Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 King Nursing & Rehabilitation Community during CMS and state inspections, most recent first.
A resident who wandered frequently exited through a west hall door after the exit alarm failed to alert staff. Staff did not immediately check outside when the alarm activated, and the resident was later found outside by a neighbor and returned to the facility. Investigation showed the door could be opened without properly alarming, and weekend staff were not aware they were responsible for testing the exit doors.
The facility did not conduct or document the required annual full-scale or community-based emergency preparedness exercises, nor did it provide evidence of a qualifying actual event or tabletop exercise within the past year. This deficiency was confirmed during record review and interview with the Facility Administrator, potentially affecting all occupants in the event of a disaster.
The facility did not provide documentation that the fire alarm system was fully tested and maintained according to NFPA 70 and NFPA 72, with 28 devices left untested and no records of required semiannual visual inspections. These deficiencies were confirmed during a record review and interview with the Maintenance Assistant.
The facility did not provide documentation that deficiencies from the annual sprinkler system inspection were corrected, failed to show evidence of a completed quarterly flow test, and had undated or outdated sprinkler gauges with no records of their installation or manufacture dates. These issues were confirmed by facility staff.
The facility did not provide complete documentation for the required 4-year testing of fire dampers in its HVAC system, with records showing that only a portion of the dampers were inspected or tested according to NFPA standards. This was confirmed during a review of records and an interview with the Maintenance Assistant.
The facility did not provide documentation of required weekly generator inspections for the past year, instead only documenting one inspection per month. This failure to maintain proper records and conduct inspections as required by NFPA standards was confirmed during a record review and interview with a maintenance staff member.
A resident with dementia, stroke, and hyponatremia had a physician order for a daily fluid restriction, but staff failed to monitor or document fluid intake as required. The resident was served more fluids than planned, and staff interviews confirmed that fluid intake was not being tracked. The care plan and facility policy lacked specific procedures for fluid distribution and documentation, resulting in the potential for fluid imbalance.
A resident with cancer did not receive a scheduled dose of hydrocodone, leading to a medication discrepancy. An LPN retroactively documented an unscheduled dose, which the resident denied receiving. The DON was informed, and local law enforcement suggested the LPN may have stolen the medication. Facility policies on controlled substances were not followed.
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards, potentially resulting in foodborne illness among 42 residents. Observations revealed expired and unlabeled food items in the activity room refrigerator, and the temperature log was initially found blank, indicating a lack of monitoring.
The facility failed to implement enhanced barrier precautions (EBP) for seven residents with conditions such as indwelling catheters, PEG tubes, and wounds. Observations revealed a lack of EBP signage and PPE carts, and the Director of Nursing admitted to not maintaining EBP protocols after a recent COVID outbreak.
The facility failed to implement interventions for a resident with severe cognitive impairment and ROM deficits, leading to the potential for extreme pain and worsening of contractures. Despite recommendations for palm protectors, the devices were not consistently used or documented, and staff could not confirm their application.
Elopement Due to Malfunctioning Exit Door and Inadequate Response
Penalty
Summary
The facility failed to prevent, detect, and respond to an elopement for one resident who was independently ambulatory and routinely walked around the room and facility as desired. The resident’s care plan identified wandering behavior and stated the goal was that he would not injure or harm himself secondary to wandering, with an approach to remove him from other residents’ rooms and unsafe situations. The resident was also described as agitated and busy, touching items such as fire extinguishers and door keypads, and staff reported they usually walked with him and were instructed to keep an eye on him. On the evening of the incident, the resident exited through the west hall door and went outside. Staff accounts showed that the alarm did not sound overhead as expected, and one CNA reported hearing someone say to turn off the alarm while another stated she never heard any alarm. Staff did not go outside to look for the resident when the alarm was activated, and one CNA later acknowledged she should have checked the outside perimeter. The resident was later found outside on the grass down the hill from the building and was brought back by a neighbor who had seen him in the wooded area behind the facility. The investigation found the west hall exit door was malfunctioning and could be opened without properly alarming when the key portion was moved out from the door bar. The NHA and LPN later tested the door and confirmed it could be opened without an alarm when the key spot was toggled. The maintenance director stated he tested exit doors Monday through Friday and housekeeping was responsible on weekends, but weekend staff interviewed said they did not know they were supposed to test the doors and did not check the alarms. The resident’s BIMs assessment completed after the incident showed a significant decline in cognitive status.
