Above average — CMS composite of the measures below.
The next survey window likely opens around June 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Novi Lakes Health Campus during CMS and state inspections, most recent first.
A resident admitted with multiple pressure injuries had no initial wound orders for the knees or ankle, and only limited coccyx care was started on admission. Several days later, the wound nurse documented worsening sacral and extremity wounds with slough, drainage, and odor, after which treatment orders were finally implemented. The resident was later sent to the hospital after the family insisted on transfer, where CT showed concern for necrotizing fasciitis and a gluteal abscess, and the resident required debridement and IV abx for an infected decubitus ulcer with fat necrosis.
A facility failed to follow current standards of practice for obtaining weights for a resident with dysphagia and severe protein-calorie malnutrition. The resident had a PEG tube placed, was NPO, and had only one documented weight in the record, with no weekly weights obtained before discharge despite a nutritional assessment noting the need for weekly monitoring.
Failure to Maintain and Communicate Water Management Program: The facility did not fully implement its Legionella WMP. The WMT did not meet regularly and had not reviewed or updated the program annually. The written plan lacked a risk assessment and did not include procedures for communicating annual Legionella test results or follow-up activities to the WMT. The DPO stated the WMT was not informed of the 2026 results, and the ED and DHS were not aware of the 2025 or 2026 sampling results.
Failure to Verify Safe Self-Administration of Bedside Medications: A resident with confusion and two other residents had topical medications observed at the bedside without MAR orders or prescriber authorization for self-administration. Another resident with diagnoses including encephalopathy, dementia, anxiety, and psychotic disorder had anti-fungal powder at the bedside, but the record showed no order for the medication or for self-administration. The DON confirmed these products are medications that should be documented on the MAR and that residents must have an order to self-administer.
Medication storage and labeling were not maintained properly in multiple carts and a medication room. An unlocked treatment cart contained resident treatment meds, a medication cart held unlabeled eye drops and nasal spray with no patient identifiers, unpackaged tablets, and expired IV fluids in a medication room cart. The DON was informed of the concerns, and ADON acknowledged the unlocked cart should not have been left that way.
Bathroom Floor Not Cleaned After Bowel Movement: A resident who was cognitively intact reported having a bowel movement during a shower, after which an aide covered it with a towel and the bathroom floor remained visibly soiled with brown material and staining for several days. An LPN, CNA, and housekeeping were involved in attempts to clean the area, but the resident and surveyor still observed the mess, and the Administrator stated it was not acceptable for the brown matter to remain on the floor.
Tube Feeding Flushes Not Set Per Order: A resident with stroke, dysphagia, and lung cancer had a physician order for automatic water flushes at 40 ml/hr, but repeated observations showed the tube feeding pump was not set for flushes and the water bag remained full. The DON verified the settings were blank and stated the resident should have been receiving the ordered automatic flushes.
A resident’s medical record was incomplete and inaccurate because the face sheet did not list diagnoses, yet a social service note documented depression and insomnia. Staff said diagnoses were being pulled from hospital records when face sheets were blank, but the SSD could only verify a history of insomnia and could not confirm depression. The Administrator and CCRN acknowledged delays in entering diagnoses and concern about incorrect diagnoses in the record.
A resident with multiple chronic conditions was given metoprolol despite physician orders to hold the medication for low systolic blood pressure. The medication was administered on two occasions when the resident's blood pressure was below the specified threshold, and the resident subsequently required intervention for low blood pressure. The DON confirmed the medication should have been held according to the order.
The facility failed to provide readily accessible Medication Regimen Review (MMR) documentation within the EMR for five residents during an investigation into unnecessary medications. Additionally, a resident was observed with a power cord wrapped around her fingers, and her activity records were not found within the EHR. The Administrator acknowledged the issue and mentioned a potential pilot program to address it.
The facility failed to ensure proper infection control protocols, including EBP, hand hygiene during medication pass, and cleanliness of medical equipment for multiple residents. Several LPNs did not perform proper hand hygiene, and there was a lack of clear policy on cleaning medical equipment, leading to unsanitary conditions.
