Above average — CMS composite of the measures below.
The next survey window likely opens 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 Tuscola County Medical Care Facility during CMS and state inspections, most recent first.
Food Service Area Sanitation and Hot Holding Deficiencies: Surveyors observed multiple improper drain line setups in the kitchen, including ice machine and other tubing sitting directly in floor drains or below floor level without an air gap, along with debris in the drain area. Wet nosey cups were stored in a covered container, and built-up residue was seen on the meat slicer despite the DFDNS stating it was cleaned after each use. During lunch service, chicken nuggets on the steam table were temped at 106°F, below the stated 135°F hot-holding standard.
Backflow Prevention Not Properly Installed at Plumbing Fixtures: During an environmental tour, a hose was observed attached to a spigot without a backflow preventer at the cold water line in the boiler room, and the water softener drain line was sitting directly inside a drain. Utility sinks in multiple housekeeping and janitor closets also had chemical feeds, chemical dispensers, or hoses downstream of atmospheric vacuum breakers.
Call lights were not kept within reach for one resident, and multiple residents reported long waits for staff response, often 30 minutes or more. One resident used a metal bell instead of a call light and said staff had not come after ringing it, while another resident reported repeated delays and that staff sometimes turned off the light and said they would return but did not. A confidential group of residents also reported frequent call light delays, especially on 3rd shift and during mealtimes, with some experiencing incontinence while waiting for help.
Food was not consistently served at a palatable temperature for a resident and a group of residents. Residents reported cold eggs, vegetables, milk, and ice cream, and one resident said dinner was "colder than cold" even when eating in the dining room. A test tray showed hot items below the stated holding temp and milk at 50 degrees, while the FNS Director and CDM in training said they were unaware of the temperature concerns.
A resident with Alzheimer’s disease, dementia, prediabetes, and hypothyroidism had a hospice order in place, but the EMR contained no hospice documentation. A hospice binder at the nurse’s station only had CNA and nurse visit logs with tasks completed, while nursing assessment findings were absent. The UM said hospice nurses only sign care plans, while the DON said hospice nurses write notes and fax them for filing, but none were present.
Failure to Properly Manage a Heel Wound and Apply Pressure Relief Devices: A resident with DM and limited mobility developed a right heel wound that was documented inconsistently as diabetic, arterial, or mixed etiology, while staff could not clearly explain the cause. Surveyors observed Prevalon heel boots positioned incorrectly so the heels were not floated, and the resident reported foot pain and a heel wound. The record also showed no routine BG monitoring despite a diabetes care plan, and staff and the physician gave conflicting explanations about the wound’s etiology and whether pressure was involved.
Incomplete and Inaccurate Posted Nurse Staffing Information: The facility’s daily posted nurse staffing form did not separate RN and LPN hours, and surveyors observed the same incomplete format posted in the main hallway on consecutive days. The Administrator stated the form did not show whether an RN was in the building and that it did not accurately reflect staffing when a staff member left early or had a call-in.
The facility failed to implement effective infection control practices, leading to the spread of a Multi-Drug Resistant Organism (MDRO) among residents. Staff did not adhere to proper hand hygiene and PPE protocols, contributing to infections. The infection control nurse acknowledged the issue but did not provide adequate staff education or corrective actions. Specific residents were affected, including one with a wound infection and another with multiple UTIs, highlighting the facility's insufficient infection control measures.
The facility failed to include Code Status preferences in the care plans of five residents, despite having documented preferences against or for certain medical interventions. This omission was identified during a review of the facility's care planning process, which requires comprehensive care plans to be completed within seven days of the Admission MDS assessment. The Social Services Director confirmed that the residents' code status was not care planned, highlighting a systemic issue.
The facility failed to follow its policy for indwelling catheter use, affecting multiple residents. Observations showed catheter bags improperly positioned, with dignity bags touching the floor, and discrepancies in catheter size documentation. Care plans lacked updates for proper catheter care, contributing to recurrent UTIs. Physician orders often did not specify catheter sizes, and infection control protocols were not consistently followed.
