STATE OF MICHIGAN DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING JENNIFER M. GRANHOLM GOVERNOR ISMAEL AHMED DIRECTOR September 3, 2009 Tracie Hernandez Cornerstone II, Inc P. O. Box 277 Bloomingdale, MI 49026 RE: License #: Investigation #: AS120265532 2009A0301021 Cornerstone II AFC Dear Ms Hernandez: Attached is the Special Investigation Report for the above referenced facility. Due to the violations identified in the report, a written corrective action plan is required. The corrective action plan is due 15 days from the date of this letter and must include the following: How compliance with each rule will be achieved. Who is directly responsible for implementing the corrective action for each violation. Specific time frames for each violation as to when the correction will be completed or implemented. How continuing compliance will be maintained once compliance is achieved. The signature of the responsible party and a date. If you desire technical assistance in addressing these issues, please feel free to contact me. In any event, the corrective action plan is due within 15 days. Failure to submit an acceptable corrective action plan will result in disciplinary action. P.O. BOX 30650 LANSING, MICHIGAN 48909-8150 www.michigan.gov (517) 335-6124
Please review the enclosed documentation for accuracy and feel free to contact me with any questions. In the event that I am not available and you need to speak to someone immediately, please feel free to contact the local office at (269) 337-5066. Sincerely, Mahtina Rubritius, Licensing Consultant Bureau of Children and Adult Licensing 301 E. Louis Glick Hwy Jackson, MI 49201 (517) 780-7138 Enclosure
MICHIGAN DEPARTMENT OF HUMAN SERVICES BUREAU OF CHILDREN AND ADULT LICENSING SPECIAL INVESTIGATION REPORT I. IDENTIFYING INFORMATION License #: Investigation #: AS120265532 2009A0301021 Complaint Receipt Date: 08/11/2009 Investigation Initiation Date: 08/11/2009 Report Due Date: 09/10/2009 Licensee Name: Licensee Address: Cornerstone II, Inc 44409 Baseline Rd. Bloomingdale, MI 49026 Licensee Telephone #: (269) 521-4130 Administrator: Licensee Designee: Name of Facility: Facility Address: Tracie Hernandez, Designee Tracie Hernandez, Designee Cornerstone II AFC 157 W. Garfield Road Coldwater, MI 49036 Facility Telephone #: (517) 278-0313 Original Issuance Date: 08/20/2004 License Status: REGULAR Effective Date: 03/13/2009 Expiration Date: 03/12/2011 Capacity: 6 Program Type: MENTALLY ILL, DEVELOPMENTALLY DISABLED PHYSICALLY HANDICAPPED TRAUMATICALLY BRAIN INJURED 1
I. ALLEGATION(S) A staff member takes a resident out in a vehicle to get high. The medication logs are not being signed when the medication is given. II. METHODOLOGY 08/11/2009 Special Investigation Intake 2009A0301021 08/11/2009 Special Investigation Initiated - Telephone Telephone call to Witness #1. Interview. 08/14/2009 Contact - Face to Face Unannounced on-site inspection. 08/14/2009 Inspection Completed-BFS Sub. Compliance 08/14/2009 Contact - Document Received 08/14/2009 Contact - Telephone call received Telephone call from the licensee. 08/17/2009 Contact - Telephone call received Case discussion with the licensee. 09/03/2009 Exit Conference with the Home Manager ALLEGATION: A staff member takes a resident out in a vehicle to get high. INVESTIGATION: I contacted Witness #1 regarding the allegations listed above. According to Witness #1, Resident A was sitting on the couch, began to roll his fingers together and stated to Employee #2 hey, can you get me one of these? Employee #2 said no you re not supposed to be doing that. Resident A responded well Employee #1 said he s going to bring me in a couple tonight. Witness #1 also stated that Resident B said I ain t saying no names, but I think a staff member takes that boy (Resident A) out in the vehicle to get him high. On 08/14/2009 I conducted an unannounced on-site inspection, and I interviewed the Substitute Home Manager regarding the allegations. He stated that he heard that Resident A said someone was supposed to give him a joint, and that Resident A directly told him (Substitute Home Manager) that someone was supposed to bring him three joints but he would not say who. According to the Substitute Home 2
Manager, there had not been any problems with staff using marijuana, and Employee #1 was not that type of person. I interviewed Employee #1. Upon arrival, I noted that Employee #1 s eyes appeared to be red. Employee #1 stated that he has not smoked marijuana since he was 13- years-old, and he does not drink alcohol. According Employee #1, Resident B has asked staff to get marijuana for him, but no one has done so. Regarding Resident A, Employee #1 stated that Resident A said he was going to get three joints from staff. When I asked Employee #1 to explain the situation regarding Resident A rolling his fingers together he stated Resident A bought me two cheese burgers at McDonalds when I took him to court the other day. The finger rolling was because Employee #1 owed money for the cheese burgers. Employee #1 transported Resident A to a court hearing on or about 08/11/2009. I interviewed Resident A and he first stated that he didn t know anything about the situation regarding the three joints. He then recalled that a lady said it happened but it didn t. Resident A went on to say that someone said that a staff member was going to bring him three joints, the