The Laurels Of Sandy Creek
The Laurels of Sandy Creek in Wayland, MI — inspection on March 26, 2026.
Found 5 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
During an interview on 3/25/26 at 9:32 AM, Resident #104 reported that she did recall the incident with LPN CC on 2/24/26, but Resident #104 did not want to talk about the incident with this writer. Resident #104 reported, I am just glad she (LPN CC) is gone, and that is all that mattered.
During an interview on 3/24/26 at 1:25 PM, Nursing Home Administrator (NHA) A reported that she had substantiated that LPN CC had verbally and physically abused Resident #104 on 2/4/256 based on witness interviews. NHA A reported that she terminated LPN CC on 2/16/26.
Review of the facility's Abuse policy last revised 9/9/22 revealed, Policy: Each Guest shall be free from abuse . To assure guest/residents are free from abuse, neglect, exploitation, or mistreatment, the facility shall monitor guest/resident care and treatments on an on-going basis. It is the responsibility of all staff to provide a safe environment for the guest/residents .
The facility was granted a Past Non-Compliance at the time of exit due to no further like incidents had occurred, the facility re-trained all facility staff on abuse, police were notified on 2/4/26, LPN CC was terminated from the facility, Resident #104's care plan was reviewed and updated on 2/5/26, Social Services monitored Resident #104 for emotional concerns and potential psychosocial decline related to the incident, (Local Mental Health Provider) was consulted and collaborated with facility provider on behavior interventions and medication changes for Resident #104, All residents with a Brief Interview for Mental Status (BIMS) score of 10 or higher were interviewed to ensure there were no further complaints, and the facility conducted weekly abuse audits for 4 weeks and will continue monthly for 3 months.
235313 03/26/2026
The Laurels of Sandy Creek 425 E Elm St Wayland, MI 49348
Review of Resident #104's facility reported incident (FRI) investigation summary revealed, .
Date of event: Resident #104 was exhibiting agitation and increased pacing.
Licensed Practical Nurse (LPN) CC requested Resident #104 go to her room and stay there as heard by witness. Resident #104 refused to go to her room. Resident #104 approached LPN CC attempting to strike her. LPN CC placed Resident #104's arms behind her back and physically assisted her to her room and closed the door. Resident #104 vocalized stop that hurts . In depth analysis of how deficiency occurred: LPN CC was not using skills of de-escalation.
Her frustration perpetuated the situation to intensify, resulting in verbal and physical abuse to the resident .
Disciplinary action to be taken: termination effective 2/16/26.
Noted that the FRI summary did not include documentation of the facility reporting LPN CC to the State Bureau of Professional Licensing.
During an interview on 3/24/26 at 1:25 PM, Nursing Home Administrator (NHA) A reported that she had substantiated that LPN CC had verbally and physically abused Resident #104 on 2/4/26 based on witness interviews.
NHA A reported that she terminated LPN CC on 2/16/26.
When this writer queried NHA A as to if she had reported LPN CC 's termination to the State Bureau of Professional Licensing, NHA A reported that she could not recall if she had reported LPN CC. In a follow up interview on 3/26/26 at 1:30 PM, NHA A confirmed that she had not reported LPN CC to the State Bureau of Professional Licensing.
NHA A reported she had completed the form to send to report LPN CC but that she had somehow forgot to fax the report, and this was just missed.
According to the Michigan Public Health Code MCL 333.20175: (10) A health facility or agency that employs, contracts with, or grants privileges to a health professional licensed or registered under article 15 shall report the following to the department not more than 30 days after it occurs: (a) Disciplinary action taken by the health facility or agency against a health professional licensed or registered under article 15 based on the licensee's or registrant's professional competence, disciplinary action that results in a change of employment status, or disciplinary action based on conduct that adversely affects the licensee's or registrant's clinical privileges for a period of more than 15 days. As used in this subdivision, adversely affects means the reduction, restriction, suspension, revocation, denial, or failure to renew the clinical privileges of a licensee or registrant by a health facility or agency. (b) Restriction or acceptance of the surrender of the clinical privileges of a licensee or registrant under either of the following circumstances: (i) The licensee or registrant is under investigation by the health facility or agency. (ii) There is an agreement in which the health facility or agency agrees not to conduct an investigation into the licensee's or registrant's alleged professional incompetence or improper professional conduct. (c) A case in which a health professional resigns or terminates a contract or whose contract is not renewed instead of the health facility or agency taking disciplinary action against the health professional.
235313 03/26/2026
The Laurels of Sandy Creek 425 E Elm St Wayland, MI 49348
and prepared for by the interdisciplinary team .
235313 03/26/2026
The Laurels of Sandy Creek 425 E Elm St Wayland, MI 49348
Review of Resident #121's Orders revealed, Enteral Feed Order at bedtime Jevity1.5 (type of enteral nutrition formula) @80ml/hr (at milliliters per hour).