The facility was found to have expired medications and medical supplies in two medication rooms, including expired protein supplements, aspirin, and Prevacid for a resident. Vaccines were improperly stored with other medications, and temperature monitoring was insufficient, only being recorded once daily. The facility's policy requires proper storage and monitoring of expiration dates, which was not followed.
Two residents in a dementia care unit experienced a lack of dignified and respectful care. One resident expressed back pain without acknowledgment from staff, despite having a care plan for pain management. Another resident, appearing confused, requested to lay down but was initially ignored by CNAs. The facility's policy on resident rights was not upheld, leading to a deficiency.
A resident with a history of falls and multiple medical conditions suffered repeated skin tears and bruising due to inadequate supervision and safety measures. Despite wearing protective arm sleeves, the resident continued to experience injuries, some during transfers with a mechanical lift. The facility's policies did not adequately address the investigation of these injuries, contributing to the ongoing issue.
A facility failed to maintain the prescribed head of bed (HOB) elevation for a resident with a feeding tube, as observed during a survey. The resident, with diagnoses including dysphagia and pneumonitis, required the HOB to be elevated to 30 degrees during and after feeding. However, the HOB was found at only 19 degrees, and the yellow markings meant to guide proper elevation were missing. Nurse M was unsure about the correct alignment, leading to a deficiency in care.
A resident with COPD was observed receiving oxygen at 3 LPM, contrary to the Kardex and care plan specifying 2 LPM. Staff interviews revealed inconsistencies in managing and communicating oxygen flow rates. The facility's policy requires adherence to physician orders and monitoring oxygen saturation, which was not followed.
The facility failed to implement a yearly QAPI Plan specific to its resident population, affecting 127 residents. The Administrator admitted that the QAPI committee did not meet attendee requirements, as the Medical Director/Physician was absent from a meeting, and was unable to provide original attendance documents. Additionally, the Administrator could not clearly articulate the processes for identifying improvement areas and was uncertain about the completion of a performance improvement project (PIP).
Food Service Area Sanitation and Hot Holding Deficiencies
Penalty
Summary
The facility failed to maintain best practices in the food service area during observations, interview, and record review. On 12/9/25, during an initial kitchen tour with the Dietary Manager, a drain from the walk-in freezer was observed draining into a hole in the floor with the tube lower than the floor. A drain the Dietary Manager believed was for the ice machine was observed going into a cut-out from the floor drain area without an air gap, and the drainpipe was below floor level. Another plastic tubing in the floor drainage cut-out was wrapped around the inside of the drain box, also below floor level, with debris noted where the piping lay. An osmosis system had a black tube inside a slotted box drain in the floor, and the black tube was below floor level. Nosey cups were stored in a plastic container with the lid secured, but multiple cups were wet inside; the Dietary Manager stated the items should be air dried prior to storage or stacked. On 12/11/2025, during a kitchen tour with the Director of Food and Nutrition Services, the ice machine drain line was observed sitting directly inside the kitchen drain. At that same tour, built-up residue was observed on the meat slicer, and the Director stated it was cleaned after every use. During lunch service, chicken nuggets on the steam table were temped at 106 degrees Fahrenheit, while the Director stated hot holding should be 135 degrees Fahrenheit or above. On 12/12/2025, during a kitchen tour of the Cortland House with the Director of Food and Nutrition Services, the ice machine drain line was again observed sitting inside the drain.
