Above average — CMS composite of the measures below.
A standard survey is most likely before around November 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 Regency At Lansing West during CMS and state inspections, most recent first.
A resident with a history of falls, humerus fracture, and joint replacement, care planned for touching assistance with one helper and a 2‑wheeled walker for ambulation, experienced a fall when staff did not follow these requirements. On the day of the event, the resident was assisted to standing by a CNA and then left standing alone while the CNA went into the bathroom, contrary to the care plan. The resident was later found on the floor at the foot of the bed and reported trying to get to the walker. Another CNA reported arriving as the fall was occurring, noting that a walker was present but not really being used and that no gait belt was in place, despite facility staff defining touching assistance as requiring hands‑on guidance with a gait belt.
A resident with a history of falls and recent orthopedic issues experienced a fall that was documented inconsistently and inaccurately in the medical record. Nursing notes stated the resident attempted to transfer independently from bed to walker and was later found on the floor, while an incident report recorded the resident’s statement that she was ambulating to the bathroom with a CNA present when she lost balance. Interviews with an LPN, an RN, a CNA, and the DON revealed multiple, conflicting accounts, including that a CNA had assisted the resident to stand, left the resident standing while preparing the bathroom, and that another CNA saw the aide lowering the resident to the floor without a gait belt and with the walker not truly in use. These discrepancies show the medical record did not accurately reflect how the fall occurred.
A resident with cognitive impairment and a history of femur fractures fell twice due to the bed being left in an elevated position, contrary to the care plan. The second fall resulted in bilateral femur fractures, requiring surgical intervention. Staff interviews confirmed the bed was not in the low position as required.
A resident with cognitive impairments alleged sexual abuse by a CNA during care, but the facility failed to report the incident to the State Agency. The DON and NHA concluded it was not an abuse allegation, treating it as a grievance instead. This decision was against the facility's policy, which requires immediate reporting of abuse allegations.
The facility failed to provide and complete necessary beneficiary notifications for three residents regarding their Medicare and Medicaid coverage. A resident with multiple diagnoses did not have signed and dated NOMNC and SNFABN forms. Another resident did not receive an SNFABN before the end of Medicare A services. A third resident's SNFABN was signed but lacked selected options for care continuation or appeal. The Nursing Home Administrator could not explain these deficiencies.
Three residents in the facility did not receive adequate ADL care, including hygiene and grooming. One resident was found in a soiled state with unmet hygiene needs, another reported not receiving scheduled showers, and a third was left to eat without required assistance. The facility's documentation confirmed lapses in care, and the DON was unable to explain these deficiencies.
A resident did not receive timely laboratory tests as ordered by their physician due to an error in entering lab orders into a new system. The tests, including CBC, CMP, and HgbA1c, were delayed significantly, with some not performed until months after the scheduled dates. This deficiency was noted during pharmacy medication reviews, where the absence of lab results was documented.
A resident with multiple medical conditions, including COPD and hemiparesis, was found without water at the bedside, leading to potential dehydration. Despite being cognitively intact and requesting water, staff often forgot to provide it. The resident required IV fluids for hydration, and a staff member admitted that water was not always provided due to time constraints.
Failure to Follow Care Plan and Provide Required Assist During Ambulation, Resulting in Fall
Penalty
Summary
The facility failed to ensure an area was free from accident hazards and to provide adequate supervision to prevent a fall for one resident. The resident was admitted with a history of falling, a humerus fracture, and joint replacement surgery. The admission MDS showed the resident was cognitively intact and required touching assistance with one helper and use of a 2‑wheeled walker for ambulation, as documented in the care plan initiated in mid‑December. Facility staff, including the RN and DON, described "touching assistance" as requiring staff to touch, guide, and maneuver the resident while using a gait belt. On the date of the incident, nursing documentation recorded that the resident was found on the floor at the foot of the bed after attempting to transfer from bed to walker and reported trying to get to the walker. A fall incident report documented the event as unwitnessed, but also recorded the resident’s statement that she was ambulating to the bathroom using her walker with a CNA present when she lost her balance. In interviews, the DON reported that the CNA assisted the resident to a standing position and then left the resident standing while going into the bathroom to get things ready, after which the resident fell. Another CNA reported arriving at the tail end of the fall, seeing another aide lowering the resident to the floor, with a walker present but not really being used and no gait belt in place. Staff interviews and record review confirmed that, contrary to the care plan, the resident was left standing alone without the required touching assistance, gait belt use, and proper use of the walker at the time of the fall.