The facility failed to provide SNFABN forms detailing estimated charges of continued services for three residents, as required by policy. Interviews and record reviews revealed that the responsible staff were unable to provide the necessary forms, and the Administrator confirmed the documents could not be located.
A facility failed to provide facial hair removal for a dependent resident who expressed a desire for it. Despite the resident's care plan indicating that facial shaving should be offered, staff did not take action, and there was no documentation of facial hair removal in the resident's shower schedule. Interviews with staff confirmed awareness of the issue but no action was taken.
The facility failed to provide competency documentation for three CRCAs, resulting in the potential for staff incompetency and/or harm to residents' well-being. The NHA was unable to retrieve the necessary documentation and confirmed the absence of an acting staff educator and a policy for regular in-service education.
The facility failed to document annual performance reviews and the required 12-hour in-service education for three CRCAs. The NHA was unable to retrieve the necessary documentation and confirmed the absence of a staff educator and a specific policy for regular in-service education.
The facility failed to ensure that resident food items stored in the [NAME] Parlor refrigerator were labeled, dated, and discarded when expired. Several undated or expired food items were found, and the refrigerator temperature had not been logged. The Dietary Manager admitted the refrigerator had not been checked during his absence.
Delayed Pressure Wound Treatment and Failure to Respond to Worsening Wounds
Penalty
Summary
The facility failed to timely implement appropriate treatment and interventions for a resident’s pressure wounds and failed to identify and respond to worsening wound conditions. The resident was admitted with diagnoses including rhabdomyolysis and acute kidney failure and required assistance with ADLs. Transfer paperwork from the hospital documented a coccyx deep tissue injury, bilateral knee unstageable wounds, and a left ankle unstageable wound, with specific wound care instructions including cleansing, topical treatment, offloading, turning every 2 hours, and pressure relief measures. On admission to the facility, nursing documentation noted an open area to the coccyx and bruising to both knees, but the initial orders implemented addressed only incontinence care and protective ointment after episodes. There were no initial orders for the left ankle or knees. Several days later, the wound nurse documented multiple ulcers to the bilateral knees, sacrum, and left lateral ankle, including a sacral wound with 90% slough, seropurulent drainage with a green tinge, and a slight fruity odor. Orders for wound treatment to the knees, sacrum, and left ankle were then implemented, along with monitoring and pressure-relief interventions. The resident’s condition continued to worsen, and the family expressed concern that the wound was infected and that the resident was declining. The resident was later transferred to the hospital after the daughter insisted on immediate transfer for evaluation of the buttock wound. Hospital records documented CT findings concerning for necrotizing fasciitis and a left gluteus maximus intramuscular abscess, with possible osteomyelitis, and the resident underwent debridement and received IV antibiotics. Subsequent hospital documentation described an infected decubitus ulcer with abscess and fat necrosis, and the discharge summary noted treatment for infected decubitus ulcer with debridement before discharge to another group home.
Failure to Obtain Required Weights for a Resident with Dysphagia and Malnutrition
Penalty
Summary
The facility failed to follow current standards of practice for obtaining weights for one resident with nutritional concerns. The resident was admitted with diagnoses including cerebral infarction, dysphagia, and severe protein-calorie malnutrition, and required staff assistance with ADLs. A single documented weight of 167 lbs. was obtained on 7/5/26, and no other weights were documented in the medical record. The record also showed that the resident had ongoing dysphagia and later had a PEG tube placed due to that condition. A nutritional assessment completed almost two weeks after admission documented that the resident was NPO related to dysphagia, that the current enteral order was adequate to meet nutritional needs, and that nursing reported the resident was tolerating feedings via pump. The assessment suggested bolus feedings and weekly weight monitoring, but the facility did not obtain weekly weights for the resident before discharge. The DON acknowledged that no other weights were obtained and stated the resident was discharged shortly after the dietitian saw the resident, before weekly weights could be started.