Backflow Prevention Not Properly Installed at Plumbing Fixtures
Penalty
Summary
The facility failed to ensure appropriate backflow prevention was installed at plumbing fixtures. During an environmental tour with the Life Safety Officer, a hose was observed attached to a spigot without a backflow preventer at the cold water line in the boiler room. At the same time, the water softener drain line was observed sitting directly inside a drain. Additional observations showed a utility sink with a chemical feed downstream of an atmospheric vacuum breaker in housekeeping closets in Rooms 278, 206, 136, and 178. A similar condition was observed in the janitor's closet in Cortland House, where a utility sink had an attached chemical dispenser downstream of an atmospheric vacuum breaker. In [NAME] House, a utility sink with an attached hose and a chemical dispenser was also observed downstream of an atmospheric vacuum breaker in the janitor's closet.
Call Lights Not Within Reach and Not Answered Timely
Penalty
Summary
The facility failed to ensure residents’ call lights were within reach or easily accessible and failed to ensure call lights were answered in a timely manner for multiple residents. During observation, one resident was found sitting in a wheelchair with the call light lying on the floor underneath the bed and not within reach. Another resident was observed using a metal bell instead of a call light, with no cord connected to the wall where the call light would be, and reported that staff had not come after she had already rung it. A third resident reported that staff sometimes answered the call light quickly and sometimes not, with waits of 30 minutes or more many times, and a fourth resident reported long waits for call light response and that staff sometimes turned the light off and said they would return but did not come back soon. The resident whose call light was on the floor had diagnoses including heart disease, schizophrenia, anxiety disorder, dementia, bilateral hip and knee contractures, and cerebral palsy, and the MDS showed severely impaired cognition and dependence for toileting hygiene, bathing, lower body dressing, and transfers. The resident using the metal bell had diagnoses including stroke, vascular dementia, anxiety disorder, and contracture of the right wrist, and the MDS showed severely impaired cognition and dependence for transfers. Facility staff acknowledged uncertainty about why that resident had a bell instead of a call light and stated they were unsure why the change had been made. A confidential group of residents reported widespread concerns with call lights not being answered timely, with wait times exceeding 30 minutes or longer. Residents reported that this occurred more often on 3rd shift, that staff sometimes turned off the call light and said they would return but did not, and that delays during mealtimes affected their ability to get to the bathroom and resulted in incontinence. The facility’s resident rights document stated residents have the right to a dignified existence, self-determination, communication, and access to persons and services inside and outside the facility, and to be treated in a manner that maintains or enhances dignity and respect.
Food Served at Inconsistent and Unpalatable Temperatures
Penalty
Summary
The facility failed to ensure that food was palatable and maintained at a palatable temperature for one resident and a group of confidential residents. During a group interview with 18 residents, multiple residents reported that food was sometimes served too cold in their rooms and in the dining room, including eggs, vegetables, milk, and ice cream. Several residents stated that milk served in small cartons could be warm and that some cartons smelled spoiled even when the date on the carton indicated it should still be good. Residents also reported that the issue of cold food had been discussed at monthly food committee meetings, and one resident stated, "I can't understand why it can't be warmer." Resident #68 reported that a dinner of chicken nuggets the prior evening was "colder than cold" and stated they had been told to go to the dining room for hotter food, but that the food was still cold there. During observation of second-floor dining meal service, a test tray was prepared and transported from the second floor to the first-floor conference room in approximately 65 seconds. The measured temperatures on the tray were 121.8 degrees Fahrenheit for the breaded chicken patty, 112.8 degrees Fahrenheit for the egg roll, and 50 degrees Fahrenheit for the milk. Resident #68's record showed diagnoses including hypertension, heart failure, and debility, and a most recent BIMS score indicating impaired cognition. The Food and Nutrition Services Director and CDM in training stated they were not aware of food temperature concerns and confirmed that holding temperature for hot food is 135 degrees and that food should be palatable to the resident.
