This citation pertains to intake # 2715364.Based on interview and record review, the facility failed to provide quality wound care to promote healing and prevent the deterioration of a pressure ulcer for 1 (Resident #121) of 3 residents reviewed for wound care resulting in an Immediate Jeopardy when on 1/8/26, Resident #121 was hospitalized with altered mental status and septic shock (life-threatening condition caused by a severe infection) from a necrotic (death of cells in tissue) sacral ulcer (pressure ulcer at the base of the spine) with osteomyelitis (infection in a bone) requiring surgical intervention and bone debridement. …
F686 citations in Michigan
Pressure ulcers · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Michigan cites F686 more often than its own record predicts
1.59 times the share F686 takes of citations nationally.
Of every deficiency written in Michigan in 2025, this is the portion that was F686.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Michigan surveyors wrote
F686 findings written in Michigan, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
This citation pertains to intake 3137447.Based on interviews and record reviews the facility failed to ensure timely implementation of preventative wound interventions, failed to accurately implement wound treatment orders as noted by the Wound practitioner for one (R300) of three residents reviewed for wounds, resulting in a change in condition from a wound infection that required a transfer to a higher level of care and admission into the Intensive Care Unit (ICU) requiring multiple intravenous antibiotics and surgical wound debridement.Findings include:A review of a complaint submitted to the State Agency (SA) reported neglect regarding the care provided to R300.A review of the medical record revealed R300 admitted to the facility on [DATE] with diagnoses that included: cerebral… …
Based on interview, and record review, the facility failed to complete wound care treatments for one resident (R108) out of three residents reviewed for pressure ulcers. Findings Include: This citation pertains to Intake number 3093315.A review of the electronic medical record (EMR) revealed R108 was admitted to the facility on [DATE] with medical diagnoses which included Fracture of Left Tibia (shin bone). A review of R108's MDS (Minimum Data Set) assessment dated [DATE] revealed a BIMS score (brief interview of mental status) assessment score of 15/15 indicating intact cognition. Further review of the EMR revealed an admission nurses note on 6/1/2026 documenting the following, Resident admitted to the facility from the hospital with a diagnosis of left tibia fracture. …
The short window
Recent years
| Year | Share of Michigan citations | vs expected |
|---|---|---|
| 2023 | 3.47% | 1.69× |
| 2024 | 3.51% | 1.68× |
| 2025 | 3.13% | 1.59× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Michigan surveyors cite →
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