Failure to Maintain and Communicate Water Management Program
Penalty
Summary
The facility failed to implement key elements of its infection prevention and control water management program for Legionella and other opportunistic pathogens of premise plumbing. During review of the Legionella Water Management Plan, the Water Management Team was identified as the Executive Director, Director of Plant Operations, Director of Health Services, and Director of Environmental Services, but the Director of Plant Operations stated the team did not meet regularly and had not met in the past year. The current water management program had not been reviewed or updated annually by the Water Management Team, and the written program did not include a facility risk assessment to identify areas where Legionella and other opportunistic waterborne pathogens could grow and spread. The water management program also lacked procedures for communicating program activities to the Water Management Team, including annual Legionella testing results and follow-up activities. Although the facility conducted annual Legionella testing, the Director of Plant Operations stated the Water Management Team was not informed of the 2026 test results and no retesting had occurred. The Director of Health Services and Executive Director both stated they were not aware of the 2025 or 2026 Legionella sampling results. An additional corporate SOP titled Annual Legionella Testing directed facilities management support to collaborate with the campus and vendor lab to create an action plan for positive results and to upload results, retests, and steps taken into electronic maintenance logs, but it did not include procedures for communication of testing results with the facility Water Management Team.
Failure to Verify Safe Self-Administration of Bedside Medications
Penalty
Summary
The facility failed to determine that self-administration of medications was safe and appropriate for three residents who had medications at the bedside. For one resident, two tubes of Vitamin A&D ointment and one tube of Calmoseptine were observed on the bedside table, but the MAR did not show orders for those medications and there was no prescriber order for self-administration. The resident was interviewed with a daughter present, and the resident could not explain the purpose of the medications; the daughter stated the resident had confusion and would not understand their use, and also described a history of dry skin over the eye and chaffing between the legs. For another resident, a tube of Vitamin A&D ointment was observed on the bedside table during medication administration, but the MAR did not indicate it was ordered and there was no prescriber order to self-administer. For a third resident, a tube of Zinc Oxide was observed at the bedside, and the MAR did not indicate Vitamin A&D was ordered and there was no prescriber order to self-administer. In a separate observation, two bottles of anti-fungal powder were found on the nightstand of a resident with diagnoses including encephalopathy, dementia, anxiety, and psychotic disorder; the resident stated the powder was applied under the breast for fungus-related itchiness, but the clinical record did not show any orders for fungal powder or any order allowing self-administration. The DON confirmed that Vitamin A&D ointment, Calmoseptine, and Zinc Oxide are medications that should be documented on the MAR and acknowledged residents must have an order to self-administer and medications are not left at the bedside.
Medication Storage and Labeling Deficiencies
Penalty
Summary
Medications and biologicals were not stored safely, securely, and properly in one medication administration cart, two treatment carts, and one medication room. On 7/7/26, a treatment cart on the [NAME] Trail was observed unlocked with resident treatment medications in the top drawer. Later that morning, the [NAME] Trail medication cart contained a bottle of lubricating eye drops and a nasal spray with no patient identifiers, and LPN C stated they did not know who the medications were prescribed to. The same cart also contained an unpackaged orange tablet and two unpackaged white tablets in separate drawers. In the [NAME] Lane medication room, the lower drawer of a medication cart contained IV fluids that ADON E identified as current medications for residents needing IV fluid replacement. Several bags were expired, including two D5 bags expired in October 2025, one D10 bag expired in April 2025, one 0.45% saline bag expired in April 2025, and one D5 with normal saline bag expired in January 2026. ADON E acknowledged the medications were expired and discarded them. The DON later stated nursing staff had informed them about the unidentified medications, expired IV fluids, and the unlocked treatment cart. On 7/8/26, another treatment cart was again observed unlocked with resident treatment medications in the top drawer, and ADON E acknowledged it should not have been left unlocked.