Failure to Conduct and Document Required Emergency Preparedness Exercises
Penalty
Summary
The facility failed to conduct the required exercises to test its emergency preparedness plan as mandated by federal regulations. Specifically, there was no documentation provided for an annual full-scale facility-based exercise or a full-scale community-based exercise. Additionally, there was no evidence of an actual event that would qualify as a test of the emergency plan, nor was there documentation of a tabletop exercise within the last year. During the survey, a review of the facility's emergency preparedness records revealed the absence of records demonstrating compliance with the annual testing requirements. The surveyor noted that the facility did not provide any documentation of having conducted the necessary drills, exercises, or actual emergency events that would satisfy the regulatory requirements for emergency preparedness testing. These findings were confirmed through an interview with the Facility Administrator at the time of record review. The lack of documentation and failure to conduct the required exercises constituted a deficiency in the facility's emergency preparedness program. This deficiency was noted to potentially affect all 61 occupants in the event of a facility-wide or community disaster, as stated in the report.
Plan Of Correction
E0039 #1 Facility failed to conduct exercises to test the Emergency Preparedness Plan at least annually. #2 Facility Maintenance Director was educated on putting Emergency Preparedness Drill copies into the Life Safety Book when completed. #3 Maintenance Director retrieved and made copies of both the Table Top Drill and an actual Emergency Drill. #4 Any further Table Top drills and/or conducted Emergency Preparedness Drill exercises will be conducted at least annually, and paperwork will be kept in the Life Safety Manual. #5 It will be the responsibility of the Maintenance Director to continue to conduct Emergency Plan Exercises at least annually.
Failure to Test and Maintain Fire Alarm System per NFPA Standards
Penalty
Summary
The facility failed to ensure that the fire alarm system was tested and maintained according to the requirements of NFPA 70 and NFPA 72. During a record review, it was found that documentation was missing to show that the fire alarm inspection was conducted as required, with a vendor report indicating that 28 devices remained untested. Additionally, there was no documentation provided to confirm that the semiannual visual inspection of the fire alarm initiating devices had been completed, as required by NFPA 72. These deficiencies were confirmed through an interview with the Maintenance Assistant during the record review. No information about specific residents, their medical history, or their condition at the time of the deficiency was provided in the report.
Plan Of Correction
K345#1 All current reports were placed in the Fire Safety Manual. The documentation for the semiannual visual inspection of the fire alarm system was completed on 3/13/25, and reports were obtained and placed in the Fire Safety Manual. Any items that need to be addressed will be corrected by Summit Fire Protection on 5/22/25. #2 A review of all reports was completed to ensure accuracy and completeness. #3 Maintenance Director was educated on following up on making sure all Fire Alarm System tests have been completed and complete paperwork is in the Life Safety Manual. #4 Any further Fire Alarm System tests will be followed up on to make sure all are completed and all paperwork is received and placed in the Life Safety Manual. #5 It will be the responsibility of the Maintenance Director and the Administrator to ensure sustained compliance.
Failure to Maintain and Document Sprinkler System Testing and Maintenance
Penalty
Summary
The facility failed to comply with NFPA 25 requirements for the inspection, testing, and maintenance of its automatic sprinkler system. During record review, it was found that the facility did not provide documentation showing that deficiencies identified during the annual sprinkler system inspection were corrected. Additionally, there was no documentation available to confirm that the required quarterly flow test of the automatic sprinkler system was completed for the first quarter of the year. Observation in the basement revealed three sprinkler gauges, one of which was dated from several years prior and two that were undated, with no documentation available regarding their installation or manufacture dates. These findings were confirmed through interviews with the Maintenance Assistant and Housekeeping/Laundry Manager.
Plan Of Correction
K353 #1 All items identified during the annual sprinkler testing of 12/23/2024 will be corrected by Summit Fire Protection on 5/22/25. A quarterly flow test was completed on 4/29/25 with no concerns. The gauges that were identified as requiring replacement will be replaced on 5/22/25 by Summit Fire Protection. #2 All residents have the potential of being affected by the deficient practice. All reports were reviewed and a corrective action repair visit was scheduled for 5/22/25. #3 Maintenance Director was educated to provide all paperwork and proof of Sprinkler System Testing in the Life Safety Manual. #4 Any further Sprinkler System Maintenance and Testing paperwork will be kept in the Life Safety Manual. #5 It will be the responsibility of the Maintenance Director and Administrator to ensure sustained compliance.
