Below 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 Focused Care At Hogan Park during CMS and state inspections, most recent first.
A resident without a prior diabetes diagnosis developed abdominal discomfort, nausea, and foul-smelling stool, leading the NP to order CBC and CMP labs. The lab later reported a critically elevated blood glucose (over 900 mg/dL) directly to the physician, but the facility was not notified. Staff did not review the electronic lab results in the Ring App or document any timely physician notification, despite policies requiring nurses to review all labs, date/time their review, and immediately call critical values to the MD. An ADON printed the lab report and handed it to an LVN without reviewing it; the LVN faxed it to the MD without reading the values, assuming the ADON had already done so and without confirming receipt. Over the next days, the resident continued to report symptoms and ask about his lab results until another LVN later checked the Ring App, discovered the critical glucose, confirmed hyperglycemia with a glucometer, and then sent the resident to the hospital. The failure to promptly recognize and communicate the critical lab result to the physician, and to follow facility lab monitoring and lab order policies, constituted the deficiency.
Two residents' assessments were not accurately completed, including one case where a resident was incorrectly documented as comatose on the MDS, resulting in skipped sections for cognitive, mood, and behavior assessments. The error was not identified by the MDS Coordinator or DON during their review processes.
A resident's Safe Smoking Assessment contained conflicting information about supervision and safety measures required while smoking. The resident reported being allowed to smoke unattended without a fire-resistant apron, while the assessment indicated both supervision and unsupervised smoking were permitted. The RN responsible for the assessment acknowledged the documentation error.
Staff failed to follow infection control protocols during wound care for a resident with multiple medical conditions, including not using a paper towel to turn off faucets after handwashing and reusing the same gauze for multiple wound swipes. These actions did not comply with established procedures for infection prevention, despite staff having received relevant training.
The facility failed to maintain food safety and sanitation standards, with unlabeled and improperly stored food, unsanitary kitchen conditions, and inadequate staffing for cleaning. Observations included open spice containers, unlabeled food in the refrigerator, and a general lack of cleanliness, with staff acknowledging the issues but citing staffing constraints as a barrier to resolution.
Two residents experienced privacy breaches during care activities. A resident with severe cognitive impairment was exposed during wound care due to inadequate privacy curtains and an open door. Another resident with Alzheimer's was left exposed to passersby during incontinent care because the CNA forgot to close the window blinds. The DON and Administrator acknowledged the failure to maintain privacy as per facility policy.
The facility did not ensure residents' rights to receive visitors at any time, as a sign at the entrance restricted visiting hours from 9:00 AM to 9:00 PM. Despite being informed by the Ombudsman that this was against regulations, the administrator refused to remove the sign. The DON mentioned the sign was intended to deter vagrants and drug dealers, although the hours were not enforced. No visitation policy was available.
The facility failed to provide residents with private telephone access, allowing only the use of phones at the nurse's station and front reception, which lack privacy. The DON confirmed the absence of a designated phone for residents since September 2024, due to a past issue with a confused resident frequently calling 911. The interim administrator had no additional information, and no policy for telephone privacy was available.
The facility failed to properly dispose of garbage and refuse, with two dumpsters not placed on a concrete slab and three dumpsters left open. The area around the dumpsters was not maintained, with loose garbage and debris present. Interviews revealed a lack of awareness and absence of a policy for proper dumpster placement.
A facility failed to adhere to infection control protocols when a Wound Care nurse did not use the required PPE during the treatment of a resident on Enhanced Barrier Precautions due to a pressure ulcer. Despite the presence of an EBP posting, the nurse only wore gloves, omitting the gown, which is necessary for high-contact care activities. The lapse was acknowledged by the nurse and confirmed by the DON/IP, highlighting a breach in the facility's infection prevention policy.
A resident with quadriplegia was unable to reach the call light due to staff not consistently placing it within reach, despite the care plan's requirements. Observations showed the call light hanging off the bed, and staff did not ensure it was accessible after interactions. The DON was unaware of the issue, and no policy for call lights was available.
Residents in the facility reported significant delays in call light responses, especially during night shifts, with some lights going unanswered. Multiple residents observed night staff sleeping and expressed dissatisfaction with the care provided. Despite these complaints, facility management claimed to be unaware of any issues, although resident council meetings consistently highlighted these concerns.
