Above average — CMS composite of the measures below.
A standard survey is most likely before around December 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 Hamilton Nursing Home during CMS and state inspections, most recent first.
Antibiotic Stewardship Program Not Effectively Implemented: The facility failed to accurately monitor antibiotic use and infection data. One resident received Bactrim DS for a UTI without documented signs or symptoms or lab work, another resident remained on Bactrim despite a urine culture showing resistance and no documented review of the result by the IP or MD, and a third resident’s azithromycin was not captured on the infection control report, making the infection rate inaccurate.
Resident rooms did not meet required square footage standards in 18 of 28 rooms. Surveyors observed multiple-occupancy rooms that did not provide 80 square feet per resident and one single resident room that measured only 92 square feet instead of the required 100 square feet. Each room was observed, and cognitively intact residents were interviewed with no concerns observed or reported.
A facility failed to update a care plan for a resident with dementia and moderately impaired cognition. The resident's care plan initially addressed elopement risk but was not revised to reflect a low risk, as indicated by a Nursing Evaluation Quarterly assessment. Interviews confirmed the care plan should have been updated, contrary to the facility's policy on revising care plans as resident conditions change.
A resident with dementia and a history of substance abuse eloped from the facility after learning the front door code, which was not adequately supervised during dinner time. The resident, who had moderately impaired cognition, left without an authorized absence and was later found staying with family. The facility's policy on preventing elopement was not effectively implemented.
The facility failed to ensure proper food safety and sanitation practices, affecting all residents consuming food. Observations revealed that meal trays were processed without verifying the sanitizing solution, and no sanitizing log was available. The caulking on the dish machine backsplash and handwashing sink was chipped or missing, and dust was found on the eye washing station. Expired food was stored with active stock, and the ice machine's drain line lacked the required air gap.
The facility failed to maintain cleanliness in the outside garbage area, as observed with open dumpster doors and food debris on the ground, attracting pests. The Maintenance/Environmental Director confirmed that the dumpster doors should be closed to prevent critter access. The facility's policy requires waste to be handled in a sanitary manner and dumpster doors to remain closed.
The facility failed to implement an active water management plan to reduce the risk of legionella and other pathogens. The water safety plan workbook was incomplete, and the maintenance supervisor admitted to not using testing worksheets or logs. Preventative maintenance on air conditioning units was not documented. The administrator was unaware of the plan's details, and water testing was not conducted unless there was a problem, increasing the risk of respiratory infection among residents.
The facility failed to maintain its grounds, with overgrown weeds in planters visible from residents' rooms and a detached downspout. The Maintenance/Environmental Director and NHA acknowledged the issue, but no additional documentation was provided before the survey concluded.
An LPN administered an inaccurate dose of MiraLAX to a resident by using a 30-milliliter pill cup instead of the calibrated cap, resulting in the resident receiving double the prescribed amount. The resident, with a history of chronic conditions, was on MiraLAX for constipation prophylaxis. The facility's policy mandates precise medication administration.
A resident with severe cognitive impairment and multiple diagnoses experienced significant weight loss while receiving 100% of nutritional needs through a feeding tube. Despite a prescribed regimen that should have promoted weight gain, the resident's weight declined due to incomplete administration of the tube feeding. The RD was unaware of the issue, and there was no documentation explaining the incomplete feeding, leading to a deficiency finding.
A facility failed to promptly notify a physician of a resident's low Valproic Acid level, which was critical for managing their epilepsy. The resident, with moderate cognitive impairment, was on divalproex (Depakote), and the lab result was significantly below the reference range. The delay in communication was acknowledged by the DON, and the physician adjusted the medication dosage after being informed.
The facility did not provide the required square footage per resident in 18 out of 28 rooms. Observations showed that several rooms did not meet the minimum space requirements, such as room 104 with 155 square feet for 2 beds and room 113 with 92 square feet for 1 bed. No concerns were reported by residents during interviews.