Incomplete Fire Damper Testing Documentation in HVAC System
Penalty
Summary
The facility failed to ensure that its heating, ventilation, and air conditioning (HVAC) systems were in compliance with National Fire Protection Association (NFPA) standards. During a review of facility records, it was found that documentation for the required 4-year testing of fire dampers, as specified by NFPA 80, was incomplete. A vendor report dated March 14, 2025, showed that only 15 out of 30 fire dampers had been inspected or tested. An additional vendor report from August 9, 2022, indicated that only 8 fire dampers were inspected and all passed. These findings were confirmed through an interview with the Maintenance Assistant during the record review.
Plan Of Correction
K521 #1 The missing report was obtained and placed in the Life Safety Manual to ensure all 30 items were tested. #2 All residents have the potential to be affected by this deficiency. Any deficiencies identified will be corrected by Summit Fire Protection on 5/22/25. #3 The Maintenance Director was educated on providing all paperwork as proof that the heating, ventilation and air conditioning is in compliance with NFPA and paperwork will be kept in the Life Safety Manual. #4 Any further heating, ventilation and air conditioning shall continue to stay in compliance with NFPA and paperwork will be provided and put in Life Safety Manual. #5 It will be the responsibility of the Maintenance Director and Administrator to insure sustained compliance.
Failure to Document and Complete Required Weekly Generator Inspections
Penalty
Summary
The facility failed to ensure compliance with required maintenance and testing protocols for its emergency generator system as outlined by NFPA 110, NFPA 99, NFPA 111, and NFPA 70. Specifically, during a review of facility records, it was found that documentation for weekly generator inspections over the past 12 months was incomplete. Only one weekly inspection per month was documented, rather than the required weekly inspections for each month. This deficiency was confirmed during an interview with the Maintenance Assistant at the time of the record review. The lack of proper documentation and completion of weekly generator inspections means the facility did not meet the standards necessary to ensure the emergency power system would function as required in the event of an electrical failure. The deficiency could potentially affect all occupants who rely on the emergency power source for safety and essential services during power outages, as the facility could not demonstrate that the generator was being properly maintained and inspected according to regulatory requirements.
Plan Of Correction
K918 #1 Based on record review and interview, the facility failed to ensure generators or other alternative power sources are in accordance with NFPA 110, NFPA 99, NFPA 111, and NFPA 70. This deficient practice could affect all occupants in the event of electrical failure requiring emergency generator power. #2 Facility Maintenance Director was educated that there must be weekly generator inspections and that there needs to be a monthly load test as well. #3 The Maintenance Director immediately corrected his inspections to weekly and will continue his monthly load test as well. Proof will be kept in the Life Safety Manual. #4 All further weekly and monthly logs will be kept in the Life Safety Manual. #5 It will be the responsibility of the Maintenance Director to ensure sustained compliance.
Failure to Monitor and Document Fluid Restriction for Resident with Hyponatremia
Penalty
Summary
The facility failed to monitor and document fluid intake as ordered for a resident with a physician-ordered fluid restriction due to hyponatremia. The resident was admitted with diagnoses including dementia, stroke, and hyponatremia, and had a physician order for a daily fluid restriction of 1.5 liters. Observations showed that the resident was served more fluids than planned at meals, and the resident reported not limiting fluid intake. The tray card and care plan indicated the fluid restriction, but there was no individualized plan for fluid distribution. Record review revealed that no fluid intake was documented in the medical record for the resident over a one-month period. Interviews with staff, including a CNA and an LPN, confirmed that fluids were not being documented, and the DON acknowledged there was no process in place to total or analyze fluid intake for residents on restriction. The facility's policy only required staff to be aware of residents on fluid restrictions, with no further procedures for monitoring or documentation. This lack of monitoring and documentation resulted in the potential for fluid imbalance for the resident.
Plan Of Correction
#1 Resident 6 remains in the facility and does not appear to have been affected by this deficient finding. Documentation of fluid intake has been added to the EMAR for completion each shift. Night shift will complete 24-hr totals and update the provider PRN for concerns. Care plan has been reviewed and updated regarding fluid restriction. #2 All facility residents requiring fluid restriction had the potential to be at risk for the same deficiency. No other residents were found to be affected by this deficient practice. #3 Licensed nurses, CNA's, activity staff, and therapy staff have been educated by the DON or designee regarding residents requiring fluid restriction and necessary documentation. #4 The DON or designee will audit residents requiring fluid restriction for intake documentation 3X a week for 4 weeks, then weekly for 4 weeks. Any identified concerns will be addressed immediately by the DON or designee. Finding will be submitted to the facility QA committee for further recommendations.
