deemed incapacitated received a COVID-19 vaccine after the IP documented consent and education in the EHR, despite the resident’s inability to consent and the absence of a legally authorized representative at the time consent was recorded. A family member later identified as the legal guardian stated that no verbal consent was given, no vaccine education was provided, and that COVID-19 vaccination would have been declined due to the resident’s history of Type 2 MI and concerns about cardiovascular side effects. Facility records showed a consent form signed by the resident after incapacity was established and another form signed by the IP indicating verbal consent from the family member before guardianship was in place, contrary to facility policy requiring proper legal consent and documented education before vaccination.
A resident with severe cognitive impairment was found with an unexplained bruise on her arm. The incident was not reported to the State Agency within the required timeframe because the DON, serving as backup Abuse Coordinator, was unable to access the reporting system due to unresolved technical issues. The delay in reporting was acknowledged by the NHA, who noted a lack of follow-up on the DON's system access.
The facility did not submit completed abuse investigation documentation to the State Agency within the required five-day period for two separate incidents involving resident-to-resident sexual and physical abuse. In both cases, residents with cognitive impairment were involved, and delays occurred due to administrative oversight and access issues with the reporting system.
A resident with multiple chronic conditions was found with several oral medications left at the bedside, some of which were not prescribed, and documentation indicated these medications had been administered despite not being taken. Facility staff failed to ensure medications were given per physician orders, did not observe the resident swallowing the medications, and left medications at the bedside without approval for self-administration, in violation of facility policy and professional standards.
A resident with Parkinson's disease and dementia, severe cognitive impairment, and dependence for mobility sustained a head injury after a 32-inch TV fell onto her while it was stored on an overbed table. A CNA reported the TV had been leaning earlier in the day and that the resident could reach and grasp for objects; the DON and DM stated the overbed table was not sturdy enough to safely hold the TV.
A facility failed to prevent verbal and physical abuse involving residents and staff. A CNA verbally abused a resident after being hit, and a resident with severe cognitive impairment physically abused two other residents. Despite medication adjustments, the aggressive resident continued to exhibit aggressive behaviors. The facility's abuse prohibition policy was not effectively implemented, leading to these deficiencies.
A facility failed to report an incident of resident-to-resident abuse involving two residents, where one resident with severe cognitive impairment hit another resident in the dining room. The incident was not reported to the State Agency as required by the facility's policy, and no investigation file was available. The Nursing Home Administrator believed the act was not willful due to the resident's agitated state.
A resident with severe cognitive impairment and multiple health issues reported rough handling by a CNA during ADL care. The care plan required two staff members for assistance, but the CNA proceeded alone, contrary to the directive. The DON noted the two-person requirement was due to the resident's history of false allegations and physical size. The CNA admitted not informing the nurse and continuing care alone was a mistake.
A resident was discharged with another resident's medications due to a verification error by an LPN. The medications, intended for a resident with seizure disorder and dementia, were mistakenly given to a resident with hypertension and Down's syndrome. The DON confirmed this as a medication error and HIPAA violation.
The facility failed to store delivered food stock properly, resulting in a potential for contamination and deterioration of food products. Food items, including refrigerated and dry goods, were observed stored on the floor for an extended period without being placed on a Dollie or pallet. The Dietary Manager acknowledged the lack of proper storage equipment and the inability to store the food immediately due to staff being occupied with lunch service.
A resident with multiple medical conditions was found to have a room with a gaping hole in the ceiling and another hole under the window, with cans placed to catch water. The Maintenance Director confirmed no active leaks but could not explain the presence of the cans or confirm repair requests. The facility's policy did not address the homelike environment of resident rooms.
The facility failed to maintain cooking equipment and the physical environment in a safe and sanitary manner. Observations revealed layers of old grease on kitchen equipment, chipped paint, crumbling plaster, and large stains in the kitchen and dining areas. The middle support column had detached protectors, posing an injury risk. Additionally, the air vents were soiled, and gnats were observed. Several rooms on the fifth floor had damaged walls and ceilings, and the areas between the wall and handrail on the fourth and fifth floors were dirty. The paint on an elevator door had peeled off, exposing an unsmooth surface.
