Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Corewell Health Grand Rapids Hospitals Rehabilitat during CMS and state inspections, most recent first.
The facility failed to maintain resident dignity and respect, as observed in three residents. A resident with moderate cognitive impairment was fed without interaction, while another cognitively intact resident experienced similar treatment. A third resident, with a history of stroke, reported being ignored by staff and faced delays in assistance. Additionally, this resident's personal care needs were neglected, with long, dirty fingernails and an old bandage on his finger. Staff interactions were dismissive, contributing to feelings of frustration and neglect.
Two residents in the facility were found with long and dirty fingernails, indicating a failure in providing adequate assistance with ADLs. One resident, with a history of stroke and cognitive impairment, expressed discomfort and a desire for shorter nails, while staff were unaware of his needs. Another resident, dependent on staff due to a traumatic brain injury, was initially thought to refuse care but later allowed nail trimming. The deficiency points to inconsistent nail care and communication among staff.
A facility failed to document a resident's death thoroughly, lacking details on the circumstances and condition prior to passing. The resident had a history of stroke and infections, with a noted decline before death. Staff interviews revealed inconsistencies in documentation practices, with some unaware of the resident's details and others noting the absence of required notes, despite existing policies.
A resident at risk for falls was improperly transferred by a CNA who did not follow the care plan, resulting in a fall. The incident was not reported to the State Agency as required by facility policy, which mandates immediate reporting of all neglect allegations.
A resident, admitted for rehabilitation after a foot fracture, experienced a fall due to the facility's failure to follow the care plan for safe transfers. The care plan required a sit-to-stand lift, but the CNA relied on the resident's input instead. During the transfer, the resident was not positioned correctly in the wheelchair, leading to a fall. The CNA called for help, and a nurse assisted in safely lowering the resident to the ground.
Failure to Uphold Resident Dignity and Respect
Penalty
Summary
The facility failed to uphold the dignity and respect of residents during meal times and in their daily interactions, as observed in three residents. Resident #13, who has moderate cognitive impairment, was assisted with his meal by a CNA who did not engage in any communication or interaction, potentially leading to feelings of neglect. Similarly, Resident #56, who is cognitively intact, experienced a lack of interaction during meal assistance, with the CNA standing and feeding her quickly without any conversation. This behavior was noted by another CNA who stated that staff should sit beside residents when assisting them with meals. Resident #21, who has moderate cognitive impairment and a history of stroke, reported being ignored by staff when requesting assistance. On multiple occasions, Resident #21's requests for help were either delayed or dismissed, such as when he asked for hot cocoa and was told it would be checked on, despite not being on a fluid restriction. Additionally, Resident #21's call light was turned off by staff without providing the requested assistance, and he was spoken to in a dismissive manner by a CNA who referred to him as "Honey" and instructed him to be more positive. Further issues were observed with Resident #21's care, as his fingernails were long and dirty, with a bandage on one finger that had been applied by an external clinic. The LPN was unaware of the bandage and interrupted Resident #21 when he tried to explain its presence. The LPN then took a phone call at the bedside and left without addressing the resident's concerns. These actions demonstrate a lack of attention to the resident's dignity and personal care needs, contributing to feelings of frustration and neglect.
Deficiency in Resident Nail Care
Penalty
Summary
The facility failed to provide adequate assistance with fingernail grooming and hygiene for two residents, leading to potential issues with dignity, skin integrity, and nail infection. Resident #21, who has a history of stroke and moderate cognitive impairment, was observed with long and dirty fingernails on multiple occasions. Despite receiving a shower, his nails were not cleaned or trimmed. Staff interviews revealed a lack of awareness and communication regarding the resident's nail care needs, with some staff assuming the resident preferred to cut his own nails or was refusing care. However, the resident expressed a desire for shorter nails and reported discomfort due to a bandage applied by an external clinic. Resident #19, who requires assistance with ADLs due to a traumatic brain injury and paralysis, was also found with long and dirty fingernails. The resident is completely dependent on staff for care, and nail care should have been part of regular bed baths. An LPN initially believed the resident was refusing care, but later reported that the resident allowed her to cut his nails, which were then short and clean. The deficiency highlights a lack of consistent nail care and communication among staff regarding the residents' needs.
Incomplete Documentation of Resident's Death
Penalty
Summary
The facility failed to ensure thorough documentation of a resident's death, specifically for one resident who was reviewed for accurate and complete medical records. The resident, who had a history of stroke and multiple hospitalizations for sepsis and infections, experienced a progressive decline in the nine months preceding his passing. The medical records indicated the date and time of death, but lacked detailed documentation about the circumstances surrounding the death, such as how or where the resident was found or his condition prior to passing. Interviews with facility staff revealed a lack of clarity and consistency in the documentation process. A nurse supervisor was uncertain of the details of the resident's death, and another nurse supervisor was unaware of the resident and noted the absence of a nurse's note describing the death. The nurse manager mentioned that it was not typical to write a nurse's note when a resident passed away. The Director of Nursing acknowledged the absence of documentation related to the death, despite a facility policy requiring a nursing narrative note to be created.
Failure to Report Allegation of Neglect
Penalty
Summary
The facility failed to report an allegation of neglect to the State Agency after a staff member did not follow a resident's care plan, resulting in a fall. The resident, identified as Resident #103, had a care plan indicating they were at risk for falls and required assistance with mobility, specifically using a sit-to-stand lift for transfers. On the date of the incident, a CNA attempted to transfer the resident from the bed to a wheelchair without consulting the resident care summary, instead relying on the resident's verbal input. This led to the resident being improperly positioned and subsequently falling, although staff were able to assist the resident to the ground. Interviews conducted during the investigation revealed that the CNA did not adhere to the care plan, and the Nursing Home Administrator acknowledged the failure to report the incident to the State Agency. The facility's policy mandates that all allegations of neglect, even if not credible, must be reported immediately to the Administrator and the State Survey Agency. However, this protocol was not followed, resulting in the potential for continued violations involving neglect going undetected and unreported.
Failure to Follow Care Plan Leads to Resident Fall
Penalty
Summary
The facility failed to implement care plan interventions and perform safe transfers for a resident, resulting in a fall. The resident, who was admitted for rehabilitation following a fall at home that resulted in a foot fracture, was assessed to be at moderate risk for falls. The care plan indicated that the resident required assistance with mobility and specified the use of a sit-to-stand lift for transfers. However, during a transfer from bed to wheelchair, the CNA did not follow the care plan and instead relied on the resident's input on how he transferred. The CNA attempted to stand the resident up and sit him down in the wheelchair without checking the Resident Care Summary. During this process, the resident was not positioned correctly in the wheelchair, leading to a fall. The CNA called for help, and a nurse assisted in lowering the resident to the ground safely. Interviews with the family member, LPN, and Nursing Home Administrator confirmed that the care plan was not followed, resulting in the fall.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Grand Rapids
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Optalis Health & Rehabilitation At Leonard | 0.6 mi | — | 14 | 0 |
| Medilodge Of Grand Rapids | 1 mi | — | 2 | 1 |
| Mary Free Bed Sub-acute Rehabilitation | 1.6 mi | — | 1 | 0 |
| Corewell Health Rehabilitation & Nursing Center - | 1.9 mi | — | 0 | 0 |
| Clark Retirement Community | 2.3 mi | — | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.