Missing Hospice Nursing Documentation
Penalty
Summary
The facility failed to ensure ongoing collaboration with hospice care for one resident, who had diagnoses including Alzheimer's disease, dementia, prediabetes, and hypothyroidism and had a physician's order for hospice care dated 5/2/25. During record review, the resident's EMR did not contain any hospice documentation. A hospice binder kept at the nurse's station contained nurse and CNA visit documents from 5/8/25 through 8/1/25, but those records only listed the date, who provided the visit, and the tasks completed during the visit. The hospice binder did not include documentation of findings from nursing assessments performed during hospice nurse visits. The Unit Manager stated the CNA documents shower visits and said she had never seen hospice nurses make notes, stating they come in to sign the care plans and that is it. The DON stated hospice nurses do write notes and fax them to the facility for filing in the binder, but no nursing documentation was present for the resident. The facility policy titled Hospice Care and Coordination of Care stated hospice and TCMCC nursing staff will communicate changes in resident condition and needs.
Failure to Properly Manage a Heel Wound and Apply Pressure Relief Devices
Penalty
Summary
The facility failed to implement and operationalize its pressure ulcer management policies for one resident with a right heel wound. Resident #33 had diagnoses including heart failure, pacemaker, diabetes mellitus, and depression, and was assessed as cognitively intact but requiring substantial to total assistance for toileting, bathing, hygiene, dressing, and transferring. The resident was identified as at risk for pressure ulcer development, and the care plan included interventions such as floating heels in bed and using Prevalon boots while in bed and in the chair. Survey observations showed the resident lying flat in bed with bilateral Prevalon heel boots in place, but the boots were positioned incorrectly so the heels were not in the open area designed for the heel and were instead resting on the side of the boot. The resident stated they had pain in their feet and reported having a wound on the heel but did not know what caused it. Nursing staff described the wound as being right over the heel and like a dark bruise, and the wound was first identified as a purple/gray discoloration on the right heel with firmness and no open area. Later documentation described the wound as a diabetic/arterial ulcer with intact skin and changing discoloration, while the resident remained in bed with the boots still positioned incorrectly during a later observation. Record review showed conflicting and incomplete wound etiology documentation. Two paper forms signed by the physician identified the right heel wound as mixed etiology but did not specify what the mixed etiology was. Staff interviews showed uncertainty about the cause of the wound, with one LPN stating it was diabetic and another stating it was diabetic and arterial insufficiency, while also saying pressure was not a contributing factor because pressure prevention interventions were in place. The physician stated the wound was arterial and diabetic, then later said it did not appear to be arterial based on the arterial doppler, and also acknowledged that pressure might be a possibility. The resident’s blood glucose monitoring was not being routinely documented, with the last recorded glucose check noted in the record on 11/8/25 despite a diabetes care plan intervention to monitor blood glucose as ordered. The facility policy required nursing staff to document initial findings, relieve pressure and/or causative measures, and evaluate pressure relief devices and interventions, but the record and observations showed the wound etiology was not comprehensively identified and the pressure reduction devices were not correctly applied.
Incomplete and Inaccurate Posted Nurse Staffing Information
Penalty
Summary
The facility failed to ensure that the daily posted nurse staffing information included a clear delineation of licensed nursing staff and accurate documentation of actual hours worked. On 12/10/25, surveyors observed nurse staffing hours posted in the main hallway, and the section for Licensed Nursing Staff did not distinguish between the number and/or hours of RNs versus LPNs working. The same staffing form was observed again on 12/11/25, and it still did not separate RN and LPN hours on the posted information. During an interview on 12/11/25, the Administrator reviewed the staffing form and stated they could not tell whether an RN was in the building because the posting did not distinguish between RN and LPN hours. The Administrator also stated they were not familiar with the posted nurse staffing requirements until F732 in the SOM was reviewed with them. When asked about how the facility accounted for call-ins or staff leaving before the end of a shift, the Administrator stated the form did not provide accurate staffing information if a staff member left early and that the posted information was not accurate in those situations.