The facility failed to ensure a functioning specialty mattress for a resident with stage 4 pressure ulcers, despite the resident's need and staff documentation indicating its use. The malfunction went unnoticed by the Nurse Manager and wound care nurse, leading to the potential for continued impaired skin integrity.
A resident with quadriplegia and contractures of all four extremities did not receive the necessary splints or restorative therapy to maintain or improve mobility. Despite a physician's order and an occupational therapy plan, the resident was observed without splints and reported not receiving therapy for a while. Facility staff confirmed the lack of documentation and could not explain the failure to provide the required services.
The facility failed to arrange a psychiatric evaluation for a resident with severe cognitive impairment and dementia, despite physician orders and a pharmacist's recommendation. The resident was prescribed Escitalopram for behavior issues and depression, but the necessary psychiatric services were not set up, as confirmed by the Nursing Home Administrator and Social Worker.
The facility failed to follow Infection Control protocols for two residents. One resident with Covid-19 did not receive care from staff wearing the required N-95 mask, face shield, or goggles. Another resident under Enhanced Barrier Precautions did not receive care from staff wearing gowns, despite clear signage and facility policy.
Failure to Obtain Valid Consent and Provide Education Before COVID-19 Vaccination
Penalty
Summary
The deficiency involves the facility’s failure to obtain valid legal consent and provide required education prior to administering a COVID-19 vaccine to one resident. The resident’s immunization record showed that a COVID-19 vaccine was administered intramuscularly on 12/12/2024 by the Infection Preventionist (IP) A, with the EHR documenting the vaccine status as complete, consent confirmed by IP A, and education provided. However, record review showed that the resident had been deemed incapacitated on 08/06/2024 through a statement of capacity indicating an inability to make informed medical decisions. Despite this, a consent form for the COVID-19 vaccination was signed by the resident on 10/20/2024, and a separate consent form was signed by IP A acknowledging verbal consent from a family member identified as the resident’s legal guardian on the same date. Further review and interviews revealed that the family member did not become the resident’s legal guardian until 12/05/2024 and denied ever giving verbal consent for the COVID-19 vaccination, stating that consent would have been declined due to the resident’s medical history of Type 2 myocardial infarction and concerns about cardiovascular side effects associated with the vaccine. The family member also reported that no COVID-19 vaccine education was provided to either the resident or the family member. IP A stated in interview that verbal consent had been obtained from the family member and acknowledged that incapacitated residents cannot provide consent, and the Nursing Home Administrator confirmed that consent must come from the resident or legal guardian. The facility’s own COVID-19 Vaccination Policy required a signed consent from the resident or designated health care representative, or consent by two physicians for residents incapable of consenting without a representative, and required validation of consent and education prior to vaccine administration, which was not followed in this case.
Failure to Timely Report Injury of Unknown Source Due to Reporting System Access Issues
Penalty
Summary
The facility failed to report an incident of injury of unknown source to the State Agency in a timely manner for one resident. The incident involved a resident with severe cognitive impairment, who was found with a large, purplish bruise on her left forearm above the elbow. The resident was unable to explain how the bruise occurred, and staff who worked prior to the incident did not observe the bruise. The resident had recently been on a leave of absence with her guardian to get her hair done, and upon return, did not report any pain related to the bruise. The nurse notified the DON, who then attempted to notify the Administrator, but the Administrator was out of town at the time. The facility's policy required immediate reporting of such incidents to the Administrator and DON, and notification to State or Federal agencies within specified timeframes. However, the DON, who was the backup Abuse Coordinator, was unable to access the reporting system due to ongoing technical issues that had not been resolved since August. As a result, the incident was not reported to the State Agency until several days after it was discovered. The NHA acknowledged the lack of follow-up regarding the DON's access to the reporting system, which contributed to the delay in reporting.