Antibiotic Stewardship Program Not Effectively Implemented
Penalty
Summary
The facility failed to implement an effective Antibiotic Stewardship Program. During review of the Infection Control task, the Antibiotic Surveillance Program was examined with the Infection Preventionist, RN A, and the facility’s July 2025 infection control program showed that R40 received Bactrim DS for seven days for a diagnosis of UTI, but the Infection Report did not document signs or symptoms of UTI or any urinary lab work. RN A confirmed that the facility used McGeer’s criteria to determine whether residents had true infections and should receive antibiotics, and stated there was no documentation in the medical record to support that R40 had a UTI and no lab work was present. R27 received Bactrim DS for 10 days for a diagnosis of UTI, but there was no Infection Report and no documented signs or symptoms of infection. A urinalysis from 7/18/25 showed the resident was positive for an infection resistant to Bactrim and identified Nitrofurantoin as a more effective antibiotic against the pathogen aerococcus sanguinicola. RN A acknowledged that the urine culture indicated resistance to Bactrim, but there was no documentation that the lab report had been reviewed by RN A or the attending physician, MD B. MD B stated he reviewed most labs through an application on his cell phone and, after reviewing R27’s urinalysis, could not explain why the resident remained on Bactrim. Review of the facility’s June 2025 infection control program also showed that R4 had been prescribed azithromycin on 6/23/25, but this antibiotic was not identified on the June Infection Control Report and was not included in the facility’s infection rate, making the June 2025 infection rate inaccurate. The facility’s Surveillance for Infections policy stated that the Infection Preventionist is responsible for ongoing surveillance, that laboratory records and antibiotic review are part of surveillance data, and that positive urine cultures with corresponding signs and symptoms should be further evaluated and recorded on an individual infection report form.
Resident Rooms Did Not Meet Required Square Footage
Penalty
Summary
The facility failed to provide at least 80 square feet per resident in multiple resident rooms and at least 100 square feet for single resident rooms, affecting 18 of 28 resident rooms (#104, 105, 106, 107, 108, 109, 110, 111, 113, 204, 205, 206, 207, 208, 209, 210, 211, and 213). During observation of the resident rooms and review of the Facility Bed Count Information sheet, surveyors found that several multiple-occupancy rooms did not meet the required square footage per resident based on the number of beds and residents in each room, and room 113, a single resident room, measured 92 square feet. Each resident room was observed, and cognitively intact residents were interviewed; no concerns were observed or reported.
Failure to Update Care Plan for Elopement Risk
Penalty
Summary
The facility failed to revise a care plan in a timely manner for a resident identified as R401. The resident was admitted with diagnoses including dementia, psychoactive substance abuse, and neurocognitive disorder, and had a BIMS score indicating moderately impaired cognition. A review of the resident's care plan showed it was initially set to address elopement risk, with interventions ongoing until a target date. However, the care plan was not updated to reflect a change to low elopement risk, as indicated by a Nursing Evaluation Quarterly assessment. Interviews with the social worker and the nursing home administrator confirmed that the care plan should have been updated to reflect the resident's low risk for elopement, but this was not done in a timely manner, contrary to the facility's policy on revising care plans as resident conditions change.
Resident Elopement Due to Inadequate Supervision
Penalty
Summary
The facility failed to provide adequate supervision for a resident, identified as R401, who eloped from the facility. The incident occurred when R401 was last seen by staff at approximately 5:00 PM and was reported missing at 11:22 PM. R401 had a history of dementia, psychoactive substance abuse, and neurocognitive disorder, with a BIMS score indicating moderately impaired cognition. The resident was under the guardianship of an agency and did not have an authorized leave of absence. The facility's investigation revealed that there was no staff monitoring the front door during dinner time, which allowed R401 to learn the door code and exit the building. Interviews conducted with R401 and a family member confirmed that R401 used the front door code to leave the facility and was staying with family. The Nursing Home Administrator acknowledged that staff should be vigilant when entering the door code to prevent residents from learning it. The facility's policy on elopement, revised in June, emphasized the need for a safe and secure environment and proactive measures to prevent elopement, especially for residents with a history of substance abuse. However, these measures were not effectively implemented, leading to the resident's unsupervised departure.
