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Complaint Investigation

Canal View - Houghton County

September 25, 2025 · Hancock, MI · 1100 Quincy Street
Citations 2
CMS Rating 4/5
Beds 197
Provider ID 235031
Healthcare Facility
Canal View - Houghton County
Hancock, MI  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

Canal View - Houghton County in Hancock, MI — inspection on September 25, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

Inspection Findings

FF0684
Quality of Life and Care Deficiencies

manner to prevent contamination or infection .

Administration should occur within 60 minutes prior to

effective 12/2024, revealed the following, in part: The facility will keep its residents as pain free as

will be implemented to comply with professional standards of practice, focusing on comprehensive person-centered care planning to include the resident's goals and preferences .G.

Nursing should evaluate pain status, interventions and effectiveness of pain interventions and document in the nursing notes and EMAR as applicable.

Update the Physician as needed. H.

When giving PRN pain medications, nursing should document follow-up assessment in the EHR. I.

Non-pharmacological interventions for pain (i.e., repositioning, massage, turning lights off, warm cloth, etc.) should be attempted and documented appropriately.

These may be used alone or in combination with pharmacological interventions.During the exit conference, at approximately 3:10 p.m., in the presence of the NHA, DON and Corporate Compliance Officer U. the NHA and DON acknowledged LPN E should have assessed the effectiveness of the Morphine Sulfate and Lorazepam both administered at approximately 7:30 p.m., to determine if additional interventions and/or medications were necessary to provide comfort during the dying process.

The NHA acknowledge and agreed that nursing documentation should have included assessment of the resident's condition.

This Surveyor expressed concern that R1's primary nurse, LPN E did not enter the resident's room after administration of Morphine Sulfate and Lorazepam, until more than two hours later, and no assessment of her comfort level was performed or documented.During a return telephone interview on [DATE] at 5:33 p.m., Friend D, who was present with R1 on the evening of her passing, was asked to provide details of the evening of [DATE].

Friend D stated, .around 8:00 p.m. she [R1] started breathing a lot heavier, but by 8:30 p.m. she was gasping for air.

Between 8:30 p.m. and 9:20 p.m., she would literally sit up and cry out and say ,?Please help me I can't breathe. I can't breathe'. [A family member] went out to talk to one of the med techs that was on that night, to ask if [R1] could get her morphine dose .

She (R1) would shoot up, sitting right up and begging for us to help her . we waited . and were told she (nurse) could not give another dose (of morphine) .

The last hour was the worst thing I have ever seen in my whole life. It would be one thing if she wasn't asking us for help, but she was begging us to help her and there was nothing we could do.

The nurse never came back into the room after giving the morphine at 7:30 p.m.

The nurse did not come back in until a half hour after [R1] was already gone.

235031 09/25/2025

Canal View - Houghton County 1100 Quincy Street Hancock, MI 49930

Review of R2's Care Plans revealed the following, in part: DO NOT leave me unattended as I have fallen in the past.

Two people must remain with for the entire toileting duration.

Date Initiated: 08/17/2023 .

Revision on 05/16/2025.

Review of the facilities' Investigation Summary revealed the following interventions to prevent recurrence and ensure residents' safety, in part: .Staff members will remain with the residents throughout the entire toileting process.

During clothing changes, staff will remain contact guard assist to ensure stability and prevent loss of balance. A commode with armrests will be used to provide additional support and stability during toileting.

Random audits will be conducted daily for 2 weeks, 3x's week for 1 week, 2x week for 1 week and 1x a week for 1 week for a duration of 5 weeks to ensure adherence to the updated protocol and care plan requirements .

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Hancock, MI, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Canal View - Houghton County or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


More Reports

About This Inspection Report

Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.

Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.

Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.