Maple Lawn Medical Care Facility
50 Sanderson Lane, Coldwater, MI 49036 · Branch County · 114 certified beds · avg 106 residents/day · certified since Jan 1, 1967
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 5/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Aug 27, 2025 · F-0689
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Sep 24, 2025 (Deficient, Provider has date of correction)
All citations in the current public record (20)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Aug 27, 2025 | ▲ G · Actual harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Aug 27, 2025 | E · Potential for harm, repeated | The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. |
| Aug 27, 2025 | D · Potential for harm, one-off | The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. |
| Jun 18, 2025 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| Sep 6, 2024 | D · Potential for harm, one-off | The facility did not provide the right treatment and services for residents with dementia or signs of dementia. Dementia care requires specific approaches, training, and patience. · from a complaint |
| Aug 15, 2024 | F · Potential for harm, facility-wide | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Aug 15, 2024 | E · Potential for harm, repeated | The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. |
| Aug 15, 2024 | D · Potential for harm, one-off | The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. |
| Aug 15, 2024 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Aug 15, 2024 | C · Minimal risk, facility-wide | The facility did not post its nurse staffing information every day. Nursing homes must publicly display how many nurses and aides are on duty each day. |
| Nov 15, 2023 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Nov 15, 2023 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint |
| Jun 28, 2023 | E · Potential for harm, repeated | The facility did not give residents the required written notice of their rights, the facility's rules, the services offered, and what those services cost. |
| Jun 28, 2023 | E · Potential for harm, repeated | The facility did not give residents important notices in a format and language they can understand — for example, translated documents or accessible formats for those with vision or hearing loss. |
| Jun 28, 2023 | E · Potential for harm, repeated | The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. |
| Jun 28, 2023 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Jun 28, 2023 | D · Potential for harm, one-off | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. |
| Jun 28, 2023 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Jun 28, 2023 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (5 → 4).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 9 | 0 | E |
| 2024 | 6 | 0 | F |
| 2025 | 5 | 1 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Michigan avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 5.46 | 4.32 | 3.95 | top 12% in Michigan; top 8% in the U.S. |
| Registered Nurse hours | 1.10 | 0.84 | 0.69 | top 19% in Michigan; top 12% in the U.S. |
| Weekend total nurse staffing | 4.95 | 3.79 | 3.50 | top 11% in Michigan; top 7% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.70 | 0.49 | 0.48 | top 19% in Michigan; top 16% in the U.S. |
| Total nursing staff turnover (%) | 30.9 | 44.1 | 45.8 | top 17% in Michigan; top 16% in the U.S. |
| RN turnover (%) | 21.4 | 39.2 | 42.9 | top 17% in Michigan; top 16% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.67, RN 0.94, weekend 4.23. Staffing rating: 5/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 4/5 · long-stay residents: 3/5 · short-stay residents: 5/5
Who owns this facility
Government - County
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Cowden, Donna | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/01/2024 |
| Roper, Sara | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/01/2025 |
| Sabaitis, Jayne | Individual | Corporate Officer | NOT APPLICABLE | 01/18/2010 |
| Sabaitis, Jayne | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/18/2010 |
| Sabaitis, Jayne | Individual | ADP of the SNF | NOT APPLICABLE | 01/18/2010 |
| Weigt, Steven | Individual | Managing Control - Governing Body | NOT APPLICABLE | 11/01/2023 |
| Whitaker, Charles | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/01/2014 |
| Whitaker, Charles | Individual | ADP of the SNF | NOT APPLICABLE | 03/04/2025 |
| Worden, Jessica | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/21/2014 |
| Worden, Jessica | Individual | ADP of the SNF | NOT APPLICABLE | 04/21/2014 |
| Zierle, Ashley | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/24/2025 |
| Zierle, Ashley | Individual | ADP of the SNF | NOT APPLICABLE | 01/24/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
- "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
- "If my family member's health suddenly changes, how quickly do you reassess them and update their care?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "What specific dementia training do your staff receive, and how do you handle difficult moments without medication?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| The Laurels of Coldwater | 0.7 mi | Coldwater, MI | ★★☆☆☆ | 2/5 | |
| Hillsdale County Medical Care Facility | 17.8 mi | Hillsdale, MI | ★★★☆☆ | 2/5 | abuse |
| Hillsdale Hospital McGuire & Macritchie Long Term | 18.4 mi | Hillsdale, MI | ★★★★★ | 5/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 235008.