Pomeroy Living Rochester Skilled Rehabilitation
Inspection Findings
F-Tag F0690
F 0690 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
cells).A review of a hospital Hospitalist consult dated 8/22/25 at 12:14 PM, documented in part . Change in mental status-toxic metabolic encephalopathy. Lactic acidosis due to septic shock, UTI with sepsis, Acute renal failure, multifactorial, Hematuria.Plan -Patient is transferred to inpatient hospice -Remains hypotensive, noted shallow breathing, decreased respiratory rate today. presented to the hospital with septic shock. Patient initially was admitted to the intensive care unit with change in mentation with lactic acidosis urinary tract infection. Received a fluid resuscitation pressor support was evaluated by multidisciplinary team. has had acute renal failure on presentation. Patient has declined to decline despite maximal medical therapy and after meeting with palliative care team patient had a hospice informational visit. Pressors were discontinued patient remained hypotensive, lethargic and was transferred to inpatient hospice. I have discussed during the intensive care unit admission and today with the (Resident R202's family member). is agreeable with plan of care and. understands the grave prognosis. Patient has shallow breathing remains hypotensive with minimal urine output.On 8/27/25 at 8:27 AM, the Director of Nursing (DON) was interviewed and asked about the delayed UA, culture and sensitivity results and the DON stated
they were newly employed with the facility and realized coming in that there were issues with the contracted laboratory. The DON stated they started a past non compliance regarding the laboratory services. The DON identified delayed completion and reporting of test results. At 9:02 AM, the DON stated they were trying to find a new laboratory provider for the facility. The DON was asked about Resident R202's clinical signs/symptoms of
a UTI that was not initially reported to the Physician/NP, the failure to timely identify and treat Resident R202's UTI and the DON acknowledged the concern, stating they were awaiting the results of the testing before treatment was started. The DON explained that the resident was newly admitted to the facility so the staff was unaware of the change from the resident's baseline. The DON was asked why the CBC and CMP was not ordered/completed. The DON stated they read the note regarding the test pending, however they could not find results. A review of a facility policy titled Acute Change in Condition dated July 2021, documented
in part . An Acute Change of Condition (ACOC) is a sudden, clinically important deviation from a resident's baseline in physical, cognitive, behavioral, or functional domains. Clinically important means a deviation that, without intervention, may result in complications or death. Resident's are assessed upon admission to establish Baseline Data. Changes (symptoms) in a resident's condition are communicated by any staff member to nurses. Document in the medical record all interventions to address the change of condition.
Changes (symptoms) are communicated to the physician.No further explanation or documentation was provided by the end of the survey.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
08/28/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Pomeroy Living Rochester Skilled Rehabilitation
3500 West South Blvd Rochester Hills, MI 48309
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0773
F 0773 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
ordered for Resident R202. The DON stated they saw that it was documented and noted to be pending, however the facility did not have the results. The DON stated they had identified issues/concerns with the facility's contracted lab services and was working toward a solution. The DON was then asked about Resident R202's abnormal UA and C&S results to have been reported on 8/18/25, however not reported to the Physician until 8/19/25. The DON stated they recognized the long processing times with the third-party laboratory to have been problematic and stated the nurse should have followed up on 8/18/25 when the abnormal UA & C&S was completed to report it to the Physician. The DON stated they had started education with the nursing staff regarding the concern. No further explanation or documentation was provided.
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Pomeroy Living Rochester Skilled Rehabilitation in Rochester Hills, MI inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 Rochester Hills, 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 Pomeroy Living Rochester Skilled Rehabilitation or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.