Lake Orion Nursing Center

In the surveyor’s words

From the most serious findings on record at Lake Orion Nursing Center, in the surveyor’s own words.

• Actual harm, isolatedF684Jul 15, 2026

  This citation pertains to intake: 3053736.Based on interviews and record reviews the facility failed to promptly implement treatments and interventions as directed by the clinician and failed to ensure ongoing monitoring and evaluation of a resident with an identified change in condition for one (R103) of three residents reviewed for a closed record investigation, resulting in the continued unrecognized decline that required CPR (cardiopulmonary resuscitation) and EMS (emergency medical service) transport to the hospital where the resident subsequently expired, and also failed to ensure medication was available for administration for one resident (R105) of one resident reviewed for medication availability/administration. […]

• Actual harm, isolatedF600Sep 10, 2025

  This citation pertains to Complaint #1337621.Based on observation, interview, and record review, the facility failed to protect the resident's right to be free from neglect for one (R801) of three residents reviewed for accidents and supervision, resulting in the resident being hospitalized for alcoholic ketosis due to alcohol ingestion and lactic acidosis due to walking in 94 degree Fahrenheit (F) temperatures after staff allowed him to go on a leave of absence (LOA) with an unknown individual without consent from the legal guardian and did not identify he had not returned for approximately 30 hours. […]

• Actual harm, isolatedF689Jun 16, 2025

  This citation pertains to Intake Number(s): MI00153580. Based on interview and record review, the facility failed to provide supervision according to the individualized plan of care for one (R801) of three residents reviewed for falls, resulting in an acute intertrochanteric fracture of the left femur (hip) and an acute subdural hematoma (bleeding between the brain and the skull that ultimately resulted in the resident's death after R801 was left unsupervised on the toilet and sustained a fall. Findings include: A review of R801's hospital records revealed the following: A Discharge summary dated [DATE] documented, Discharge Final Diagnosis: Subdural hematoma .(R801) .presented to hospital on [DATE] s/p (status post) unwitnessed fall at her assisted living facility (nursing home). […]

• Actual harm, isolatedF689Mar 25, 2025

  This citation pertains to Intake Number(s): MI00150810, MI00150926, MI00151349 Based on interview and record review, the facility failed to ensure one (R801) of three residents reviewed for accidents, was transferred in a safe manner with fully functioning equipment and with the proper level of assistance, resulting in the resident falling out of the mechanical lift sling and sustaining an acute impacted fracture (fracture typically caused by force or trauma) of the right hip, a distal intertrochanteric fracture (fracture between the bony protrusion of the thighbone) of the right hip, an acute intertrochanteric fracture of the left hip, and Focal round hyperdensity (spot brighter than the surrounding brain indicating an abnormality) within the right sylvian fissure (part of the brain)… […]

• Actual harm, isolatedF686Apr 6, 2023

  This citation pertains to intake: MI00133899. Based on interview and record review the facility failed to timely assess, identify and notify the physician of the worsening of the sacrum wound and consistently implement and apply adequate treatment and interventions for one (R69) of three residents reviewed for pressure ulcers, resulting in the development of an infected stage IV pressure ulcer (Stage 4 Pressure Ulcer- Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone in the ulcer). Findings include: Review of the medical record revealed R69 was admitted to the facility on [DATE] with a readmitted [DATE] and diagnoses that included: dementia, chronic kidney disease, difficulty walking and muscle weakness. […]