Failure to Review and Communicate Critical Lab Result to Physician
Penalty
Summary
The deficiency involves the facility’s failure to promptly review and communicate critical laboratory results to the attending physician in accordance with its Lab Monitoring and Lab Orders policies. A male resident with schizoaffective disorder, bipolar type, PTSD, and constipation, but no history or diagnosis of diabetes and no orders for insulin or blood glucose monitoring, reported abdominal discomfort and gastrointestinal issues. A nurse practitioner ordered a CBC and CMP after the resident complained of foul bowel odor, bad breath smell, and nausea. The following day, the lab drew the ordered tests, and the laboratory report showed a critically elevated blood glucose level of 934 mg/dL, with documentation that the critical result was called directly to the resident’s physician by the lab technician. The facility was not contacted by the lab, and there is no documentation that the physician notified the facility of the critical value. Facility staff did not identify or act on the critical lab result in a timely manner despite having access to the results through the Ring App and despite facility policy requiring that all lab results be reviewed by a nurse, dated and timed, and that critical values be called to the physician immediately. The 24-hour report noted that labs were done and described them as having a “negative outcome,” but did not document the critical glucose value or any physician notification. The ADON later printed the lab results from the Ring App and handed them to the nurse on duty, instructing her to contact or call the physician, but he stated he did not review the results himself. The nurse who received the printed results stated she did not review the lab values, assumed the ADON had already reviewed them, and only faxed them to the physician because the report indicated the physician was already aware. She did not confirm receipt of the fax and did not document any direct notification or follow-up with the physician regarding the critical value. Over the subsequent days, the resident continued to experience symptoms, including nausea and bowel issues, and asked staff about his lab results. One nurse directed him to ask another nurse, and the nurse who had been given the printed results denied that the resident asked her to read the results. On a later shift, another LVN observed that the resident appeared pale and was “talking differently,” prompting her to check his vital signs and then review the Ring App, where she saw the critically high glucose value of 945 mg/dL. She then checked the resident’s blood sugar with the facility glucometer and obtained a reading of 478 mg/dL, after which the resident was sent to the hospital. Interviews with the NP, Medical Director, ADONs, and nursing staff confirmed that the facility’s policies required nurses to review lab results, document the date and time of review, and promptly notify the physician of abnormal and critical values, and that this process was not followed for this resident’s critical glucose result. The failure to promptly notify the physician of the critical lab value and to follow the lab monitoring and lab orders policies constituted the deficiency. The report also documents that the facility’s Lab Monitoring policy required all lab results to be reviewed by a nurse, with the nurse dating and documenting the time the result was reviewed, and that critical lab results be called to the physician or on-call physician immediately. The Lab Orders policy required the facility to ensure timeliness of services, monitor lab orders daily, and ensure that all lab results were communicated to the physician in a timely manner, with proof of notification included on the lab report or in nurse’s notes. Interviews with the Administrator, ADON, and Medical Director confirmed that nurses were expected to review lab reports before forwarding them, to notify the physician of critical values, and not to assume that the physician had already been informed. In this case, multiple staff members acknowledged that the critical glucose value was not recognized or acted upon as required, and that the facility did not follow its own policies for lab review, tracking, and physician notification for this resident’s critical lab result.
Inaccurate Resident Assessment on MDS
Penalty
Summary
The facility failed to ensure that resident assessments accurately reflected the residents' current status for two of six residents reviewed. Specifically, for one resident, the quarterly Minimum Data Set (MDS) assessment incorrectly indicated that the resident was in a comatose or persistent vegetative state. This error caused several key assessment sections, including cognitive patterns, mood, and behavior, to be skipped. Direct observation showed the resident was conscious, able to converse, and followed staff instructions. The resident also confirmed in an interview that he had not been in a comatose state during his stay at the facility. The MDS Coordinator acknowledged being unaware of the error and stated it was a typographical mistake, confirming that the resident had never been comatose while at the facility. The Director of Nursing (DON) reported that she conducts random reviews of MDS assessments but was not aware of this specific error. The DON also clarified that the MDS Coordinator is responsible for completing MDS assessments for each resident. These actions and inactions led to the inaccurate documentation of the resident's condition.
Inaccurate Documentation of Resident Smoking Assessment
Penalty
Summary
The facility failed to maintain accurate medical records in accordance with accepted professional standards for one resident. Specifically, the Safe Smoking Assessment for a resident with acute respiratory failure and Type 2 Diabetes Mellitus contained conflicting documentation regarding the resident's smoking status. The assessment, completed by an RN, indicated both that the resident was safe to smoke unsupervised and that the resident required direct supervision and a fire-resistant apron while smoking. It also stated that all smoking materials would be kept at the nurse's station and that the care plan was up to date. Interviews revealed discrepancies between the documentation and the resident's actual smoking practices. The resident reported being able to smoke unattended since admission and not being required to wear a smoking apron, although staff held her supplies and lit cigarettes for her. The RN who completed the assessment acknowledged the error, attributing it to a possible typo and was unable to recall the intended documentation due to the passage of time and working at different facilities.
