Excelcare at Lewes LLC

In the surveyor’s words

From the most serious findings on record at Excelcare at Lewes LLC, in the surveyor’s own words.

• Actual harm, isolatedF692Feb 18, 2026

  Based on interview and record review, it was determined that for one (R173) out of two residents reviewed for hydration, the facility failed to ensure that R173 maintained proper hydration which resulted in harm, requiring hospitalization on 6/1/25 and 6/19/25 with diagnosis of acute kidney injury (AKI) and dehydration. Findings include:The BUN (blood urea nitrogen) lab test measures the amount of urea nitrogen in the blood. The BUN is directly related to the metabolic function of the liver and the excretory function of the kidney . BUN levels also may vary according to the state of hydration, with increased levels seen in dehydration and decreased levels seen in overhydration. Mosby's Diagnostic and Laboratory Test Reference 2023. […]

• Actual harm, isolatedF600Nov 14, 2025

  Based on interview, record review and review of other documentation as indicated, it was determined that for one (R2) out of seven residents reviewed for abuse the facility failed to ensure residents were free from abuse. R2 was found on the floor of his room, with R1 standing over him, and sent to ER for a head injury. This failure resulted in physical harm (R2) and psychosocial harm as the reasonable person would be adversely affected by being attacked in their home. Findings include:Cross refer F609 and F740.Review of R1's and R2's record revealed:7/1/25 - R2 was admitted to the facility.7/28/25 - R1 was admitted to the facility.8/12/25 - A care plan was initiated for R1 documenting socially inappropriate behavior as evidenced by verbal aggression toward staff and other residents. […]

• Actual harm, isolatedF697Feb 1, 2023

  Based on record review and interview, it was determined that the facility failed to provide pain management according to professional standards of practice for one (R97) out of three residents sampled for pain. R97 was not provided pain medication causing unrelieved pain for approximately six hours resulting in harm. Findings include: November 2009 - The American Academy of Pain Medicine, Pharmacological Management of Persistent Pain in Older persons, stated to refer to the previous American Geriatrics Society for specific recommendations for pain assessment in older persons that remain relevant. […]

• No harm, potential for more than minimal, widespreadF812Oct 10, 2022

  Based on review of the food temperature logs and staff interview, it was determined that the facility failed to consistently monitor food temperatures prior to food service. Findings include: 10/10/22 9:35 AM - A review of facility food temperature logs between between April 1, 2022 and September 30, 2022 revealed that 75 out of 549 (13.7%) meals served lacked evidence that food temperatures were monitored. 10/10/22 10:10 AM - During an interview, E3 (FSD) confirmed that temperatures were not taken at every meal. Findings were reviewed with E1 (NHA) and E2 (DON) during the exit conference on 10/10/22, beginning at approximately 2:15 PM.

• No harm, potential for more than minimal, patternF644Mar 20, 2024

  Based on interview and record review, it was determined that for five (R41, R309, R14, R65, R5 and R90) out of eight residents reviewed for PASARR, the facility failed to ensure that a referral for a PASARR screening was completed. Findings include: 1. Review of R41's clinical record revealed: 12/6/23 - R41 had a PASARR I completed at the hospital with the indication of no level II needed and no suspected or confirmed PASARR conditions. 12/19/23 - R41 had a PASARR completed at a different facility with indication of level I negative and no suspected or confirmed PASARR conditions. 12/22/23 - R41 was admitted to the facility with diagnosis of persistent mood affective disorder, unspecified. […]