Wellbridge Of Novi

Meals was reviewed and documented, in part: .Residents shall receive assistance with meals that meets the individual needs of each resident.All residents shall be encouraged to eat in the dining room.Residents confined to bed.nursing staff will prepare residents for eating.Nursing staff and/or Feeding Assistants will feed those residents needing full assistance within _____ (*It should be noted that a blank line was in the policy, no time was noted).Resident who cannot feed themselves will be fed with attention to safety.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/07/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Wellbridge of Novi

48300 11 Mile Road Novi, MI 48374

SUMMARY STATEMENT OF DEFICIENCIES

Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY This citation pertains to intake: 2634191.Based on interview and record reviews the facility failed to ensure a STAT (immediate) chest x-ray was ordered and completed as noted by the physician assistant for one (R702) of one resident reviewed for radiology services.

Findings include:A review of the medical record revealed R702 was re-admitted to the facility on [DATE] with a primary diagnosis of acute on chronic diastolic (congestive) heart failure and additional diagnoses of edema, paroxysmal atrial fibrillation and acute embolism and thrombosis of unspecified deep veins of lower bilateral extremity. A Minimum Data Set (MDS) assessment dated [DATE] noted a Brief Interview for Mental Status (BIMS) score of 13, which indicated intact cognition. A review of a Physician progress note dated 4/28/25 at 1:57 PM, documented in part .

Reason for visit: request by patient/family/nurse regarding weakness, fatigue, pain.

Patient seen and examined. C/O (complaints of) increased weakness and fatigue.

Also C/o generalized joint pain.

States she is feeling weakness than when she was admitted . C/o dysuria (pain with urination), urgency, urinary frequency.

Also c/o SOB (shortness of breath). chronically ill appearing, weak.

Diminished BS (breath sounds) with crackles at bases. + (positive) trace BLE (bilateral lower extremities) edema.

Assessment SOB, suspect secondary to CHF (congestive heart failure). decompensated CHF, Fatigue, Urinary . UTI, Persistent atrial fibrillation with RVR (rapid ventricular response), BLE edema.

Plan. check UA (urinalysis), C&S (culture & sensitivity), CHF - with SOB.

Check CXR (chest x-ray) PA (posterior - anterior)/lat (lateral) STAT (immediate).

Give extra 20 mg (milligram) Lasix QD (every day) x3 days-1st dose today.

Begin duoneb (nebulizer treatment) QID (four times a day).

Continue Lasix. A review of the physician orders revealed no order implemented for the STAT chest x-ray until 5/6/25, more than a week later. On 10/7/25 at 1:37 PM, the Unit Nurse Manager (UNM) A (the nurse manager for the unit R702 resided on) was interviewed and asked the facility's practices when a nurse practitioner, physician assistant or physician examines a resident and orders new medications and test to be completed whose responsibility was it to put in the orders for the new medications and tests. UNM A stated the provider would tell the floor nurse to put in the order or they would usually tell them (the unit manager) and they would put in the orders.

When asked why R702's STAT chest x-ray was ordered more than a week after the provider examined and noted to have the STAT chest x-ray completed, UNM A stated the ordered probably did not hit the board (electronic medical system notification) delaying the implementation. UNM A stated they would look into the concern and follow back up. At 2:41 PM, UNM A stated they reviewed the medical record and they were unable to provide further information or documentation on why the STAT chest x-ray order was not implemented and completed timely. No further explanation or documentation was provided by the end of the survey.

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