Failure to Timely Submit Abuse Investigation Documentation
Penalty
Summary
The facility failed to timely submit documentation of completed investigations to the State Agency regarding alleged resident-to-resident sexual and physical abuse incidents. In the first incident, one resident with severe cognitive impairment was kissed on the mouth by another resident with moderate cognitive impairment. The event was witnessed, and the facility self-reported the incident to the State Agency. However, the five-day completed investigation was not submitted within the required timeframe, as the Nursing Home Administrator was out of town and the DON, who was the backup Abuse Coordinator, was unable to access the reporting system. There was no documentation provided to show communication with the State Agency about this access issue. In the second incident, a maintenance staff member observed a resident with moderate cognitive impairment hitting another resident with severe cognitive impairment with a banana. The incident was reported to the charge nurse, and the involved residents were separated. The five-day completed investigation for this incident was also submitted late due to an oversight by the Nursing Home Administrator. Facility policy and federal regulations require that the results of all investigations be reported to the State Agency within five working days, but this was not done in either case.
Failure to Ensure Proper Medication Administration and Adherence to Physician Orders
Penalty
Summary
A deficiency occurred when a resident with multiple diagnoses, including peripheral vascular disease, hypertension, alcoholic cirrhosis of the liver, hypothyroidism, and irritable bowel syndrome, was observed experiencing stomach pain while in bed. The resident reported the pain to a CNA, who stated she informed an RN, but the RN denied receiving this information. Upon entering the resident's room, surveyors and the RN found seven oral medications left on the overbed table, with two tablets loose and five in a medicine cup. The RN identified the medications, noting that some were prescribed for gastrointestinal issues, and acknowledged that one medication, atorvastatin, was not prescribed for the resident. A review of the Medication Administration Record (MAR) revealed that the medications left at the bedside, including sucralfate, metoprolol, pantoprazole, levothyroxine, acetaminophen, atorvastatin, and oxycodone, had been documented as administered, despite not being taken by the resident. The facility's policy requires that medications are administered according to physician orders, that nurses verify medication details, and that they observe residents swallowing oral medications. The policy also prohibits leaving medications at the bedside unless the resident is approved for self-administration, which was not the case for this resident. Further review with facility leadership confirmed that the resident had not been evaluated or approved to self-administer medications. Additionally, the administration of a controlled substance (oxycodone) was inconsistently documented, being recorded on the narcotic sheet but not on the MAR. The facility was unable to explain how an unprescribed medication (atorvastatin) was given to the resident, and the medications were not administered in accordance with professional standards or facility policy.
Unsafe storage of television led to resident head injury
Penalty
Summary
The facility failed to properly secure a television for one resident, resulting in the resident receiving a head injury. The resident had diagnoses including Parkinson's disease and dementia, and an MDS assessment showed severe cognitive impairment with a BIMS score of 1 out of 15 and dependence for mobility except for eating with set-up. On 10/8/2025, the resident was observed seated in a wheelchair with a bump on the forehead and was unable to explain how the injury occurred. Record review and staff interview showed that on 9/30/25 the resident was found in bed with a television laying on top of her and a large hematoma on the left side of the forehead. A CNA stated the television had been stored on the resident's overbed table and had been leaning earlier in the day; the CNA also stated the resident was able to reach and grasp for objects. The Director of Maintenance and the Nursing Home Administrator both stated that a 32-inch television should not be stored on an overbed table because the table was not sturdy enough to safely hold it. The resident's care plan identified a history of falls and risk for fall/injury, with interventions to keep the environment safe and avoid repositioning furniture.
Failure to Prevent Verbal and Physical Abuse
Penalty
Summary
The facility failed to prevent verbal and physical abuse involving multiple residents. On one occasion, a Certified Nurse Aide (CNA) verbally abused a resident after being physically hit by the resident. The incident occurred when the CNA was distributing juice in the dining room, and the resident struck the CNA in the neck. The CNA reacted by shouting profanity at the resident, which constitutes verbal abuse. In another incident, a resident with severe cognitive impairment and a history of aggressive behavior physically abused two other residents. The first incident involved the resident hitting another resident in the dining room, which was not reported to the State Agency. The second incident involved the same resident slapping another resident, which was witnessed by a Registered Nurse (RN) who intervened by separating the residents. The aggressive resident had a history of schizophrenia and vascular dementia, and despite medication adjustments, continued to exhibit aggressive behaviors. The facility's policy on abuse prohibition was not effectively implemented, as evidenced by the failure to prevent and report these incidents of abuse. The policy outlines that residents should be free from all forms of abuse, including verbal and physical abuse. However, the incidents involving the aggressive resident and the CNA's verbal outburst indicate lapses in adherence to this policy, leading to the cited deficiencies.