Inadequate Infection Control Practices Lead to MDRO Spread
Penalty
Summary
The facility failed to implement an effective infection prevention and control program, resulting in the continued spread of a Multi-Drug Resistant Organism (MDRO), Proteus Mirabilis, among residents. Observations revealed that staff did not adhere to proper hand hygiene and personal protective equipment (PPE) protocols. For instance, a Certified Nursing Assistant (CNA) was observed performing perineal care on a resident without changing gloves after touching multiple surfaces, and a nurse was seen conducting wound care without proper hand hygiene between glove changes. These lapses in infection control practices contributed to the spread of infections within the facility. The facility's infection control nurse acknowledged the presence of MDRO infections but failed to provide adequate staff education and reeducation on infection control practices. Despite conducting hand hygiene and PPE audits, there was no evidence of corrective actions or staff education to address the identified failures. The infection control nurse also relied on educational games rather than direct observation and reeducation of staff performing actual resident care, which may have contributed to the ongoing spread of infections. Specific residents were affected by these deficiencies, including a resident with a wound infection caused by Proteus Mirabilis and another resident with a history of multiple urinary tract infections. The facility's infection control measures were insufficient to prevent the transmission of infections, as evidenced by the presence of contaminated surfaces and improper handling of urinary catheters. The lack of effective infection control practices and oversight led to the continued risk of infection spread among residents.
Failure to Include Code Status in Care Plans
Penalty
Summary
The facility failed to develop person-centered comprehensive care plans for five residents regarding their Code Status preferences. This deficiency was identified during a review of the facility's policy on comprehensive care plans, which mandates that all residents have a baseline care plan completed and a comprehensive care plan in the electronic chart within seven days of the completion of the Admission MDS assessment. The care plans are intended to provide staff with guidelines on resident care needs. For Resident #4, the record review revealed that the resident had several medical conditions, including dementia and Parkinson's disease, and required assistance with all care. Despite having a Code Status form indicating preferences against CPR, use of respirators, ventilators, tube feeding, and transfer to an acute care hospital, these preferences were not included in the resident's comprehensive care plan. Similarly, Resident #17, who had severe cognitive impairment and multiple medical conditions, had specific Code Status preferences that were not reflected in their care plan, including no CPR, no use of a respirator/ventilator, and no transfer to an acute hospital, except for specific conditions. The deficiency extended to Residents #22, #66, and #68, who also had their Code Status preferences omitted from their care plans. Resident #22, with moderate cognitive decline, had a Do-Not-Resuscitate order that was not included in their care plan. Resident #66, who had full cognitive abilities, had preferences for CPR and other interventions that were not documented in their care plan. Lastly, Resident #68, who had full cognitive abilities and a DNR order, also had their preferences omitted from the care plan. The Social Services Director acknowledged that the residents' code status was not care planned, indicating a systemic issue in the facility's care planning process.
Improper Catheter Management and Infection Control
Penalty
Summary
The facility failed to adhere to its policy for indwelling catheter use, affecting five residents. Observations revealed that catheter bags were improperly positioned, with dignity bags touching the floor, which is against the facility's policy. For instance, Resident #52's catheter bag was observed hanging below the bed, covered by a dignity bag, but there was no documentation of the catheter size used during a recent change. Similarly, Resident #106's dignity bag was resting on the floor, and there was a discrepancy between the catheter size documented in the care plan and the size used during a recent change. Resident #17's catheter bag was observed on the floor, with the bag bent, preventing free urine flow. The care plan for this resident was not updated to reflect the correct positioning of the catheter bag. Resident #22's catheter bag was also found on the floor, with cloudy urine observed in the tubing, and the care plan lacked instructions to keep the bag off the floor. Additionally, Resident #51's catheter bag was resting on the floor, and there was no guidance on when to change the bag cover or keep it off the floor. The facility's policy requires that catheter use be in accordance with physician orders, including catheter size and frequency of change, and that collection bags be kept off the floor. However, the physician orders for several residents did not specify catheter sizes, and the care plans were not consistently updated to reflect changes or proper catheter care. These deficiencies contributed to recurrent urinary tract infections among the residents, as the facility did not ensure proper catheter management and adherence to infection control protocols.