Spanish pot, but he never got the joints. Resident A has not seen anyone getting high in the van, and he denied getting high. According to Resident A, Employee #1 only smokes cigarettes. I reviewed Resident A s file and he does not have a documented history of substance abuse. Resident B stated to me that I ain t no snitch when I inquired about the situation regarding the joints. He denied that he has ever seen marijuana or drugs (other than prescription) at the facility. Resident C stated that he has not seen or smelled any marijuana in the facility, that it s been many years since he smoked marijuana, and that they (the residents) only sit around and joke about it. I attempted to interview two other residents in the facility; however, they were unable to articulate any information related to the investigation. I spoke to the Licensee via telephone while I was at the facility. She stated that Residents A & B both have a history of being untruthful, and that she was aware of the situation regarding Resident A saying that he was going to get three joints from Van Buren County. The Licensee has never smelled marijuana in the van and did not suspect that Employee #1 was using drugs. I informed her of Employee #1 s eyes being red, and the Licensee stated she would possibly have him complete a substance abuse screen. The Licensee also stated that Employee #1 may have allergies. The substance abuse test was completed at a later date and the results were negative. 3
APPLICABLE RULE R 400.14305 Resident protection. (3) A resident shall be treated with dignity and his or her personal needs, including protection and safety, shall be attended to at all times in accordance with the provisions of the act. ANALYSIS: CONCLUSION: According to the manager, staff, and residents (including Resident A), Resident A was not provided with three joints, and no one has seen drugs at the facility. The Resident s have been treated with dignity and their personal needs, including protection and safety, have been attended to in accordance with the provisions of the act. VIOLATION NOT ESTABLISHED ALLEGATION: Witness #1 stated the Substitute Home Manager was not appropriately documenting transactions regarding residents medications, and that he does not sign the medication log. INVESTIGATION: Upon arrival to the facility, I spoke to the Substitute Home Manager regarding the medication log allegations. I also reviewed the medication logs at that time, and they appeared to be completed appropriately. I later reviewed the medication log again for Resident B and noted that the medication log had not been signed for the noon medications; even though it was after noon. I inquired about whether Resident A would be receiving his medication and the Substitute Home Manager informed me that he gave Resident B the medication at 11:30am. However he did not sign the book. APPLICABLE RULE R 400.14312 Resident medications. (4) When a licensee, administrator, or direct care staff member supervises the taking of medication by a resident, he or she shall comply with all of the following provisions: (a) Be trained in the proper handling and administration of medication. (b) Complete an individual medication log that contains all of the following information: (i) The medication. (ii) The dosage. 4
(iii) Label instructions for use. (iv) Time to be administered. (v) The initials of the person who administers the medication, which shall be entered at the time the medication is given. (vi) A resident's refusal to accept prescribed medication or procedures. (c) Record the reason for each administration of medication that is prescribed on an as needed basis. ANALYSIS: CONCLUSION: The medication log was not initialed at the time the noon medication was administered to Resident B as required by the rule. VIOLATION ESTABLISHED ADDITIONAL FINDINGS: INVESTIGATION: Employee #1 stated that Resident A bought me two cheese burgers at McDonalds when I took him to court the other day. APPLICABLE RULE R 400.14315 Handling of resident funds and valuables. (10) A licensee, administrator, direct care staff, other employees, volunteers under the direction of the licensee, and members of their families shall not accept, take, or borrow money or valuables from a resident, even with the consent of the resident. ANALYSIS: CONCLUSION: Employee #1 admitted that he allowed Resident A to purchase two cheese burgers for him when he took Resident A to court. VIOLATION ESTABLISHED INVESTIGATION: During the course of the investigation I reviewed Resident B s file and the Resident Funds Part II form had not been completed since April 2009. The Home Manager completed the form and faxed it to the agency for review. 5
APPLICABLE RULE R 400.14315 Handling of resident funds and valuables. (3) A licensee shall have a resident's funds and valuables transaction form completed and on file for each resident. A department form shall be used unless prior authorization for a substitute form has been granted, in writing, by the department. ANALYSIS: CONCLUSION: The Resident Funds Part II form had not been completed since April of 2009 for Resident B. VIOLATION ESTABLISHED III. RECOMMENDATION Upon receipt of an acceptable written corrective act plan, the status of this license will remain unchanged. 09/03/2009 Mahtina Rubritius Date Licensing Consultant Approved By: 09/03/2009 Gregory V. Corrigan Date Area Manager 6