Failure to Report Resident-to-Resident Abuse Incident
Penalty
Summary
The facility failed to report an incident of resident-to-resident abuse and the subsequent 5-day investigation to the State Agency. The incident involved two residents, R102 and R106, where R102 was observed hitting R106 in the dining room. Both residents were separated, and R102 was removed from the area. R102, who has a history of agitated behaviors and diagnoses of schizophrenia and severe vascular dementia with psychotic disturbance, stated that she did not like R106 and that R106 had called her a derogatory name. R106, who has moderate cognitive impairment, reported that R102 rolled her wheelchair beside hers and started hitting her but stated she was not hurt. The Nursing Home Administrator (NHA) did not report the incident to the State Agency, believing it was not a willful or targeted act due to R102's agitated state. The facility's policy requires that all allegations of abuse, including physical abuse such as hitting, be thoroughly investigated and reported to the appropriate state agencies within specified timeframes. However, the NHA indicated there was no investigation file available for this incident, and the facility did not provide any additional documentation or information during the exit conference.
Failure to Follow Care Plan for Resident Requiring Two-Person Assist
Penalty
Summary
The facility failed to provide proper care as indicated on the resident care guide for a resident dependent on staff for activities of daily living (ADL). The incident involved a resident with severe cognitive impairment, frequent incontinence, and dependence on staff for toileting hygiene. The resident, who had diagnoses including congestive heart failure, chronic obstructive pulmonary disease, unspecified dementia, major depressive disorder, conductive hearing loss, and morbid obesity, reported that a Certified Nurse Aide (CNA) was rough while providing care. The care plan required two staff members to assist with ADL care, but the CNA proceeded to change the resident alone, which was against the care plan's directive. The Director of Nursing (DON) acknowledged that the resident had a history of making false allegations, which was part of the rationale for requiring a two-person assist for ADL care. This was to ensure a collaborative witness of the care rendered for both the resident's and staff's safety, as well as due to the resident's physical size. Despite the resident's complaint of rough handling, the CNA did not inform the nurse and continued to provide care alone, admitting it was a mistake. The facility did not provide any additional documentation or information before the end of the survey.
Medication Error and HIPAA Violation During Resident Discharge
Penalty
Summary
The facility failed to ensure the proper medications were provided to a resident, identified as R104, upon discharge. R104, who had diagnoses including hypertension and Down's syndrome, was mistakenly sent home with medications labeled for another resident, R105. This error was discovered when a Home Care Nurse reported that R104 received about six different medications intended for R105. The medications included amlodipine, atorvastatin calcium, esomeprazole magnesium, donepezil, levetiracetam, baclofen, and divalproex, all of which were prescribed for R105's conditions such as seizure disorder, dementia, and hypertension. The error occurred when LPN F, responsible for discharging R104, failed to properly verify the medications against the discharge orders and prescriptions. Instead, R105's medications were mistakenly given to the transport person for R104. The Director of Nursing confirmed that the medications were incorrectly bagged due to R105 being moved to another nursing unit, and acknowledged that this incident constituted a significant medication error and a HIPAA violation. The facility did not provide any additional documentation or information to the surveyors before the conclusion of the survey.
Improper Food Storage Leading to Potential Contamination
Penalty
Summary
The facility failed to store delivered food stock properly, resulting in a potential for contamination and deterioration of food products. On two separate occasions, food stock was observed stored on the floor outside of the walk-in refrigerator and in the kitchen. The delivered food items included both refrigerated and dry goods, which were left on the floor for an extended period without being stored off the floor or placed on a Dollie. The Dietary Manager indicated that the food stock was delivered on Tuesdays and Thursdays and acknowledged that there was no available employee to store the food immediately due to lunch service duties. During an interview, the Dietary Manager explained that the department did not have a pallet or Dollie for storing delivered food stock and that the vendor had always stored the food stock in the same area until it could be put away by the staff. This practice was observed despite the 2013 Food Code, Section 3-305.11, which requires food to be stored in a clean, dry location, protected from contamination, and at least 6 inches above the floor. The failure to adhere to these standards resulted in a potential risk for contamination and deterioration of the food products.
