Life Care Center of Michigan City: Constipation Crisis - IN
The October 28 complaint inspection at Life Care Center of Michigan City, a nursing home at 802 US Highway 20 East, documented what happened to one resident across a week in which the warning signs were recorded in the chart and the response kept falling short.
A physician ordered Miralax, one packet twice daily for five days, starting October 15. The medication administration record shows it was given as ordered. A progress note from October 16 recorded one medium soft bowel movement. A progress note from October 17 recorded none. The documentation continued, but the situation did not improve.
By the evening of October 20, the resident was complaining of increasing abdominal pain and still had not had a bowel movement. A nurse practitioner was notified and ordered a Fleet enema. The enema was administered. It didn't work. The resident's pain worsened. She said she felt like she could have a seizure.
911 was called. The nurse practitioner and family were notified.
The following morning, a progress note recorded that the resident had been admitted to the hospital. The CT scan of her abdomen and pelvis, taken the night before, told the story plainly: a large volume of stool throughout the colon and rectum, mild wall thickening of the rectum with adjacent inflammatory change consistent with proctitis, an inflammation of the anus and the lining of the rectum. The scan also noted that stercoral colitis, a rare and serious inflammatory condition that occurs when impacted fecal material causes the colon to distend, could not be excluded.
She was admitted for proctitis and constipation.
When inspectors interviewed the Director of Nursing on October 28, she said the facility's protocol called for constipation interventions to begin if a resident had not had a bowel movement in three days. The progress note from October 17 documented that the resident had not had a bowel movement. The next documented entry was October 20, when she was already in pain and the situation had become an emergency. The Director of Nursing told inspectors she was unable to find any other documentation from the days in between.
The facility's own bowel protocol, last reviewed September 15, 2025, required nursing staff to record each bowel movement in the electronic health record and directed the facility to implement standing orders in coordination with the attending practitioner when a resident wasn't moving their bowels. The protocol acknowledged those orders might vary by practitioner or by resident need. What it did not account for was the gap between the October 17 note and the October 20 crisis, a gap the Director of Nursing could not fill with any records.
Inspectors cited the facility under F0684, which covers the standard of care residents are entitled to receive. The level of harm was assessed as minimal harm or potential for actual harm. Given that the resident was hospitalized with a colon full of stool and a diagnosis that left open the possibility of a more serious inflammatory condition, the distance between that assessment and what the CT scan showed is its own kind of documentation.
The resident had told staff her bowels weren't moving like they should. The chart recorded it. The laxative was ordered and given. And then, for the better part of three days, the record goes quiet, while somewhere in a room at 802 US Highway 20 East, a woman's pain was building toward a 911 call.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Life Care Center of Michigan City from 2025-10-28 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 4, 2026 · Our methodology
LIFE CARE CENTER OF MICHIGAN CITY in MICHIGAN CITY, IN was cited for violations during a health inspection on October 28, 2025.
A physician ordered Miralax, one packet twice daily for five days, starting October 15.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.