Corewell Health Rehabilitation & Nursing Center -

(diluted bleach to kill bacteria in wounds) apply Santyl followed by alginate cover with clean dry

pressure ulcer stage 3, length 7.6 cm x width 5.4 cm x depth 1.5 cm. R703 was transferred to the

that R703 admitted to the facility with a dime-sized open area on the coccyx that developed into a larger stage 3 pressure ulcer and was hospitalized . RN A confirmed that no skin treatments had been documented until 10/24/25, 9 days after admission. RN A stated, The first skin note I can see is 10/29/25, two weeks after admission. RN A said the wound care nurse who documented the first skin assessment note on admission had abruptly resigned and no longer worked at the facility. RN A was asked to review R703's MARs and stated, Yes, there are some holes there. I don't know why they did not receive all the prescribed skin treatments.According to the facility's Wound and Skin Management Policy last revised on 5/2025 in part reads: 'The facility must ensure that a resident who enters the facility without pressure ulcers does not develop pressure ulcers unless the individual's clinical condition demonstrates that they were unavoidable, and receives necessary treatment and services to promote healing, prevent infection and prevent new areas from developing.

Routine preventative care shall include turning and proper positioning, application of pressure reduction or pressure relief devices, providing good skin care, clean/dry bed linens and maintaining adequate nutrition and hydration.Documentation of risks and preventative measures will be included on the resident's plan of care and in the medical record as indicated.SKIN CHECKSSkin assessments are performed daily for each resident by the CNA.

Any new breakdown must be reported to the charge/staff nurse and/or treatment nurse so that the appropriate treatment can be initiated.On the resident's bath/shower days the nurse must validate the shower, complete skin assessment.