Deficiencies in Kitchen Sanitation and Food Safety Practices
Penalty
Summary
The facility failed to ensure proper food safety and sanitation practices in the kitchen, which had the potential to affect all residents consuming food from the facility. During an observation, it was noted that meal trays were processed through a low-temperature chemical sanitizing dish machine without verifying the sanitizing solution, and no sanitizing log was available. Additionally, the caulking on the dish machine backsplash and handwashing sink was chipped or missing, allowing water to potentially seep behind these areas. Dust was observed on the top of the eye washing station, indicating inadequate cleaning of kitchen surfaces. Furthermore, expired food was found stored with active food stock, as approximately ten slices of American cheese with a past use-by date were discovered in the reach-in cooler. The facility also failed to maintain the required air gap for the ice machine's drain line, which was observed to lack the minimum one-inch air gap necessary to prevent backflow. These deficiencies were identified through observation, interview, and record review, and no additional documentation or information was provided by the facility before the end of the survey.
Improper Garbage Disposal and Pest Control
Penalty
Summary
The facility failed to properly dispose of rubbish and maintain cleanliness in the outside garbage area, which could potentially lead to pest harborage. During an observation, the commercial dumpster's side doors were found open, and food debris such as pizza crust, corn cob, and a partial hamburger bun were scattered on the ground near the dumpster. A squirrel was seen eating the corn cob. The Maintenance/Environmental Director acknowledged that the dumpster doors should be closed to prevent critter access. The facility's policy on Garbage and Pest Control, dated 11/30/14, mandates that waste and refuse be handled in a sanitary manner to prevent cross-contamination or pest infestation, and that the dumpster door must remain closed at all times. Despite being asked, the Nursing Home Administrator and Director of Nursing did not provide any additional documentation or information before the survey concluded.
Failure to Implement Water Management Plan for Legionella Prevention
Penalty
Summary
The facility failed to implement an active water management plan to reduce the risk of legionella and other opportunistic pathogens in its plumbing system. During a survey, it was found that the facility's water safety plan workbook was incomplete, with missing facility assessment worksheets and water testing audits. Additionally, the flow map included in the workbook inaccurately listed areas on a non-existent fourth floor. The maintenance supervisor (MS) admitted to not using testing worksheets or logs, and not establishing control limits or monitoring water systems as instructed in the workbook. Furthermore, the MS confirmed that no preventative maintenance was performed on air conditioning units, which are identified as a significant risk for legionella, other than cleaning filters, for which no documentation was provided. The facility's policy on water management was not being followed, as evidenced by the lack of completed CDC worksheets to identify risks for legionella growth and spread. The administrator was unaware of the details of the water management plan and relied on the MS to handle it. The administrator acknowledged that water testing was not conducted unless there was a problem and was unable to confirm if the water management toolkit was being utilized or implemented. This lack of adherence to the facility's water management policy increases the potential for waterborne pathogens to exist and spread, posing a risk of respiratory infection among residents.
Facility Grounds Maintenance Deficiency
Penalty
Summary
The facility failed to maintain its grounds in a clean and appealing manner, as observed during a survey. On August 20, 2024, it was noted that approximately 40 feet of outdoor planters positioned along the building and visible from residents' rooms and the dining/activity room were overgrown with weeds reaching at least five feet tall. The Maintenance/Environmental Director acknowledged the poor condition of the planters, admitting that it was not good for residents to view such overgrowth. Additionally, a downspout was found detached from the gutter along an exterior wall in the backyard. On August 22, 2024, the Maintenance/Environmental Director reiterated that the weeds were excessively tall and acknowledged there was no excuse for their growth. On August 23, 2024, the Nursing Home Administrator stated that maintenance employees should address the issue by cutting down the weeds. However, no additional documentation or information was provided by the facility before the end of the survey.