Bathroom Floor Not Cleaned After Bowel Movement
Penalty
Summary
The facility failed to provide a clean, comfortable, homelike environment for one resident who was observed sitting in a wheelchair in their room and was cognitively intact per a BIMS dated 7/6/26. The resident reported that on Saturday they were showering when they had a bowel movement, and the aide placed a towel over it. The resident also stated that on Sunday they told an LPN that the bathroom floor had not been cleaned, and that three people were sent in to clean it, but it still was not clean. When the bathroom was observed, multiple spots of brown material were seen on the floor between the toilet and shower area, along with an area of grout that appeared to have dried brown liquid on it. The same brown spots and grout staining were still observed on the bathroom floor on 7/7/26. The LPN stated that a CNA had been thought to have cleaned the area after the bowel movement during the shower, but the resident later said it was still not clean, so the LPN sent the CNA back with two other staff members to clean it. The CNA stated she had tried to clean the bowel movement up with towels as best as she could and later finished trying to clean it with a friend. The Administrator stated it was not acceptable for brown matter to remain on the bathroom floor from Saturday to Tuesday and said the floor should have been cleaned on Saturday. The facility policy on room cleaning stated to clean the floor and remove trash, replacing bags, and to use the room service standards checklist to ensure the room meets standards.
Tube Feeding Flushes Not Set Per Order
Penalty
Summary
The facility failed to ensure that tube feeding automatic water flushes were administered according to the physician order for one resident, R70, who was admitted with diagnoses including stroke, dysphagia, and lung cancer. R70 was cognitively intact per a BIMS dated 7/3/26 and had a care plan that included administering enteral feeding per doctor’s order and assessing for dehydration. The physician order dated 7/5/26 directed automatic water flushes at a rate of 40 ml/hr. On 7/6/26 and again on 7/7/26, R70 was observed in bed with a tube feeding pump delivering formula and a separate water bag hanging from the pole, but the pump was not set for automatic water flushes and the settings were blank. The water bag remained full at the 1000 ml mark during these observations. The DON later verified that the flush bag was full and the pump was not set to deliver automatic flushes, and stated that R70 should have been receiving automatic flushes at 40 ml/hr.
Incomplete and Inaccurate Resident Diagnosis Documentation
Penalty
Summary
The facility failed to ensure one resident’s medical record was accurate and complete. During observation, the resident was found lying in bed, alert, but having difficulty answering questions because of a language barrier, and the resident’s family member stated the resident had been admitted following a fall at home. Review of the electronic medical record showed the face sheet did not list the resident’s diagnoses, even though the surveyor’s guide directed review of the face sheet for current ICD-10 diagnoses. Further record review found a social service note stating the resident was admitted with diagnoses of depression and insomnia and would remain on trazodone. When questioned, the Social Service Director said the diagnoses were obtained from hospital records when no diagnoses were listed on the face sheet, but after reviewing the hospital record could only locate a history of insomnia and could not find a diagnosis of depression, stating the note would need revision. The Administrator acknowledged that newly admitted residents’ diagnoses were not being entered into the medical record by facility staff, and the Corporate Clinical RN confirmed awareness of the delay and that incorrect diagnoses in the record were a concern.
Failure to Hold Blood Pressure Medication per Physician Order
Penalty
Summary
A facility failed to administer blood pressure medication according to a physician's order for one resident following their re-admission after a hospital stay. The resident had multiple diagnoses, including chronic obstructive pulmonary disease, hypertensive heart disease with heart failure, chronic kidney disease, diabetes, and anxiety disorder. The physician's order for metoprolol specified that the medication should be held if the resident's systolic blood pressure (SBP) was less than 110 or heart rate (HR) was less than 60. Despite this, the medication was administered on two occasions when the resident's SBP was documented as 101/56 and 101/59, both below the specified threshold. A progress note indicated that after one of these administrations, the resident's blood pressure remained low, with a last reading of 85/57, prompting notification of the nurse practitioner and a new order for a one-time dose of Midodrine to address the low blood pressure. The facility's Director of Nursing confirmed in an interview that the metoprolol should have been held per the instructions. The facility's policy on medication administration requires medications to be given in accordance with prescriber orders, which was not followed in this instance.
