Inspection Reports for Hampton Manor of Clinton
18401 15 Mile Rd, Clinton Twp, MI 48035, United States, MI, 48035
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Inspection Report
Renewal
Census: 31
Capacity: 101
Deficiencies: 4
Mar 26, 2025
Visit Reason
The inspection was conducted as a Renewal Licensing Study Report to evaluate compliance with licensing requirements and to determine if the facility license should be renewed.
Findings
The facility was found to be in non-compliance with several administrative rules including lack of signed service plans by residents or POAs, unsafe bed rail assist device posing entrapment risks without physician orders or staff training, incomplete medication administration logs, and unsafe storage of hazardous materials with oxygen tanks stored in a resident's room.
Deficiencies (4)
| Description |
|---|
| Service plans for residents were not signed by the residents or their POAs. |
| Unsafe bed rail assist device with entrapment hazards and no physician order or staff training. |
| Medication count sheet was not always signed or initialed. |
| Five free standing oxygen tanks were stored unsafely in a resident's room. |
Report Facts
Number of residents interviewed and/or observed: 31
Number of staff interviewed and/or observed: 9
Capacity: 101
Number of free standing oxygen tanks stored in resident's room: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shahid Imran | Authorized Representative/Administrator | Named as facility administrator in identifying information |
| Brender Howard | Licensing Staff | Author of the report and contact person |
Inspection Report
Complaint Investigation
Capacity: 101
Deficiencies: 1
Jan 22, 2025
Visit Reason
The inspection was conducted in response to a complaint alleging that Resident A eloped from the facility during the night and was missing for over 30 minutes before being found by public safety.
Findings
The investigation substantiated that Resident A eloped from the facility through the front door at 4:09 a.m. Staff did not realize Resident A had left, and the service plan did not adequately address monitoring or protection measures. Resident A was found by police and taken to the hospital. A violation was established due to failure to ensure resident safety consistent with the service plan.
Complaint Details
Complaint received on 2025-01-21 alleged Resident A eloped from the facility at night, was missing for over 30 minutes, and was found by public safety. The claim was substantiated based on investigation findings.
Deficiencies (1)
| Description |
|---|
| The service plan does not adequately provide information on how Resident A is monitored and protected, resulting in Resident A eloping from the facility unnoticed. |
Report Facts
Capacity: 101
Complaint Receipt Date: Jan 21, 2025
Investigation Initiation Date: Jan 22, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jane Goulette | Director | Interviewed regarding Resident A elopement incident |
| Brender Howard | Licensing Staff | Author of the Special Investigation Report |
Inspection Report
Complaint Investigation
Capacity: 101
Deficiencies: 1
Dec 10, 2024
Visit Reason
The inspection was conducted in response to a complaint alleging that Resident A had bruising which was not reported by staff.
Findings
The investigation substantiated that Resident A sustained bruising and a possible injury to her left pinky finger. Employee #2 failed to report the fall and notify required parties, resulting in termination. Other staff also failed to report the injuries to the family or hospice team.
Complaint Details
The complaint alleged that Resident A had bruising on her jaw, face, and eye that was not reported. The allegation was substantiated based on investigation findings.
Deficiencies (1)
| Description |
|---|
| Failure to report Resident A's bruising and injury as required by facility policy. |
Report Facts
Capacity: 101
Complaint Receipt Date: Dec 2, 2024
Investigation Initiation Date: Dec 2, 2024
Inspection Date: Dec 10, 2024
Exit Conference Date: Dec 13, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shahid Imran | Authorized Representative/Administrator | Participated in exit conference and is the facility administrator |
| Jessica Rogers | Licensing Staff | Conducted the investigation and authored the report |
Inspection Report
Complaint Investigation
Census: 44
Capacity: 101
Deficiencies: 4
Nov 25, 2024
Visit Reason
The inspection was conducted in response to allegations received from Adult Protective Services (APS) regarding medication administration errors, short staffing, and residents falling and lying on the floor overnight at Hampton Manor of Clinton.