Inaccurate MiraLAX Dosage Administered
Penalty
Summary
The facility failed to administer an accurate dose of MiraLAX laxative to a resident, identified as R12, during a medication pass. On the morning of 8/21/2024, an LPN was observed preparing the medication by pouring the powdered MiraLAX into a 30-milliliter pill cup without measuring the amount. The LPN assumed the cup size was equivalent to the prescribed dose of 17 grams, as the original scoop had been misplaced. Upon questioning, the LPN admitted to using the pill cup for dosing, which resulted in the resident receiving double the prescribed amount of MiraLAX. R12, who has a medical history including chronic obstructive pulmonary disease, congestive heart failure, and vascular dementia, was receiving MiraLAX as a prophylactic treatment for constipation. The medication administration record indicated that the medication was given daily. The Director of Nursing later confirmed that the nurse should not have assumed the dosage and should have used the purple cap provided with the medication, which is calibrated for the correct dose. The facility's policy requires medications to be administered as prescribed and in accordance with manufacturers' specifications.
Failure to Address Weight Loss in Tube-Fed Resident
Penalty
Summary
The facility failed to adequately assess and address factors related to a significant weight loss in a high-risk resident who was receiving 100% of his nutritional requirements through a feeding tube. The resident, who had severe cognitive impairment and multiple diagnoses including adult failure to thrive, unspecified protein-calorie malnutrition, Parkinsonism, and a gastrostomy tube, experienced approximately 20% weight loss over six months. Despite being on a prescribed tube feeding regimen that should have met his nutritional needs, the resident's weight continued to decline. The Registered Dietitian (RD) acknowledged that the current tube feeding order should have promoted gradual weight gain but did not assess why the resident was not gaining weight. The Medication Administration Records (MAR) revealed that the resident did not receive the full amount of prescribed Jevity 1.5 on multiple occasions, which the RD was unaware of. The Director of Nursing (DON) stated that it was expected for residents on tube feedings to receive their feedings according to the RD's recommendations and physician orders. However, there was no documentation in the resident's clinical record explaining why the full amount of tube feeding was not administered. The lack of documentation and failure to investigate the incomplete administration of tube feeding contributed to the deficiency identified during the survey.
Failure to Timely Notify Physician of Abnormal Lab Results
Penalty
Summary
The facility failed to notify the physician in a timely manner regarding a low lab level for a resident who was being treated for epilepsy. The resident, who had moderate cognitive impairment, was prescribed divalproex (Depakote) to manage their condition. A lab test for Valproic Acid, which is used to monitor Depakote levels, showed a result of 18.5, significantly below the reference range of 50.0 - 100.0. Despite this abnormal result, there was a delay in notifying the physician, which was acknowledged by the Director of Nursing (DON) during an interview. The physician was eventually informed of the low Valproic Acid level and subsequently adjusted the resident's medication dosage. However, the delay in communication was a critical lapse in the facility's protocol for managing lab results and ensuring timely physician notification. The resident did not exhibit any changes in cognition or seizure activity at the time, but the deficiency highlights a failure in the facility's process to promptly report and address abnormal lab findings as outlined in the resident's care plan.
Deficiency in Resident Room Square Footage
Penalty
Summary
The facility failed to meet the required square footage per resident in multiple resident rooms and single resident rooms, affecting 18 out of 28 rooms. Observations and record reviews revealed that several rooms did not provide the minimum 80 square feet per resident in shared rooms or 100 square feet in single rooms. Specific rooms, such as room 104 with 155 square feet for 2 beds and room 113 with 92 square feet for 1 bed, were among those not meeting the space requirements. Despite these deficiencies, no concerns were observed or reported by cognitively intact residents during interviews.
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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) |
|---|---|---|---|---|
| Qualicare Nursing Home | 0.2 mi | ★★★★★ | 8 | 0 |
| Riverview Health & Rehab Center | 0.9 mi | ★★★★★ | 0 | 0 |
| Ambassador, A Villa Center | 1 mi | ★★★★★ | 8 | 0 |
| Regency At Chene | 1.3 mi | ★★★★★ | 1 | 0 |
| Mission Point Nursing & Physical Rehab Center Of D | 1.6 mi | ★★★★★ | 17 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.