Improper Storage and Expired Medications Found in Facility
Penalty
Summary
The facility failed to ensure proper storage and disposal of medications and medical supplies in accordance with professional standards, as observed in two of five medication rooms. During a tour of the Second Redwood Medication Room, expired medications and medical supplies were found, including ProSource NoCarb Protein, UTI-Stat, Aspirin, Prevacid for a specific resident, a Universal Viral Transport for Covid, an oral dispenser syringe, an IV catheter, and Point-Lok Sharps Safety devices. The Unit Manager RN confirmed the expiration of these items and indicated they would be disposed of. Additionally, vaccines were improperly stored on the top shelf of the refrigerator with other medications, and temperature monitoring was only documented once per day, contrary to CDC recommendations. In the Second Hickory Medication Room, further expired medications were discovered, including Vitamin E softgels, Acetaminophen tablets, Geri-kot stool softener, and Banatrol Plus anti-diarrheal solution. The facility's policy on the storage and labeling of medications and biologics, which was reviewed in December 2023, mandates that all medications be stored according to the manufacturer's recommendations and that expiration dates be monitored to prevent the use of expired medications. The CDC's Vaccine Storage and Handling Toolkit also requires that storage unit temperatures be checked and recorded at least twice per workday, which was not adhered to in this facility.
Failure to Provide Dignified and Respectful Care
Penalty
Summary
The facility failed to provide dignified and respectful care to two residents, resulting in a deficiency. Resident #96, who has Alzheimer's disease, dementia, intervertebral disc disorders, osteoarthritis, and a history of falls, was observed in the dining room expressing discomfort by repeatedly saying, 'Oh my back.' Despite the presence of staff members, including a CNA, no one acknowledged or responded to the resident's verbalization of pain. The resident's care plan included interventions for pain assessment and monitoring, yet the Medication Administration Record indicated a pain level of zero, and there was no documentation of the resident's discomfort in the progress notes. Resident #114, also diagnosed with Alzheimer's disease, dementia, and hypertension, was observed with unkempt hair and appeared confused. The resident expressed a desire to lay down, stating they were tired and gesturing towards a CNA who did not respond. Another CNA was called but also did not provide a response, only stating that dinner would be served soon. Eventually, the resident was assisted to their room and observed in bed. The facility's policy on resident rights emphasizes the right to a dignified existence and self-determination, which was not upheld in these instances. The Director of Nursing was interviewed and acknowledged the expectation for staff to respond to residents' needs. However, there was no explanation provided for the lack of response to Resident #96's pain or Resident #114's request to lay down. The facility's failure to acknowledge and respond to the residents' verbalizations of discomfort and care needs resulted in a deficiency, as it did not align with the facility's policy on maintaining residents' dignity and respect.
Failure to Prevent Resident Injuries
Penalty
Summary
The facility failed to ensure a safe environment for a resident, resulting in repeated skin tears and bruising. The resident, who had a history of falls and multiple medical conditions including Alzheimer's and heart disease, was observed with protective arm sleeves due to attempts to climb out of bed. Despite these measures, the resident continued to suffer from skin tears and bruises, some of which were attributed to bumping into bed rails and during transfers. The resident experienced two falls within the year, with one incident resulting in a head laceration requiring staples. Additionally, the resident sustained 13 skin tears and bruises over a period of several months. Some injuries occurred during transfers with a mechanical lift, raising concerns about the adequacy of supervision and assistance provided during these transfers. The care plan indicated the use of a Hoyer lift with one-person assistance, but it was unclear if this was sufficient given the resident's dependency. The facility's policies on skin care and fall risk management were reviewed, but they did not adequately address the investigation of causes for injuries other than falls. The Quality Nurse acknowledged the resident's confusion and attempts to get out of bed, but there was no clear explanation for injuries potentially caused by mobility bars or during transfers. The facility's failure to identify and mitigate these hazards contributed to the resident's repeated injuries.