Failure to Provide Homelike Environment
Penalty
Summary
The facility failed to provide a homelike environment for a resident (R74) who had been admitted with diagnoses including osteomyelitis, hypertension, amputation of the left lower limb, and diabetes mellitus. Observations on two consecutive days revealed a gaping hole in the ceiling above the television and hand sink, with surrounding broken plaster, and another hole underneath the window. Two large cans were placed near these areas to catch water entering through the holes. The resident reported that the holes had been present for about two months and that staff had left the cans but did not return to repair the ceiling. Additionally, the bathroom's cove base was detached from the wall around one-third of the room's perimeter. The Maintenance Director (MD) confirmed there were no active leaks in the room but was unable to explain why the cans were left there. The MD also stated that daily rounds were conducted but the issues in the resident's room had not been identified. The facility used a computerized system for entering repair requests, but the MD could not confirm if any requisitions or orders for the needed repairs were in the system. The MD acknowledged being recently hired and unaware of the identified concerns. The facility's policy on Resident's Personal Property did not specifically address the homelike environment of resident rooms.
Facility Fails to Maintain Safe and Sanitary Kitchen and Physical Environment
Penalty
Summary
The facility failed to maintain cooking equipment and the physical environment in the kitchen in a safe and sanitary manner. Observations revealed that the deep fat fryer, Vulcan stove, South bend double oven, and other kitchen equipment were covered with layers of old grease and ash. The walls and ceilings in the kitchen, dish room, and preparation areas had chipped paint, crumbling plaster, and large stains. The middle support column near the old tray line area had detached stainless-steel protectors, posing an injury risk to employees. Additionally, the air vents were heavily soiled, and gnats were observed inside a dustpan. The grill of the industrial fan was soiled, and the hand sink in the dish room continuously ran. The tile and grout in the dish machine area were soiled with a mold-like substance, and the caulking beneath the scrape table was cracked. The floor tiles underneath the dirty end of the scrape table were broken, and the drain and floor underneath the three-compartment sink were heavily soiled. The window above the three-compartment sink had missing tiles. The Dietary Manager indicated that four bids had been submitted for repairs and painting, but no approval had been received, and the kitchen was last painted seven years ago. On the fifth floor, several rooms were observed with chipped paint, bubbling plaster, detached cove bases, and stained ceilings. The dining area on the floor had multiple yellow rings. The areas between the wall and handrail on the fourth and fifth floors were covered with spilled condiments, exposed wire, food crumbs, butter, and dust. This area was used to set up trays and serve residents' food. The paint on one of the elevator doors on the North side of the first floor had peeled off, exposing a surface that was not smooth for adequate cleaning. During a Quality Assurance interview, the Nursing Home Administrator indicated that the identified concerns would be addressed.
Failure to Ensure Functioning Specialty Mattress for Pressure Ulcer Care
Penalty
Summary
The facility failed to consistently implement interventions for a resident with stage 4 pressure ulcers by not ensuring a properly functioning specialty mattress. The resident was observed on multiple occasions lying on a deflated, flat mattress despite having an order for an alternating pressure relief mattress. The resident confirmed that the mattress had not been working for a couple of days and that the issue had been reported but not resolved. The resident's Electronic Health Record indicated the necessity of the mattress for wound care, and the Medication Administration Record showed that staff had documented the mattress as being in use, despite its malfunction. The Nurse Manager was unaware of the malfunction until it was pointed out during the survey, and the wound care nurse had not noticed the issue during wound care sessions. The facility's policy or protocol related to pressure ulcers and the alternating pressure relief mattress was requested but not provided before the survey exit conference. This lack of attention to the resident's critical need for a functioning specialty mattress resulted in the potential for continued impaired skin integrity.
