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Pilgrim Manor

📍 2000 Leonard N E, Grand-rapids, MI 49505 📞 (616) 458-1133 🛏️ 55 beds

Inspection History Overview

Detailed Inspection Reports

Notice: These are official CMS inspection narratives containing detailed regulatory findings. This information is not available in searchable format anywhere else online.

June 4, 2025 Health Inspection

Fines and Penalties by Year

2025 2 penalties totaling $43,140

$25,795
Jan 6, 2025

Fine

$17,345
Jan 6, 2025

Fine

2022 3 penalties totaling $24,750

$15,000
Feb 25, 2022

Fine

$9,750
Feb 25, 2022

Fine

$0
Feb 25, 2022

Payment Denial

2020 1 penalties totaling $58,320

$58,320
Jul 14, 2020

Fine

2018 1 penalties totaling $20,965

$20,965
Mar 7, 2018

Fine

2017 1 penalties totaling $11,180

$11,180
Dec 20, 2017

Fine

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Health Violations by Year

2025 15 violations

Tag 0658 D Jun 4, 2025

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Jun 23, 2025
Tag 0693 D Jun 4, 2025

Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

✓ Corrected: Jun 23, 2025
Tag 0725 E Jun 4, 2025

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

✓ Corrected: Jun 23, 2025
Tag 0742 D Jun 4, 2025

Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.

✓ Corrected: Jun 23, 2025
Tag 0812 F Jun 4, 2025

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Jun 23, 2025
Tag 0867 F Jun 4, 2025

Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

✓ Corrected: Jun 23, 2025
Tag 0550 D Jan 10, 2025

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

✓ Corrected: Jan 16, 2025
Tag 0580 D Jan 10, 2025

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

✓ Corrected: Jan 16, 2025
Tag 0658 D Jan 10, 2025

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Jan 16, 2025
Tag 0684 J Jan 10, 2025

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

✓ Corrected: Jan 16, 2025
Tag 0689 G Jan 10, 2025

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jan 16, 2025
Tag 0725 E Jan 10, 2025

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

✓ Corrected: Jan 16, 2025
Tag 0880 F Jan 10, 2025

Provide and implement an infection prevention and control program.

✓ Corrected: Jan 16, 2025
Tag 0609 D Jan 6, 2025

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

✓ Corrected: Jan 16, 2025
Tag 0689 J Jan 6, 2025

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jan 16, 2025

2024 23 violations

Tag 0561 E Jul 25, 2024

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

✓ Corrected: Aug 21, 2024
Tag 0565 E Jul 25, 2024

Honor the resident's right to organize and participate in resident/family groups in the facility.

✓ Corrected: Aug 21, 2024
Tag 0578 D Jul 25, 2024

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

✓ Corrected: Aug 21, 2024
Tag 0584 E Jul 25, 2024

Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

✓ Corrected: Aug 21, 2024
Tag 0644 D Jul 25, 2024

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

✓ Corrected: Aug 21, 2024
Tag 0656 D Jul 25, 2024

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Aug 21, 2024
Tag 0677 E Jul 25, 2024

Provide care and assistance to perform activities of daily living for any resident who is unable.

✓ Corrected: Aug 21, 2024
Tag 0684 D Jul 25, 2024

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

✓ Corrected: Aug 21, 2024
Tag 0688 D Jul 25, 2024

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

✓ Corrected: Aug 21, 2024
Tag 0690 D Jul 25, 2024

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

✓ Corrected: Aug 21, 2024
Tag 0693 D Jul 25, 2024

Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

✓ Corrected: Aug 21, 2024
Tag 0695 D Jul 25, 2024

Provide safe and appropriate respiratory care for a resident when needed.

✓ Corrected: Aug 21, 2024
Tag 0725 E Jul 25, 2024

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

✓ Corrected: Aug 21, 2024
Tag 0770 D Jul 25, 2024

Provide timely, quality laboratory services/tests to meet the needs of residents.

✓ Corrected: Aug 21, 2024
Tag 0804 E Jul 25, 2024

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

✓ Corrected: Aug 21, 2024
Tag 0809 E Jul 25, 2024

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

✓ Corrected: Aug 21, 2024
Tag 0812 F Jul 25, 2024

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Aug 21, 2024
Tag 0550 D Apr 23, 2024

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

✓ Corrected: May 22, 2024
Tag 0561 D Apr 23, 2024

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

✓ Corrected: May 22, 2024
Tag 0602 D Apr 23, 2024

Protect each resident from the wrongful use of the resident's belongings or money.