Findings
The investigation substantiated violations related to improper medication administration documentation, inadequate staffing levels especially during night shifts, and failure to fully adhere to residents' fall prevention and care plans. Additional findings included outdated resident service plans and lapses in communication and documentation.
Complaint Details
The complaint investigation was initiated following APS allegations received on 11/18/2024 concerning medication errors, short staffing from March to September 2024, and residents falling and lying on the floor overnight. The violations were substantiated based on staff interviews, document reviews, and on-site inspection.
Deficiencies (4)
| Description |
|---|
| Medications were not administered per physician orders; medication administration records contained blank dates and unclear documentation. |
| The facility was short staffed, particularly during night shifts, not meeting staffing guidelines for memory care and assisted living residents requiring assistance. |
| Residents had falls and were found lying on the floor overnight; staff actions did not fully align with residents' service plans and fall prevention policies. |
| Resident B’s service plan was not updated as required by regulation. |
Report Facts
Facility capacity: 101
Memory care residents: 5
Assisted living residents: 39
Staff on night shift: 2
Medication administration system implementation date: Nov 8, 2024
Medication Paxlovid prescribed duration: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Rogers | Licensing Staff | Author of the Special Investigation Report |
| Shahid Imran | Authorized Representative/Administrator | Facility administrator interviewed during investigation |
Inspection Report
Complaint Investigation
Census: 8
Capacity: 101
Deficiencies: 1
Apr 14, 2023
Visit Reason
The inspection was conducted in response to a complaint alleging that Resident A did not receive his prescribed medications, which allegedly contributed to his death, and that residents lacked supervision at the facility.
Findings
The investigation substantiated that Resident A did not receive medications as prescribed due to medication delivery and administration issues, including inconsistent documentation and medication unavailability. However, there was insufficient evidence to support the allegation that residents lacked supervision.
Complaint Details
Complaint alleged Resident A did not receive prescribed medications leading to his death and that residents lacked supervision. The medication administration allegation was substantiated; the supervision allegation was not substantiated.
Deficiencies (1)
| Description |
|---|
| Facility lacked an organized program to ensure Resident A’s medications were ordered, delivered, and administered as prescribed by his licensed health care professional. |
Report Facts
Capacity: 101
Census: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Jessica Rogers | Licensing Staff | Author of the Special Investigation Report |
| Shahid Imran | Administrator/Authorized Representative | Facility administrator involved in the investigation and exit conference |
Inspection Report
Renewal
Deficiencies: 0
Apr 12, 2023
Visit Reason
The document serves as a renewal notification for the Home for the Aged license of Hampton Manor of Clinton, confirming substantial compliance with public health code and administrative rules over the past year.
Findings
An administrative review found substantial compliance with applicable regulations, resulting in the renewal of the facility's 12-month license effective from 4/12/2023 to 4/11/2024.
Report Facts
License effective period (months): 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Brender Howard | Licensing Staff | Author of the renewal notification letter |
Inspection Report
Complaint Investigation
Census: 27
Capacity: 101
Deficiencies: 2
Mar 15, 2023
Visit Reason
The investigation was initiated due to a complaint alleging inadequate staff to assist residents, failure to provide reasonable care to a Resident of Concern (ROC), and conditions placed on releasing the ROC's medications when she was moved out of the facility.
Findings
The investigation found that the facility did not have adequate staff to assist residents, and the facility failed to maintain records of the in-house physician's examinations. However, violations were not established regarding the ROC being dropped during transfers or the facility placing conditions on releasing the ROC's medications.
Complaint Details
The complaint alleged that the facility did not provide adequate staffing, dropped the Resident of Concern during transfers, failed to treat intestinal bleeding and fungal infection, and placed conditions on releasing the resident's medications. The investigation substantiated inadequate staffing and failure to maintain physician records but did not substantiate the other allegations.
