Deficiencies per Year
4
3
2
1
0
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Complaint Investigation
Capacity: 138
Deficiencies: 1
Jun 26, 2025
Visit Reason
The investigation was initiated due to complaints alleging that employees were not trained and competencies were not checked on medication administration.
Findings
The investigation found that the facility changed its staffing model to have resident assistants administer medications without formal training or competency testing. There was a lack of training documentation and competency checks on injection medications and catheter care, and employees had not acknowledged their position changes.
Complaint Details
The complaint alleged that certified nurse assistants were administering medications without formal training. The violation was established based on interviews and documentation review.
Deficiencies (1)
| Description |
|---|
| Employees are not trained, and competencies are not checked on medication administration. |
Report Facts
Capacity: 138
Complaint Receipt Date: Jun 17, 2025
Investigation Initiation Date: Jun 20, 2025
Report Due Date: Aug 17, 2025
Training hours: 12
Training hours: 8
Passing grade: 95
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kari Conn | Administrator | Interviewed regarding staffing model change and training. |
| Kimberly Horst | Licensing Staff | Conducted investigation and authored report. |
| Andrea L. Moore | Manager, Long-Term-Care State Licensing Section | Approved the report. |
Inspection Report
Complaint Investigation
Capacity: 138
Deficiencies: 1
Jun 11, 2025
Visit Reason
The inspection was conducted in response to a complaint alleging that care staff were rude to Resident A, Resident A's care needs were not met, and Resident A's room had not been cleaned.
Findings
The investigation found that the allegation of care staff being rude to Resident A was not substantiated. However, a violation was established regarding Resident A's care needs not being fully met due to inconsistent shower documentation and lack of detailed information in the service plan. The allegation that Resident A's room was not cleaned was not substantiated.
Complaint Details
Complaint received on 2025-06-02 alleging care staff were rude to Resident A, Resident A's care needs were not met, and Resident A's room was not cleaned. The allegation of rudeness was not established; care needs not met was established; room cleanliness allegation was not established.
Deficiencies (1)
| Description |
|---|
| Inconsistent shower documentation and lack of detailed information in Resident A's service plan regarding care needs and independence encouragement. |
Report Facts
Capacity: 138
Shower dates documented: 5
Shower refusals documented: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kari Conn | Administrator/Authorized Representative | Interviewed regarding Resident A's care and facility operations |
| Kimberly Horst | Licensing Staff | Conducted the investigation and authored the report |
Inspection Report
Complaint Investigation
Census: 64
Capacity: 138
Deficiencies: 1
May 21, 2025
Visit Reason
The inspection was initiated due to multiple complaints alleging inadequate staffing at the facility, including concerns about resident falls, medication administration delays, and resident neglect.
Findings
The investigation found that the facility had worked below their staffing ratios on several occasions, requiring use of staff from another licensed health care facility to fill shortages. Call light response times were sometimes prolonged, and staffing shortages impacted resident care and medication administration.
Complaint Details
The complaint alleged inadequate staffing resulting in residents not being checked regularly, resident falls, elopements, and neglect. The complaint was substantiated with a violation established.
Deficiencies (1)
| Description |
|---|
| Inadequate staff at the facility. |
Report Facts
Capacity: 138
Census: 64
Call light response time (minutes): 9
Staffing shortages: 3
Call light response times (minutes and seconds): Detailed daily average call light response times from 07/02/2025 to 07/09/2025 as listed in the report.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kari Conn | Administrator | Interviewed regarding staffing and facility operations. |
| Kimberly Horst | Licensing Staff | Author of the Special Investigation Report. |
| Andrea L. Moore | Manager, Long-Term-Care State Licensing Section | Approved the report. |
Inspection Report
Renewal
Census: 20
Capacity: 221
Deficiencies: 2
Feb 22, 2024
Visit Reason
The inspection was conducted as a renewal licensing study for the Michigan Masonic Home to assess compliance with applicable rules and regulations.
Findings
The facility was found to be in non-compliance with rules related to medication administration documentation and food handling practices, specifically incomplete medication logs and leftover food not destroyed as required.
Deficiencies (2)
| Description |
|---|
| Staff did not complete the medication administration record (MAR) on 02/06 for Resident A as prescribed by the physician. |
| Leftover food was found in a refrigerator on the second floor, which should have been destroyed. |
Report Facts
Number of staff interviewed and/or observed: 10
Number of residents interviewed and/or observed: 20
Facility capacity: 221
Notice
Deficiencies: 0
May 8, 2023
Visit Reason
The document serves as a notification of license renewal following an administrative review of licensing activity for the past year, confirming substantial compliance with public health code and administrative rules.
Findings
The administrative review revealed substantial compliance with applicable regulations, resulting in the renewal of the Home for the Aged license effective May 4, 2023.
Report Facts
License duration: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Horst | Licensing Staff | Signed the license renewal notification letter |
Inspection Report
Renewal
Deficiencies: 0
Apr 4, 2022
Visit Reason
The document is a licensing renewal notification following an administrative review of licensing activity for the past year, confirming substantial compliance with public health code and administrative rules for home for the aged facilities.
Findings
The review revealed substantial compliance with applicable regulations, resulting in the renewal of the facility's 12-month license effective 2022-05-04.
Report Facts
License duration: 12
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Horst | Licensing Staff | Author of the licensing renewal letter |
Inspection Report
Original Licensing
Capacity: 221
Deficiencies: 0
Jun 22, 2021
Visit Reason
The document is an addendum to the Original Licensing Study Report for Michigan Masonic Home, reflecting renovations and changes to the facility.
Findings
The facility renovated the former memory care unit on the third floor into a common living area, dining area, nurse station, laundry room, storage, and eight resident suites allowing double occupancy. The apartments include studio and two-bedroom floor plans with bathrooms equipped with emergency pull cords. No marketing of memory care programming was found for the aged areas.
Report Facts
Licensed beds: 221
Resident suites: 8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Kimberly Horst | Licensing Staff | Author of the report and recommendation |
| Russell Misiak | Area Manager | Signed the recommendation |
| Michael Logan | Authorized Representative of the facility | |
| Kari Conn | Administrator | Facility Administrator |
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