Plan Of Correction
F684 SS=D Quality of Care Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents' choices. Element 1 Resident #901 no longer remains within the facility. Nurse "A" that completed medication errors received 1:1 education on following parameters noted within blood pressure medication orders. Element 2 All current residents receiving blood pressure medications that have parameters have the potential to be affected by this citation. These residents have had a medication administration record reviewed for the last 7 days to ensure blood pressure medications were administered appropriately. Element 3 Actively scheduled floor nurses have been educated on medication administration policy and specifically following parameters noted within blood pressure medication order. Actively scheduled floor nurses that have not completed this education by the date of compliance will be in-serviced prior to their next shift. Element 4 DHS/Designee will audit 5 residents' administration records that have blood pressure medications with parameters to ensure the assigned nurse followed the parameters listed within the medication order x4 weeks. Findings/trends will be submitted to the QAPI committee for review and recommendation on continued audits. Executive Director is responsible for obtaining compliance. Element 5 July 3rd, 2025
Failure to Provide Accessible Medical Records
Penalty
Summary
The facility failed to provide readily accessible Medication Regimen Review (MMR) documentation within the Electronic Medical Record (EMR) for five residents (R17, R27, R33, R150, R15) during an investigation into unnecessary medications. On 4/16/24, the EMR was reviewed for these residents, and MMR documentation was not readily accessible. The Director of Nursing (DON) confirmed that MMR documentation is not located in the EMR but is uploaded into a different software program, requiring designated staff members to retrieve it. This lack of accessibility hinders the ability of all disciplines to obtain necessary information regarding the residents' conditions, care, and services. Additionally, on 04/15/24, a resident (R251) was observed lying in bed with the power cord for the overhead light wrapped tightly around her fingers, appearing anxious and restless. A family member reported that the resident often fixates on the cord/light and is difficult to redirect. On 04/16/24, an attempt to review the resident's activity records within the EHR was unsuccessful, as no records were found. The Life Enrichment Director reported that a change of condition assessment had been completed for the resident, but those records were documented in a separate EHR system, to which the survey team was not given access. The Administrator acknowledged that the facility's documents were not all located in the residents' electronic records and mentioned that a sister facility was working on a pilot program to address this issue.
Infection Control Deficiencies
Penalty
Summary
The facility failed to ensure proper infection control protocols and practices, including enhanced barrier precautions (EBP), hand hygiene during medication pass, and proper cleanliness of medical equipment for multiple residents. For instance, R150, who required EBP due to a dialysis catheter, had no precaution signs on their door on multiple occasions. Similarly, R44, who had a feeding tube, initially had no EBP notification on their door until it was later posted by the Director of Nursing (DON). R18, who was dependent on a PEG tube, had visibly soiled tube feeding equipment, and there was no EBP signage or PPE visible in or around the room until much later. Additionally, R20, who had a Foley catheter, also lacked EBP documentation on their door until an order was entered later in the day. During medication administration, several Licensed Practical Nurses (LPNs) failed to perform proper hand hygiene. LPN C did not perform hand hygiene before administering medications to R202, LPN D did not perform hand hygiene before administering medications to R203, and LPN E picked up a paper towel off the floor and proceeded to administer medications to R204 without performing hand hygiene. The DON confirmed that hand washing should have been performed prior to administering medications. The facility also lacked a clear policy on cleaning medical equipment, as evidenced by the soiled condition of R18's tube feeding equipment. When questioned, the assigned Registered Nurse (RN) G incorrectly stated that housekeeping was responsible for cleaning the equipment. The DON confirmed that the equipment was not sanitary and needed cleaning. The Nursing Home Administrator (NHA) later confirmed that there was no specific policy for cleaning medical equipment, indicating a gap in infection control practices.
Failure to Provide SNFABN Forms
Penalty
Summary
The facility failed to provide a Skilled Nursing Facility Advanced Beneficiary Notice (SNFABN) detailing estimated charges of continued services for three residents. The deficiency was identified during a review of 88 residents who were discharged from Medicare-covered Part A stay within a specified period. The review focused on three residents who either discharged from the facility or decided to remain. The facility was unable to provide the requested SNFABN forms for these residents, indicating a failure to notify them of their discontinuation of service coverage and their rights to proceed. An interview with the Social Service staff revealed that they were responsible for issuing SNFABN forms but were newly employed and unable to provide the forms for the specified residents. The Administrator also confirmed the inability to locate the requested documents. The facility's policy requires the issuance of a Notice of Medicare Non-Coverage (NOMNC) two calendar days prior to the actual discharge from Medicare, but this procedure was not followed for the residents in question.