Failure to Follow Infection Control Protocols During Wound Care
Penalty
Summary
The facility failed to maintain proper infection prevention and control practices during wound care for a resident with significant medical conditions, including Type 2 Diabetes Mellitus, metabolic encephalopathy, and chronic heart failure. Observations revealed that both a CNA and the Treatment Nurse did not use a paper towel to turn off the water faucet after handwashing, instead using their bare hands, which is contrary to infection control protocols. Additionally, the Treatment Nurse used the same 4x4 gauze multiple times to wipe wounds on the resident's right great toe and left heel, rather than using a new gauze for each swipe as required to prevent cross contamination. Record reviews indicated that the resident had a deep tissue injury on the right great toe and a stage 4 pressure injury on the left heel, with care plans and physician orders specifying daily wound care and infection prevention measures. Despite documented training for staff on proper hand hygiene and wound care procedures, direct observation and interviews confirmed that these protocols were not followed during the provision of wound care, resulting in a failure to establish and maintain an effective infection prevention and control program.
Deficiencies in Food Safety and Sanitation
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as evidenced by multiple deficiencies in the storage, preparation, distribution, and serving of food. Observations revealed that prepared food in the refrigerator was not labeled or dated, and spices in the dry storage room were left with lids open. Additionally, food items in both the refrigerator and dry storage were not stored in sealed containers, which is a violation of the facility's food safety policies. The kitchen and its storage areas were found to be unsanitary, with visible dirt and debris on the floors, greasy and sticky residues on surfaces, and a mildew odor emanating from the sink and dishwasher areas. Specific issues included a juice machine with red liquid buildup, a refrigerator containing unlabeled and discolored food items, and a dry storage area with open spice containers and unsealed bulk food containers. The kitchen's overall cleanliness was compromised, with greasy stains on walls, dust buildup, and black debris noted in various areas. Interviews with facility staff, including the Dietary Manager, Interim Administrator, Maintenance Director, and DON, revealed awareness of the sanitation issues but highlighted staffing constraints as a barrier to maintaining cleanliness. The Dietary Manager admitted to difficulties in keeping up with deep cleaning due to limited staff, while the Interim Administrator and Maintenance Director acknowledged the need for improved sanitation but cited corporate staffing formulas as a limitation. The DON confirmed ongoing issues with kitchen cleanliness predating her tenure, indicating a systemic problem within the facility's food service operations.
Privacy Breaches During Resident Care
Penalty
Summary
The facility failed to ensure personal privacy for two residents during care activities, which compromised their dignity. Resident #23, a male with severe cognitive impairment and multiple medical conditions, was subjected to wound care without adequate privacy. The privacy curtain in his room was not long enough to shield him from his roommate or the hallway, and the door was left half-open during the procedure, exposing him while he was partially undressed. The Wound Care nurse acknowledged the inadequacy of the privacy curtain and reported it. Resident #37, a female with Alzheimer's disease and muscle weakness, experienced a breach of privacy during incontinent care. Although the CNA closed the door and pulled the privacy curtain, she failed to close the window blinds, which faced an area with foot traffic. This oversight left the resident exposed to passersby. The resident expressed discomfort with the situation, and the CNA admitted to forgetting to close the blinds, acknowledging the potential for embarrassment and privacy violation. Interviews with the Director of Nursing (DON) and the Administrator confirmed that the staff did not meet the facility's expectations for maintaining resident privacy during personal care. The facility's competency evaluation document emphasized the importance of providing privacy by closing curtains, doors, and blinds, which was not adhered to in these instances.
Facility Fails to Ensure Residents' Right to Unrestricted Visitation
Penalty
Summary
The facility failed to uphold residents' rights to receive visitors of their choosing at any time, as required by regulations. An observation on January 14, 2025, revealed a sign at the facility's entrance indicating restricted visiting hours from 9:00 AM to 9:00 PM. During a resident council meeting, the Ombudsman reported that the facility's administrator had been repeatedly informed that these posted visiting hours did not comply with regulatory standards, yet the administrator refused to remove the sign. In an interview, the Director of Nursing (DON) stated that the sign was placed by the previous administrator to deter vagrants and drug dealers, although the visiting hours were not actively enforced. The interim administrator had no additional comments, and no policy on visitation hours was available at the time of the survey.
Lack of Private Telephone Access for Residents
Penalty
Summary
The facility failed to provide residents with reasonable access to a telephone for private conversations, which is a violation of resident rights. During a confidential group interview with six residents, it was revealed that their conversations could be overheard because they were only allowed to use phones located at the nurse's station and the front reception area, both of which lack privacy. The Director of Nursing (DON) confirmed that there had been no designated phone for residents since her hiring in September 2024, citing a previous issue with a confused resident who frequently called 911. The interim administrator, covering for the regular administrator on vacation, did not provide any additional information, and there was no policy available for telephone privacy.