Inaccurate Documentation of Resident Fall Event
Penalty
Summary
The facility failed to maintain accurate medical records for a resident by documenting conflicting and inaccurate information about the circumstances of a fall. The resident was admitted with a history of falling, a humerus fracture, and joint replacement surgery, and was cognitively intact per the admission MDS. On the date of the fall, nurses’ notes documented that the resident attempted to transfer from bed to walker, was observed on the floor at the foot of the bed, and stated she was trying to get to her walker. The resident was then educated to use the call light and request assistance with ambulation. An incident report, marked as privileged and not part of the medical record, described the fall as unwitnessed and recorded that the resident stated she was ambulating to the bathroom using her walker with a CNA present when she lost her balance. Interviews revealed additional, conflicting accounts that were not accurately reflected in the medical record. LPN D stated that when a code purple was called, the resident was already on the floor and that there were mixed stories about how the fall occurred. RN F, who did not witness the fall, acknowledged confusion regarding the documentation discrepancies. CNA E reported arriving at the tail end of the fall and seeing another aide lowering the resident to the floor, with a walker present but not really being used and no gait belt in place. The DON reported that CNA C, who assisted the resident, stated she had helped the resident to a standing position, left her standing while going into the bathroom to get things ready, and then the resident fell. These differing accounts show that the medical record did not accurately reflect the incident as it actually occurred.
Failure to Prevent Resident Fall Due to Bed Height Negligence
Penalty
Summary
The facility failed to prevent a fall for Resident #150, who was cognitively impaired and required a two-person assist with a Hoyer lift for transfers. The resident's care plan specified that the bed should be in the lowest position at all times unless care was being provided, and the bed remote should be out of the resident's reach due to cognitive inability to safely position the bed. However, on two separate occasions, the resident's bed was left in an elevated position, contrary to the care plan. On the first occasion, the resident was found on the floor next to her bed with the bed in an elevated position, resulting in complaints of pain. The incident report confirmed that the bed was not in the lowest position, and the resident was unable to explain how the fall occurred due to cognitive impairment. On the second occasion, the resident was found on the floor again, with the bed at waist level, after attempting to go to the bathroom. This fall resulted in bilateral femur fractures, requiring surgical intervention and a shift to comfort measures in alignment with the family's wishes. Interviews with staff confirmed that the bed was not in the low position as required by the care plan. The CNA responsible for the resident's care at the time of the second fall admitted to leaving the bed at waist level after providing care. The Director of Nursing confirmed that the plan of care was not followed, leading to the resident's fall and subsequent injuries.
Failure to Report Alleged Sexual Abuse
Penalty
Summary
The facility failed to immediately report an allegation of sexual abuse involving a resident to the State Agency. The resident, who was admitted with diagnoses including generalized anxiety disorder, major depressive disorder, and dementia, reported to a complainant that a CNA had sexually assaulted her during a bed bath. The incident was alleged to have occurred on a specific date, but the facility did not report it to the State Agency as required. The Director of Nursing (DON) and other staff members were informed of the resident's allegations. The resident expressed fear and initially hesitated to report the incident. Despite the resident's claims, the DON concluded that the incident did not constitute sexual assault and treated it as a grievance rather than an abuse allegation. The DON's decision was based on the resident's demeanor during the interview and the lack of specific allegations of inappropriate physical contact. The facility's policy mandates that all allegations of abuse must be reported to the appropriate state agencies. However, the DON and the Nursing Home Administrator, who is also the designated abuse coordinator, agreed that the incident did not need to be reported. This decision was contrary to the facility's policy, which requires thorough investigation and documentation of such allegations, as well as immediate reporting to the relevant authorities.
Failure to Provide Beneficiary Notifications
Penalty
Summary
The facility failed to provide and complete the necessary beneficiary notifications for three residents regarding their Medicare and Medicaid coverage. Resident #43 was admitted with multiple diagnoses, including dementia and COPD, and was discharged and readmitted with Medicare A services. However, the Notice of Medicare Non-Coverage (NOMNC) and the Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNFABN) lacked signatures and dates to verify receipt. Resident #53, who was admitted with conditions such as pneumonia and chronic kidney disease, did not receive an SNFABN before the completion of Medicare A services. Resident #91, with severe cognitive impairment, had an SNFABN that was signed but did not indicate any option selected for appealing the decision or continuing care at personal expense. During an interview, the Nursing Home Administrator (NHA) could not explain the absence of signatures on the NOMNC and SNFABN for Resident #43, nor the lack of an SNFABN for Resident #53. Additionally, the NHA could not clarify why Resident #91's SNFABN did not show any selected options regarding the continuation or cessation of care. These deficiencies indicate a failure in the facility's process to ensure residents are properly informed about their coverage and potential liabilities for services not covered by Medicare or Medicaid.