Start date: 2/14/26 .
Enteral Feed Order every shift Elevate head of bed at least 30 degrees during feeding.
Start date: 1/21/26.Review of Resident #121's Care Plan revealed, Focus: (Resident #104) is unable to tolerate nutritionally adequate food and/or fluids by mouth requiring the use of a feeding tube R/T: dysphagia following cerebral infarction, moderate protein calorie malnutrition .Date initiated: 1/15/26 Goal: resident will remain free of aspiration .
Interventions: resident is dependent with tube feeding and water flushes.
See MD orders for current feeding orders.
Date Initiated: 01/15/2026.During an observation on 3/25/26 at 8:00 AM, Resident #121 was lying in her bed sleeping.
Noted that Resident #121's room tray had two opened bottles of Jevity formula sitting on it.
Both bottles were 1/4 full.
One bottle was dated 3/24/26 and the other bottle was not dated. Resident #121's tube feed was running at 80 mL/hr.
Noted that the bag of formula that was running was not labeled or dated to indicate when the formula was opened. Resident #121 was lying flat. In an observation and interview on 3/25/26 at 8:04 AM, Licensed Practical Nurse (LPN) I reported that he was the nurse caring for Resident #121 today, but that he had not been into Resident #121's room to see her yet. LPN I entered Resident #121's room with this writer and stated that Resident #121 was definitely lying way too flat and he re-positioned Resident #121's head of the bed to be elevated to 45 degrees. LPN I reported that he had no idea how long Resident #121 had been lying flat while her enteral feed was running. It was noted that LPN I did not provide further assessment of Resident #121.
When this writer queried LPN I about the open Jevity containers in Resident #121's tray table, LPN I reported that they should have been discarded. LPN I reported that nurses were supposed to date enteral feeding formulas when they were opened with the date and time to ensure that the formula being administered was safe to use and not spoiled.
During an observation on 3/25/26 at 9:38 AM, Resident #121 was lying in bed. It was noted that her enteral feed was still running at 80 mL/hr, and the formula bag remained undated/unlabeled.
During an observation on 3/25/26 at 1:13 PM, Resident #121 was lying in bed. It was noted that her enteral feed was still running at 80 mL/hr, and the formula bag remained undated/unlabeled.
During an observation on 3/26/26 at 7:58 AM, Resident #121 was lying in her bed with her tube feed running at 80 mL/hr. It was noted that the formula bag did not have a date on the formula bag to indicate when the formula was opened, or what time the enteral feeding was started. Resident #121's head of bed was not elevated to 30 degrees.
During a care observation on 3/26/26 at 8:12 AM, LPN Y reported that she was caring for Resident #121 that day, and that she had been in her room shortly before to fix her tube feed. LPN Y entered Resident #121's room and adjusted Resident #121's head of the bed to 30 degrees. LPN Y confirmed that Resident #121's head of bed was not elevated to 30 degrees.
Review of the facility's Enteral Feeding policy last revised 9/22/23 revealed, Policy: Residents maintain acceptable parameters of nutritional status . residents who are unable to feed themselves receive the necessary services to maintain good nutrition, including at times, enteral nutrition .
Guidelines: 8. the resident should be in semi-Fowlers position (medical orientation where the patient lies on their back (supine) with the head of the bed elevated to a 30-45 degree angle) during administration and for 30 minutes to one hour after to prevent aspiration .
235313 03/26/2026
The Laurels of Sandy Creek 425 E Elm St Wayland, MI 49348
wing medication room was observed with bubbling and chipping surfaces on the back wall of the room
On 3/25/26 at 10:02 AM, an interview with Maintenance Director (MD) KK found that he has been
MD KK stated the roofing vendor had used 28 tubes of caulk since the snow had melted (to seal up holes until the roof could be fully redone). At this time, the surveyor and MD KK went on top of the roof to observe the current condition of the roof surface.
The roof was observed with hundreds of caulk spots throughout with numerous areas circled or outlined to show larger issues within the roof's surface. At this time, contractors were also observed on the roof assessing the project for next week.
On 3/25/26 at 12:50 PM, observation of the main middle hall near the middle back door observed numerous discolored and dried out ceiling tiles.
On 3/25/26 starting at 12:52 PM, observation of the [NAME] hall found the following: discolored and brown ceiling tiles across from resident room [ROOM NUMBER], discoloration in the ceiling tiles at the North end of the [NAME] hall, two light fixtures leading to the South end of the [NAME] hall were found with rust accumulation indicating leaking into the light, Further down the South end of the [NAME] hall found numerous tiles discolored around the roof top unit, the South end [NAME] hall Spa was found with bubbling and brown areas of the ceiling, the west hall medication room was observed with heavy discoloration and sagging of the ceiling tiles, and the [NAME] hall day room was observed with black and brown discoloration coming from the ceiling.