Improper Disposal of Garbage and Refuse
Penalty
Summary
The facility failed to properly dispose of garbage and refuse, as observed with three out of six dumpsters used for food and nutrition services. Specifically, two dumpsters were not placed on a concrete slab, with one sitting on dirt and another on rocks, causing them to be uneven. Additionally, the area surrounding the dumpsters was not maintained, with loose garbage and debris present, and a noticeable odor emanating from a puddle under one of the dumpsters. Furthermore, the lids of three dumpsters were left open when no staff were present, contributing to an unsanitary environment. Interviews with the Interim Administrator and Maintenance Director revealed a lack of awareness regarding the improper placement of the dumpsters and the absence of a facility policy or procedure for their proper placement. The Interim Administrator, being new to the position, was unaware of the issue and indicated a need to consult with the city for a solution. The Maintenance Director also expressed the need to coordinate with the city's waste removal department to address the placement and surface issues of the dumpsters.
Inadequate Use of PPE During Wound Care
Penalty
Summary
The facility failed to maintain an effective infection prevention and control program, as evidenced by the actions of the Wound Care nurse during the treatment of a resident with an unstageable ulcer. The resident, who was admitted with diagnoses including dementia, muscle wasting, and heart failure, was on Enhanced Barrier Precautions (EBP) due to the presence of a pressure ulcer. Despite the requirement for personal protective equipment (PPE) during high-contact care activities, the Wound Care nurse only wore gloves and neglected to don a gown while performing wound care. This oversight occurred despite the presence of an EBP posting above the resident's bed, indicating the need for such precautions. Interviews with the Wound Care nurse and the Director of Nursing/Infection Preventionist (DON/IP) confirmed the lapse in protocol. The Wound Care nurse admitted to forgetting to wear a gown, acknowledging awareness of the facility's policy. The DON/IP emphasized the necessity of using PPE, such as gowns and gloves, during high-contact care to prevent cross-contamination, especially for residents with conditions like pressure ulcers. The facility's policy on EBP, which mandates gown and glove use for residents with chronic wounds or indwelling devices, was not adhered to, leading to a potential risk of infection spread.
Failure to Provide Accessible Call Light for Resident
Penalty
Summary
The facility failed to provide a working communication system that was easily within reach for a resident, identified as Resident #1, who required substantial assistance due to medical conditions including spinal stenosis, muscle weakness, muscle wasting, and quadriplegia. Observations on the specified date revealed that the resident was unable to reach the call light, which was necessary for requesting assistance. Despite the care plan indicating the need for the call light to be within reach, it was observed hanging off the side of the bed, out of the resident's reach. The resident expressed that staff did not consistently place the call light over his chest, as required for him to use it effectively. During the survey, it was noted that staff entered the room in response to the call light being pressed by the surveyor but did not provide the resident with the call light before leaving. Further observations showed the resident lying in bed with the call light out of reach, even after staff interactions. The Director of Nursing (DON) acknowledged the expectation for staff to keep the call light within reach and was unaware of the issue until the survey. The facility did not have a policy available for call lights, contributing to the deficiency in accommodating the resident's needs.
Delayed Call Light Response and Staff Inaction
Penalty
Summary
The facility failed to treat residents with respect and dignity by not responding promptly to call lights, which is a critical aspect of resident care. Multiple residents reported significant delays in response times, particularly during the night shift. Residents expressed that call lights could take up to 45 minutes or more to be answered, and in some cases, they were not answered at all. This issue was consistently raised in resident council meetings over several months, indicating a persistent problem. Interviews with residents revealed that the night staff were often seen sleeping, and call lights were left unanswered. One resident reported that staff would turn off the call light and not return, while another mentioned that assistance was only provided when a roommate intervened. The residents' grievances were documented in the facility's records, highlighting a pattern of neglect in addressing call light concerns. Despite these complaints, staff members and management, including the ADON and DON, claimed to be unaware of any issues with call light response times. They conducted surprise visits and believed that the staff were performing their duties adequately. However, the residents' consistent reports and the facility's own records suggest a failure to ensure that residents' needs were met in a timely and respectful manner.
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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 Midland
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Focused Care At Midland | 1 mi | ★★★★★ | 3 | 0 |
| Midland Medical Lodge | 3.7 mi | ★★★★★ | 12 | 0 |
| Mabee Health Care Center | 5.1 mi | ★★★★★ | 10 | 0 |
| Ashton Medical Lodge | 5.9 mi | ★★★★★ | 4 | 0 |
| Parks Health Center | 15.4 mi | ★★★★★ | 0 | 0 |
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