Failure to Maintain Proper Head of Bed Elevation During Tube Feeding
Penalty
Summary
The facility failed to update and follow care planned interventions for a resident with a feeding tube, resulting in a deficiency. The resident, who was readmitted with diagnoses including dysphagia, multiple sclerosis, and pneumonitis due to inhalation of food and vomit, required extensive assistance with activities of daily living and had intact cognition. Physician orders specified that the head of the bed (HOB) should be elevated to 30 degrees during and after tube feeding to prevent complications. However, during an observation, it was found that the HOB was only at a 19-degree incline while the tube feeding was running. The care plan and Kardex indicated that yellow markings should be lined up to ensure the correct HOB elevation, but these markings were not visible during the observation. Nurse M confirmed the absence of the yellow tape and was unsure if the top of the mattress or the bed frame should align with the faint line on the headboard. This lack of clarity and failure to maintain the prescribed HOB elevation during tube feeding posed a risk of decreased tube feeding dose, aspiration, and/or pneumonia for the resident.
Failure to Follow Oxygen Administration Orders
Penalty
Summary
The facility failed to follow physician's orders for oxygen administration for a resident diagnosed with COPD, chronic pulmonary edema, anxiety, and anemia. The resident was observed receiving oxygen at a flow rate of 3 liters per minute (LPM) via nasal cannula, which did not match the Kardex or care plan that specified a continuous oxygen flow rate of 2 LPM. The resident confirmed using oxygen continuously at 3 LPM, and the oxygen concentrator was set to this rate, with the humidification bottle found empty. Interviews with staff revealed inconsistencies in how oxygen flow rates were managed and communicated. A CNA stated that nurses set the oxygen flow rate, and aides were not allowed to change it. The CNA would check the Kardex or physician orders to verify the correct rate. However, the Kardex indicated a different rate than what was being administered. An RN explained that nurses have a standing order to titrate oxygen between 1-6 LPM based on the resident's needs and that CNAs would confirm the rate with nurses. The facility's policy requires following physician orders for oxygen flow rate and monitoring oxygen saturation every shift, but these protocols were not adhered to in this case.
Failure to Implement Yearly QAPI Plan
Penalty
Summary
The facility failed to implement a yearly Quality Assessment Process Improvement (QAPI) Plan tailored to the specific needs and concerns of its resident population, which includes 127 residents. This failure was identified during an interview and record review, where it was found that the facility's QAPI committee did not meet the required standards. The Administrator, who oversees the QAPI program, admitted that the committee met monthly except for December and claimed they met the quarterly meeting requirements. However, the documentation provided did not meet the attendee requirements as the Medical Director/Physician was absent from one of the meetings. Furthermore, the Administrator was unable to provide original attendance documents and instead provided a typed document that met the quarterly requirement. Additionally, the Administrator was unable to clearly articulate the processes for identifying areas of focus for improvement, stating only that the committee focused on Quality measures without providing specifics. When questioned about the completion of a yearly performance improvement project (PIP), the Administrator initially stated that no PIP had been completed. After further clarification, he suggested that a PIP might have been completed but was unable to provide any further information before the survey exit. This lack of a specific and implemented QAPI plan poses a potential risk for negative physical and psychosocial outcomes for all residents.
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Illustrative
What surveyors actually found near you
We read the 44 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Caro
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Fisher Senior Care And Rehabilitation | 11.1 mi | ★★★★★ | 8 | 0 |
| Medilodge Of Cass City | 12.5 mi | ★★★★★ | 12 | 0 |
| Marlette Community Hospital Ltcu | 19.4 mi | ★★★★★ | 0 | 0 |
| Medilodge Of Frankenmuth | 21.3 mi | ★★★★★ | 5 | 0 |
| Wellspring Lutheran Services | 21.4 mi | ★★★★★ | 17 | 0 |
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