Failure to Provide Adequate ADL Care
Penalty
Summary
The facility failed to provide necessary services for Activities of Daily Living (ADL) for three residents, resulting in unmet care needs. Resident #9, who was admitted with multiple diagnoses including chronic obstructive pulmonary disease and hemiplegia, was found in a hospital gown with food debris, a crusted eye, and long, dirty fingernails. Her call light was out of reach, and she reported sitting in a wet brief for an extended period. Despite being cognitively intact, she expressed dissatisfaction with the frequency of her hygiene care and the availability of water. Resident #83, diagnosed with conditions such as COPD, dementia, and type 2 diabetes, was observed in an unkempt state with a strong odor, indicating a lack of regular bathing. He reported not receiving showers as scheduled and expressed a desire for a shower instead of a bed bath. Documentation revealed missed showers and a lack of ADL care on several occasions, which was confirmed by the Director of Nursing, who could not explain the lapses in care. Resident #71, with severe cognitive impairment and multiple physical limitations, was observed with unkempt nails and attempting to eat independently despite requiring assistance. Her care plan included nail care and supervised meals, but these were not consistently provided. Her husband reported difficulties in getting her nails addressed, and observations showed she was left to eat without supervision, contrary to her care plan. The Director of Nursing acknowledged the issues but was unaware of the specific problems with podiatry services and staff compliance with care plans.
Failure to Provide Timely Laboratory Services
Penalty
Summary
The facility failed to ensure timely and accurate laboratory services for a resident, leading to a deficiency in care. The resident was supposed to have several blood tests, including a CBC, CMP, Liver tests, BMP, Lipids, TSH, and HgbA1c, performed at specific intervals as ordered by the physician. However, these tests were not conducted as scheduled. The initial orders for these tests were placed on 1/6/2024, but due to an error in entering the orders into the new laboratory system, the tests were delayed significantly. The CBC, CMP, Lipid, Liver, and BMP tests were not performed until 1/12/2024, and the HgbA1c test was delayed until 7/5/2024. The deficiency was further highlighted during a pharmacy medication review on 1/9/2024 and 7/3/2024, where it was noted that the required lab results were unavailable. The Director of Nursing acknowledged that the lab orders were incorrectly entered into the new system, resulting in the tests being scheduled for incorrect future dates rather than when they were initially ordered. This oversight led to the resident not receiving the necessary laboratory evaluations in a timely manner, as required by their physician's orders.
Failure to Provide Adequate Hydration
Penalty
Summary
The facility failed to ensure that a resident, identified as Resident #9, had water available at the bedside, which could potentially lead to dehydration. Resident #9 was admitted with several medical conditions, including chronic obstructive pulmonary disease, hemiplegia and hemiparesis following a stroke, glaucoma, and dry eye syndrome. The resident was cognitively intact and required assistance for personal hygiene and toileting. During an observation, it was noted that Resident #9's call light was out of reach, and she did not have water available. The resident expressed feeling dry and mentioned that staff often forgot to bring her water despite her requests. Further observations revealed that Resident #9 was receiving intravenous fluids due to drier mucus membranes, indicating a need for hydration. A physician's order confirmed the administration of sodium chloride solution for fluid support. A confidential staff member acknowledged that while it was standard practice to provide fresh water at the start of each shift, there were times when this was not done due to time constraints. The staff member also noted that although Resident #9 sometimes refused other care activities, she did not refuse water.
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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 Lansing
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Medilodge Of Lansing | 1.4 mi | ★★★★★ | 12 | 0 |
| Aria Nursing And Rehabilitation | 8.3 mi | ★★★★★ | 3 | 0 |
| Medilodge Of Capital Area | 8.7 mi | ★★★★★ | 5 | 0 |
| Dimondale Nursing Care Center | 8.7 mi | ★★★★★ | 0 | 0 |
| Holt Senior Care And Rehab Center | 9 mi | ★★★★★ | 11 | 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.