Deficiencies (2)
| Description |
|---|
| The facility did not have adequate staff to assist the residents. |
| The facility did not keep the record of the in-house physician's examinations and observations. |
Report Facts
Facility capacity: 101
Resident census: 27
Caregiver staffing: 2
Caregiver staffing: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Barbara P. Zabitz | Health Care Surveyor | Author of the Special Investigation Report |
| Nayab Virk | Administrator | Facility administrator mentioned in the report |
| Shahid Imran | Authorized Representative | Facility authorized representative mentioned in the report |
| Andrea L. Moore | Manager, Long-Term-Care State Licensing Section | Approved the report |
Inspection Report
Complaint Investigation
Capacity: 101
Deficiencies: 1
Nov 7, 2022
Visit Reason
The inspection was conducted in response to a complaint alleging that Resident A left the facility without anyone knowing she was out of the facility.
Findings
The investigation found that Resident A was able to leave the facility unsupervised through the front door, which lacked an alarm, and was found a half mile away after a fall. The facility's service plan did not adequately specify monitoring frequency or assistance required, resulting in a violation of resident protection and safety rules.
Complaint Details
Complaint was substantiated. Resident A left the facility unsupervised and was found a half mile away after a fall. The facility failed to provide adequate supervision and assistance as required by the resident’s service plan.
Deficiencies (1)
| Description |
|---|
| Resident A left the facility by herself without anyone knowing she was out of the facility, violating the requirement for protection and safety consistent with the resident’s service plan. |
Report Facts
Capacity: 101
Complaint Receipt Date: Nov 3, 2022
Investigation Initiation Date: Nov 7, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Nayab Virk | Business Manager | Interviewed onsite regarding Resident A's supervision and facility staffing |
| Patricia Conner | Nurse | Interviewed onsite regarding Resident A's condition and care |
| Shahid Imran | Authorized Representative/Administrator | Named as authorized representative and recipient of report |
Inspection Report
Complaint Investigation
Capacity: 101
Deficiencies: 1
Aug 9, 2022
Visit Reason
The inspection was conducted in response to a complaint alleging that Resident A fell on the floor and staff did not know how long she had been on the floor.
Findings
The investigation confirmed that Resident A was found on the floor and it was unknown how long she had been there. The facility's service plan was inadequate in addressing Resident A's behavior of sitting on the floor and monitoring frequency, resulting in a violation of care plan requirements.
Complaint Details
The complaint alleged that Resident A fell on the floor and staff did not know how long she had been there. The violation was substantiated based on interviews and record review.
Deficiencies (1)
| Description |
|---|
| The facility did not provide adequate details in the service plan regarding Resident A putting herself on the floor or how often she was monitored. |
Report Facts
Capacity: 101
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shahid Imran | Administrator | Named as the facility administrator during the investigation |
| Naya Virk | Business Manager | Interviewed during onsite visit regarding Resident A |
| Lauren Morris | Receptionist | Interviewed during onsite visit regarding Resident A |
| Christian Louie | Caregiver | Interviewed by telephone about finding Resident A on the floor |
Inspection Report
Original Licensing
Capacity: 101
Deficiencies: 0
Sep 29, 2021
Visit Reason
The inspection was conducted as part of the original licensing study for Hampton Manor of Clinton to determine compliance with applicable licensing statutes and administrative rules for a home for the aged facility.
Findings
The study determined substantial compliance with the home for the aged public health code and administrative rules. Fire safety inspections were completed and approved, with one door lock issue corrected. The facility was recommended for issuance of a temporary 6-month license with a maximum capacity of 101 beds.
Report Facts
Licensed capacity: 101
Memory care beds: 22
Assisted living beds: 79
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Shahid Imran | Authorized Representative | Named in relation to technical assistance and on-site inspection |
| Carol Cancio | Assistant to Authorized Representative | Named in relation to technical assistance and submission of revised policies |
| Razanne Pedawi | Administrative Executive | Named in relation to technical assistance and submission of photographs/videos confirming corrections |
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