Majestic Care of Livonia

In the surveyor’s words

From the most serious findings on record at Majestic Care of Livonia, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Apr 4, 2024

  This citation pertains to Intake M100143712. Based on observation, interview and record review, the facility failed to provide monitoring, supervision and door alarm response to prevent the elopement of one (R901) of six residents reviewed for elopement, who was a known elopement risk and wore a Wanderguard (ankle bracelet used to set off an alarm restricting a resident from walking out the door). R901 eloped from the facility on 03/25/24 at 9:10 PM unbeknownst to staff until 5:15 AM on 03/26/24. R901 was located in the community approximately 12 miles away from the facility at 1:30 AM on 03/29/24. R901 was able to exit the facility, triggering the alarm system wearing a Wanderguard without staff being aware for appoximately eight hours. […]

• Actual harm, patternF600Oct 4, 2023

  This citation pertains to Intakes: MI00136917, MI00134758, MI00140155 and MI00137068. Based on interview, and record review, the facility failed to ensure the safety and wellbeing for five residents (R1, R8, R10, R25 and R93) out of four reviewed for abuse, to prevent physical abuse from a resident who had unpredictable behaviors and a staff member, resulting in physical abuse, bodily injuries, and psychosocial distress. Findings include: Resident 8 A review of a Facility Reported Incident dated 5/9/2023 revealed the following, Incident Summary: [R254] was observed collaring up (to hold someone so they cannot move) roommate [R8]. Residents were immediately separated. [R254] was placed on 1:1 and sent out for psychiatric observation. […]

• Actual harm, isolatedF686Jul 24, 2024

  This citation pertains to Intake MI00145744. Based on interview and record review, the facility failed to implement timely treatments for a newly identified wound for one resident (R701) out of three reviewed for wounds, resulting in the worsening of the wound. Findings include: A review of the medical record revealed that R701 admitted into the facility on [DATE] with the following diagnoses, Cerebral Infarction, Dysphagia, and Adult Failure to Thrive. A review of the Minimum Data Set assessment revealed a Brief Interview for Mental Status score of 7/15 indicating an impaired cognition. R701 also required extensive staff assistance with bed mobility and transfers. A review of the initial skin assessment dated [DATE] noted that R701 did not have any identified skin conditions. […]

• Actual harm, isolatedF686Oct 31, 2023

  This citation pertains to Intake MI00140358. Based on interview and record review, the facility failed to provide wound care treatments as ordered for one resident (R802) of three reviewed for care and treatment, resulting in the potential for worsening of existing pressure ulcers and/or development of new wounds. Findings Include: A review of the Intake revealed, The complainant states the resident wasn't getting proper wound care and [R802] was sent to hospital in [date] due to the condition of [their] wounds. On 10/31/2023 at 11:55 AM, a phone interview was conducted with the complainant. The complainant stated that R802 was not receiving proper care while in facility. They stated that R802 had several pressure sores and were not receiving care. […]

• Actual harm, isolatedF686Dec 14, 2021

  This citation pertains to intake MI 490. Based on observation, interview, and record review, the facility failed to 1) initiate specific and timely wound care orders upon a re-admission into the facility 2) provide adequate pressure ulcer treatment and preventative measures and 3) adequately control pain during wound care/incontinence care for one sampled resident (R65) of 16 reviewed, resulting in resident pain, and the potential for worsening of existing wounds and/or the development of new wounds. […]