Misappropriation of Narcotic Medication
Penalty
Summary
The facility failed to prevent the misappropriation of narcotic medication for a resident with malignant cancer of the colon and rectum, who was under hospice care. The resident was prescribed hydrocodone acetaminophen to be administered four times a day. On the morning of November 27, 2024, a discrepancy was discovered in the medication count by a Registered Nurse (RN) during a shift change. The Controlled Substance Proof of Use form indicated that the resident should have had three remaining pills, but only two were found in the medication cart. A Licensed Practical Nurse (LPN) claimed to have administered an additional dose at 5:00 AM, which was not scheduled, and retroactively documented this on the form. The Director of Nursing (DON) was notified of the discrepancy and attempted to investigate the situation. The LPN involved left the facility and refused to return for further investigation. The resident confirmed that they did not receive the medication at 5:00 AM, contradicting the LPN's claim. An incident report from local law enforcement suggested that the LPN may have stolen the medication. The facility's policies on abuse prevention and controlled substances documentation were not followed, as the LPN failed to properly document the administration of the narcotic medication.
Failure to Store and Label Food Properly
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety, potentially resulting in a foodborne illness among the 42 residents. During an observation, three individual take-out containers in the activity room refrigerator were found without resident names or dates. One container had a Styrofoam cup with a milkshake that had mold growing on it, two packages of expired hot dogs, hot dog buns with an expired date, and a large Styrofoam container with crab Rangoon without a label or date. Additionally, the Record of Refrigeration Temperatures log for the specified date range was found blank, indicating a lack of temperature monitoring for the refrigerator during that period. The Nursing Home Administrator (NHA) initially did not notice any expired or unlabeled foods and later produced a previously blank temperature log with recorded values, suggesting falsification of data. The NHA stated that the dietary department was responsible for the cleaning and maintenance of the resident refrigerator. The facility's policy on labeling and dating food brought in by visitors was reviewed, which mandates that food items must be checked by a nurse, labeled with the resident's name and date of delivery, and disposed of after three days if refrigerated. Suspicious or contaminated food must be discarded immediately, and any food found without dates must also be discarded.
Failure to Implement Enhanced Barrier Precautions
Penalty
Summary
The facility failed to implement enhanced barrier precautions (EBP) for seven residents who required such measures due to their medical conditions. Observations revealed that Resident #3, who had an indwelling urinary catheter, did not have any EBP signage or a cart for personal protective equipment (PPE) outside her room. Similar deficiencies were noted for other residents with conditions such as PEG tubes, wounds, and PICC lines, all of whom lacked EBP signage and PPE carts. The Director of Nursing (DON) admitted to not maintaining EBP protocols after a recent COVID outbreak, resulting in the removal of PPE supplies about a month prior to the surveyor's visit. Review of physician orders and care plans for the affected residents showed no orders or interventions related to EBP. The facility's policy, dated 4/5/24, mandates the implementation of EBP for residents with wounds or indwelling medical devices, including the availability of gowns and gloves near or outside the resident's room. However, this policy was not followed, leading to the observed deficiencies in infection control practices.
Failure to Implement ROM Interventions for Resident
Penalty
Summary
The facility failed to implement interventions to address range of motion (ROM) for a resident with severe cognitive impairment and multiple diagnoses, including epilepsy and dementia. The resident's medical record indicated functional limitations due to ROM deficits in both upper and lower extremities, and the resident was observed multiple times without the recommended palm protectors or any other devices to prevent discomfort or worsening of contractures. Despite recommendations from therapy in June 2023 to use palm protectors, there were no physician orders in the resident's electronic medical record, and staff were unable to confirm the consistent use of these devices. Interviews with the Director of Nursing (DON) and a Registered Nurse (RN) revealed that they were aware of the resident's contractures but could not confirm the last time the resident used the recommended devices. The Therapy Director also confirmed that staff had been educated on applying the palm protectors but could not verify their usage or documentation since the resident was no longer receiving therapy services. The resident's care plan included encouragement for the use of bilateral palm protectors, but this intervention was not being implemented, leading to the potential for extreme pain, discomfort, and worsening of contractures.
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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 Houghton Lake
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 Of | 16.9 mi | ★★★★★ | 9 | 0 |
| Gladwin Nursing And Rehabilitation Community | 23.8 mi | ★★★★★ | 14 | 0 |
| Autumnwood Of Mcbain | 23.9 mi | ★★★★★ | 0 | 0 |
| Grayling Nursing & Rehabilitation Community | 24.4 mi | ★★★★★ | 13 | 0 |
| Munson Healthcare Crawford Continuing Care Center | 25.5 mi | ★★★★★ | 7 | 0 |
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