Failure to Provide Appropriate Services and Equipment for Resident with Limited Range of Motion
Penalty
Summary
The facility failed to ensure that a resident with limited range of motion received appropriate services and equipment to maintain or improve mobility. The resident, who had been admitted to the facility in 2017 with multiple diagnoses including quadriplegia and contractures of all four extremities, was observed on two separate occasions without the necessary splints for his bilateral upper arm contractures and right wrist joint. The resident reported that he had not received therapy for a while and that his splints had been lost and not replaced. Despite a physician's order on 1/30/24 for a therapy evaluation and treatment, there was no documentation to support that the resident had received any splints or restorative therapy since that date. Further investigation revealed that the Occupational Therapy Evaluation and Plan of Treatment dated 1/30/24 included a plan to fit the resident with appropriate splints and monitor for any adverse effects. However, the resident did not receive the splints or therapy as recommended. Both the nurse manager and the occupational therapist confirmed that there was no documentation of the resident receiving the necessary splints or restorative therapy. The occupational therapist mentioned that they were waiting for insurance authorization to start therapy, but acknowledged that the resident was a candidate for restorative therapy, which did not require insurance authorization. The physical therapist and therapy director were also unable to explain why the resident had not received the recommended splints and therapy.
Failure to Facilitate Psychiatric Evaluation for Resident
Penalty
Summary
The facility failed to facilitate a psychiatric evaluation as prescribed for a resident diagnosed with unspecified dementia and severe cognitive impairment. The resident was admitted to the facility with a diagnosis of unspecified dementia and had a Brief Interview of Mental Status (BIMS) score of 3/15, indicating severe cognitive impairment. A physician ordered Escitalopram Oxalate Tablet 10 MG to be administered daily for dementia with behavior issues and depression. Subsequently, a psychiatric consultation was ordered to evaluate the resident's behaviors and medication. However, the facility did not arrange for the psychiatric services as required, resulting in the resident not being seen by psychiatric services. The pharmacist's consultation report highlighted the absence of documentation for the indication of the antidepressant use, history of gradual dose reduction (GDR), and the expected duration of therapy. Despite the physician's response to continue the medication and have psychiatric follow-up, the psychiatric evaluation was not conducted. Interviews with the Nursing Home Administrator and the Social Worker confirmed that the psychiatric services were not set up, and it was the responsibility of the social worker to arrange these services. The facility's policy on social services indicated the need to provide or obtain necessary services for residents showing signs of distress affecting their mental and psychosocial well-being, which was not adhered to in this case.
Infection Control Protocols Not Followed
Penalty
Summary
The facility failed to ensure Infection Control protocols were followed during care for two residents. One resident, who was positive for Covid-19, did not receive care from staff wearing the required N-95 mask, face shield, or goggles. Instead, the Certified Nursing Assistant (CNA) only wore a surgical mask, gown, and gloves while feeding the resident, despite clear signage indicating the need for enhanced protective equipment. The CNA acknowledged awareness of the resident's Covid-19 status but incorrectly believed that a surgical mask was sufficient for the task at hand. Another resident, who was under Enhanced Barrier Precautions (EBP) due to a history of multidrug-resistant organism (MDRO) infection and the presence of an indwelling urinary catheter, feeding tube, and pressure ulcer wounds, also did not receive proper care. A Licensed Practical Nurse (LPN) and a Lab Technician (LT) both failed to wear gowns while providing care, despite clear signage and facility policy requiring gowns and gloves for high-contact activities. The LPN and LT acknowledged the EBP signage but did not follow the required protocols. The nurse manager confirmed awareness of these lapses and stated that staff had been educated on the proper use of PPE.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Detroit
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mission Point Nursing & Physical Rehabilitation Ce | 1.4 mi | ★★★★★ | 4 | 0 |
| Heritage Manor Nursing And Rehabilitation Center | 2.2 mi | ★★★★★ | 26 | 0 |
| The Villa At The Park | 2.9 mi | ★★★★★ | 9 | 0 |
| Mission Point Nursing & Physical Rehabilitation Ce | 2.9 mi | ★★★★★ | 26 | 0 |
| Mission Point Nursing & Physical Rehab Center Of D | 3.2 mi | ★★★★★ | 17 | 0 |
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