✓ Corrected: Feb 8, 2024
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2023 30 violations

Tag 0606 D Dec 18, 2023

Not hire anyone with a finding of abuse, neglect, exploitation, or theft.

✓ Corrected: Dec 8, 2023
Tag 0623 D Dec 18, 2023

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

✓ Corrected: Jan 27, 2024
Tag 0657 D Dec 18, 2023

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

✓ Corrected: Jan 27, 2024
Tag 0658 D Dec 18, 2023

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Oct 13, 2023
Tag 0684 D Dec 18, 2023

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

✓ Corrected: Jan 27, 2024
Tag 0686 D Dec 18, 2023

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

✓ Corrected: Jan 27, 2024
Tag 0725 E Dec 18, 2023

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

✓ Corrected: Jan 27, 2024
Tag 0842 D Dec 18, 2023

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

✓ Corrected: Jan 27, 2024
Tag 0880 E Dec 18, 2023

Provide and implement an infection prevention and control program.

✓ Corrected: Jan 27, 2024
Tag 0689 J Aug 29, 2023

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jul 25, 2023
Tag 0561 D Jun 14, 2023

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

✓ Corrected: Jul 19, 2023
Tag 0578 D Jun 14, 2023

Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

✓ Corrected: Jul 19, 2023
Tag 0583 D Jun 14, 2023

Keep residents' personal and medical records private and confidential.

✓ Corrected: Jul 19, 2023
Tag 0656 D Jun 14, 2023

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Jul 19, 2023
Tag 0658 D Jun 14, 2023

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Jul 19, 2023
Tag 0677 E Jun 14, 2023

Provide care and assistance to perform activities of daily living for any resident who is unable.

✓ Corrected: Jul 19, 2023
Tag 0684 D Jun 14, 2023

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

✓ Corrected: Jul 19, 2023
Tag 0686 D Jun 14, 2023

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

✓ Corrected: Jul 19, 2023
Tag 0688 D Jun 14, 2023

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

✓ Corrected: Jul 19, 2023
Tag 0689 D Jun 14, 2023

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jul 19, 2023

2022 20 violations

Tag 0658 G Aug 24, 2022

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Sep 13, 2022
Tag 0684 G Aug 24, 2022

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

✓ Corrected: Oct 6, 2022
Tag 0689 D Aug 18, 2022

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Sep 13, 2022
Tag 0550 D May 19, 2022

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

✓ Corrected: Jun 10, 2022
Tag 0689 D May 19, 2022

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Mar 7, 2022
Tag 0776 D May 19, 2022

Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.

✓ Corrected: Jun 10, 2022
Tag 0550 D Feb 25, 2022

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

✓ Corrected: Apr 4, 2022
Tag 0623 D Feb 25, 2022

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

✓ Corrected: Apr 4, 2022
Tag 0625 D Feb 25, 2022

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

✓ Corrected: Apr 4, 2022
Tag 0688 D Feb 25, 2022

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

✓ Corrected: Apr 4, 2022
Tag 0689 D Feb 25, 2022

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Apr 4, 2022
Tag 0725 E Feb 25, 2022

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

✓ Corrected: Apr 4, 2022
Tag 0726 C Feb 25, 2022

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

✓ Corrected: Apr 4, 2022
Tag 0727 F Feb 25, 2022

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

✓ Corrected: Apr 4, 2022
Tag 0761 E Feb 25, 2022

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

✓ Corrected: Apr 27, 2022
Tag 0812 F Feb 25, 2022

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Apr 4, 2022
Tag 0842 D Feb 25, 2022

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

✓ Corrected: Apr 4, 2022
Tag 0880 E Feb 25, 2022

Provide and implement an infection prevention and control program.

✓ Corrected: Apr 4, 2022
Tag 0888 E Feb 25, 2022

Ensure staff are vaccinated for COVID-19

✓ Corrected: Apr 4, 2022
Tag 0921 F Feb 25, 2022

Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.

✓ Corrected: Apr 4, 2022
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2021 14 violations

Tag 0656 D Dec 8, 2021

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Jan 7, 2022
Tag 0658 D Dec 8, 2021

Ensure services provided by the nursing facility meet professional standards of quality.

✓ Corrected: Jan 7, 2022
Tag 0689 D Dec 8, 2021

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jan 7, 2022
Tag 0656 D Nov 17, 2021

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Jan 7, 2022
Tag 0689 D Nov 17, 2021

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jan 7, 2022
Tag 0604 D Aug 12, 2021

Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.

