The Orchards at Roseville

In the surveyor’s words

From the most serious findings on record at The Orchards at Roseville, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Apr 19, 2023

  This citation pertains to Intake: MI00135614 Based on observation, interview and record review, the facility failed to provide adequate supervision and implement interventions to prevent an elopement from the facility for a severely cognitively impaired resident (R906), who was a known wanderer and at risk of elopement. On 3/26/23, the R906 exited the facility building through an alarmed door, and then through a second unalarmed door at approximately 12:00am.The resident was located at a local gas station which was .8 miles away, and a 15-minute walk in a high traffic, busy vehicular area. The resident was transported back to the facility by the local police, after responding to a call by the gas station security, approximately 30-40 minutes after the resident was identified as missing. […]

• Immediate jeopardy, isolatedF689Aug 19, 2022

  This citation pertains to intake #'s: MI 042 and MI 210. Based on observation, interview and record review, the facility failed to secure a door prior to exiting the building, and failed to adequately supervise Resident (#711) of three residents reviewed for exit seeking behavior, resulting in an Immediate Jeopardy (IJ) when Resident #711 exited the building unbeknownst to staff after 09:00 PM on 07/25/2022, wandering approximately 1.8 miles (per map [NAME] directions) away from the facility lost, and the likelihood of serious injury, harm, impairment or death. Findings include: A review of the complaint in regard to Resident #711 revealed the following: .a concerned citizen found [Resident #711] leaned over .walker and out of breath on the road. […]

• Immediate jeopardy, isolatedF689Jan 5, 2022

  This citation pertains to intake MI 390. Based on interview, and record review the facility failed to provide appropriate supervision, monitoring, and to secure an alarmed door on the COVID unit for one sampled resident (R500) of five reviewed for elopement, allowing the resident to exit the building unbeknownst to staff on 12/11/21 between the hours of 12:31 AM to 2:30 AM, resulting in the likelihood of serious injury or death from being outside in the cold and near a heavily traffic congested road for an extended period. The police picked up the resident and transported them to the hospital on 12/11/21 at approximately 4:52 AM. […]

• Actual harm, patternF600Mar 17, 2022

  This citation pertains to Intakes: MI 752, MI 624 and MI 981 Based on observation, interview and record review, the facility 1) failed to prevent repeated and aggressive physical resident to resident abuse exerted by Residents (R604 and R608), 2) implement abuse policies and procedures and 3) failed to ensure an environment free of physical abuse for four Residents (R605, R606, R 607 and 602) out of nine residents reviewed for abuse, resulting physical abuse towards residents and staff, fear, pain, and mental anguish of residents utilizing the reasonable person concept. […]

• Actual harm, isolatedF600Jan 24, 2023

  This citation pertains to Intake MI00133133. Based on interview and record review, the facility failed to protect the resident's (R904) right to be free from physical abuse by another resident (R903), resulting in R904 being repeatedly punched in the head, transfer to the hospital for diagnostic evaluation of injury, hematoma (bruise) and redness, and continued fear. Findings include: A facility reported incident (FRI) was submitted to the State Agency alleging a resident to resident physical abuse incident involving R903 (perpetrator) and R904 (victim) that occurred on 11/16/2022. On 1/23/23 at 3:47 PM, R904 was interviewed at the facility. R904 was observed to be short in stature and petite in size. R904 used a wheelchair but was observed to be able to stand up without assistance. […]