Failure to Provide Facial Hair Removal for Dependent Resident
Penalty
Summary
The facility failed to ensure a dependent resident was provided with unwanted facial hair removal. On two separate occasions, the resident was observed with long facial hair and expressed a desire for it to be removed. The resident reported that they had not had their facial hair removed in a long time and were only receiving bed baths. The resident's care plan indicated that facial shaving should be offered on shower days, as needed, or upon request. However, there was no documentation of facial hair removal in the resident's shower schedule, and the last recorded shower was several days prior to the observations. Interviews with facility staff, including the CNA assigned to the resident and the Director of Nursing, revealed that the staff were aware of the resident's long facial hair but did not take action to remove it. The CNA stated that the resident did not ask for the hair to be removed, and the DON confirmed that the resident should have had their facial hair removed according to the care plan. The facility's policy on ADL documentation guidelines was reviewed, which stated that ADL services should be conducted and documented by the CNA each shift at the point of care or as reasonably possible after care.
Failure to Provide Competency Documentation for CRCAs
Penalty
Summary
The facility failed to provide competency documentation with proficiency of skills and techniques necessary to care and assure resident safety for three Certified Resident Care Associates/Certified Nursing Assistants (CRCA/CNA J, K, M) out of five reviewed. This deficiency was identified during an interview and record review process. On 4/16/2024, the Nursing Home Administrator (NHA) was unable to provide the requested documentation for CRCA J, K, and M, citing a delay due to a support call placed to the Internal Technology (IT) department. By 4/17/2024, the NHA confirmed that the retrieval of the competency documentation was unsuccessful and revealed that the facility did not have an acting staff educator or a policy regarding regular in-service education for CRCAs, relying solely on regulations instead.
Failure to Document Annual Reviews and In-Service Education for CRCAs
Penalty
Summary
The facility failed to provide documentation of annual performance reviews and the required minimum 12-hour in-service education competencies for three Certified Resident Care Associates/Certified Nursing Assistants (CRCA/CNA J, K, M) out of five reviewed. This deficiency was identified during an interview and record review process. The Nursing Home Administrator (NHA) was unable to retrieve the necessary documentation for these CRCAs, despite placing a support call to the Internal Technology (IT) department. The NHA confirmed that the facility could not verify if the annual performance reviews and in-service education competencies were completed for these staff members. Additionally, the NHA revealed that there is no acting staff educator for the facility and that the facility does not have a policy regarding regular in-service education for CRCAs, instead following general regulations.
Failure to Label, Date, and Discard Expired Food in Resident Refrigerator
Penalty
Summary
The facility failed to ensure that resident food items stored in the [NAME] Parlor refrigerator were labeled, dated, and discarded when expired. During an observation at 9:30 AM, several food items were found undated or past their use-by dates, including a container of green pudding, a sub sandwich, multiple brown bags labeled 'leftover meal,' a Pyrex container of meat and vegetables, a half-eaten cheeseburger, a container of pasta, and a plastic bag of unknown food. Additionally, the refrigerator temperature had not been logged since [DATE]. When queried, the Dietary Manager (DM) admitted responsibility for monitoring the refrigerator but noted it had not been checked during his absence the previous week. The facility's policy requires food brought in by family members, friends, or guests to be properly labeled, date-marked, stored, and discarded according to the facility's procedures, which was not adhered to in this instance.
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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 Novi
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Fox Run Village | 1.1 mi | ★★★★★ | 3 | 0 |
| The Manor Of Novi | 1.9 mi | ★★★★★ | 22 | 0 |
| Maple Manor Rehab Center Of Novi Inc | 2 mi | ★★★★★ | 7 | 0 |
| Wellbridge Of Novi | 3.4 mi | ★★★★★ | 2 | 0 |
| Marvin & Betty Danto Health Care Center | 4.1 mi | ★★★★★ | 6 | 0 |
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