✓ Corrected: Sep 10, 2021
Tag 0607 D Aug 12, 2021

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

✓ Corrected: Aug 27, 2021
Tag 0656 D Aug 12, 2021

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Sep 10, 2021
Tag 0689 D Aug 12, 2021

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Sep 10, 2021
Tag 0580 D Feb 10, 2021

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

✓ Corrected: Mar 23, 2021
Tag 0609 D Feb 10, 2021

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

✓ Corrected: Mar 23, 2021
Tag 0610 D Feb 10, 2021

Respond appropriately to all alleged violations.

✓ Corrected: Mar 23, 2021
Tag 0657 D Feb 10, 2021

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

✓ Corrected: Mar 23, 2021
Tag 0689 D Feb 10, 2021

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Mar 23, 2021

2020 8 violations

Tag 0656 D Jul 14, 2020

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Aug 12, 2020
Tag 0689 G Jul 14, 2020

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Aug 12, 2020
Tag 0880 J Jul 14, 2020

Provide and implement an infection prevention and control program.

✓ Corrected: Aug 12, 2020
Tag 0656 D Jan 30, 2020

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Mar 9, 2020
Tag 0657 E Jan 30, 2020

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

✓ Corrected: Mar 9, 2020
Tag 0755 D Jan 30, 2020

Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

✓ Corrected: Mar 9, 2020
Tag 0812 F Jan 30, 2020

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Mar 9, 2020
Tag 0880 D Jan 30, 2020

Provide and implement an infection prevention and control program.

✓ Corrected: Mar 9, 2020
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2019 5 violations

Tag 0580 D Sep 26, 2019

Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

✓ Corrected: Nov 4, 2019
Tag 0842 D Sep 26, 2019

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

✓ Corrected: Nov 4, 2019
Tag 0609 E Jul 16, 2019

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

✓ Corrected: Aug 24, 2019
Tag 0656 D Jul 16, 2019

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Aug 24, 2019
Tag 0689 G Apr 22, 2019

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: May 22, 2019

2018 19 violations

Tag 0656 E Nov 9, 2018

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Dec 19, 2018
Tag 0657 D Nov 9, 2018

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

✓ Corrected: Dec 19, 2018
Tag 0758 E Nov 9, 2018

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

✓ Corrected: Dec 19, 2018
Tag 0761 D Nov 9, 2018

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

✓ Corrected: Dec 19, 2018
Tag 0808 D Nov 9, 2018

Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.

✓ Corrected: Dec 19, 2018
Tag 0812 F Nov 9, 2018

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Jan 3, 2019
Tag 0868 D Nov 9, 2018

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

✓ Corrected: Dec 19, 2018
Tag 0880 E Nov 9, 2018

Provide and implement an infection prevention and control program.

✓ Corrected: Dec 19, 2018
Tag 0557 D Jul 18, 2018

Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.

✓ Corrected: Aug 14, 2018
Tag 0656 D Jul 18, 2018

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Aug 14, 2018
Tag 0689 D May 25, 2018

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Jun 8, 2018
Tag 0565 E Mar 7, 2018

Honor the resident's right to organize and participate in resident/family groups in the facility.

✓ Corrected: Mar 31, 2018
Tag 0656 D Mar 7, 2018

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

✓ Corrected: Mar 31, 2018
Tag 0657 D Mar 7, 2018

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

✓ Corrected: Mar 31, 2018
Tag 0686 G Mar 7, 2018

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

✓ Corrected: Mar 31, 2018
Tag 0689 J Mar 7, 2018

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

✓ Corrected: Mar 31, 2018
Tag 0761 D Mar 7, 2018

Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

✓ Corrected: Mar 31, 2018
Tag 0812 F Mar 7, 2018

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

✓ Corrected: Mar 31, 2018
Tag 0880 F Mar 7, 2018

Provide and implement an infection prevention and control program.

✓ Corrected: Mar 31, 2018
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2017 5 violations

Tag 0600 G Dec 20, 2017

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

✓ Corrected: Jan 26, 2018
Tag 0607 E Dec 20, 2017

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

✓ Corrected: Jan 26, 2018
Tag 0610 E Dec 20, 2017

Respond appropriately to all alleged violations.

✓ Corrected: Jan 26, 2018
Tag 0842 D Dec 20, 2017

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

✓ Corrected: Jan 26, 2018
Tag 0943 D Dec 20, 2017

Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.

✓ Corrected: Jan 26, 2018
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