Lexington Nursing Home, Inc.

In the surveyor’s words

From the most serious findings on record at Lexington Nursing Home, Inc., in the surveyor’s own words.

• No harm, potential for more than minimal, patternF656Jun 27, 2024

  Based on record review and interview, the facility failed to develop a comprehensive care plan for diabetic monitoring for one (#9) of five residents reviewed for unnecessary medications. MDS coordinator #1 identified eight residents with diabetes. Findings: Res #9 was admitted with diagnoses which included type II diabetes mellitus. A physician order, dated 07/30/23, documented obtaining finger stick blood sugar if resident becomes symptomatic. A physician order, dated 07/30/23, documented offering a diabetic protein snack at bedtime. An admission assessment, dated 08/07/23, documented the resident was cognitively intact and received insulin. A physician order, dated 09/06/23, documented to administer Trulicity 0.75 mg/0.5 ml subcutaneously once a day on Thursdays for diabetes mellitus. […]

• No harm, potential for more than minimal, patternF657Jun 27, 2024

  Based on observation, record review, and interview, the facility failed to revise the care plan related to falls for one (#9) of three residents sampled for falls. The administrator identified 84 falls in the last six months. Findings: A Managing Falls and Fall Risk policy, revised March 2018, read in parts, .If falling recurs despite initial interventions, staff will implement additional or different interventions, or indicate why the current approach remains relevant .If underlying causes cannot be readily identified or corrected, staff will try various interventions based on assessment of the nature or category of falling, until falling is reduced or stopped, or until the reason for the continuation of falling is identified as unavoidable . […]

• No harm, potential for more than minimal, patternF812Jun 21, 2023

  Based on observation and interview, the facility failed to ensure the kitchen was kept clean and maintained in good repair. The Resident Census and Conditions of Residents report, dated 06/19/23, documented 39 residents resided in facility. Findings: On 06/19/23 at 8:25 a.m., a tour of the kitchen was conducted. The following observations were made: a. floor tiles were missing, b. oven hood lights were burned out and/or not working, c. there was an accumulation of brown and black residue on the floor under equipment, d. there was an accumulation of brown residue inside of the cabinets, e. there was an accumulation of brown and black residue on the dish machine, chest freezer, stove, three door reach in cooler, dish cart, and stand mixer, and f. […]

• No harm, potential for more than minimal, patternF881Jun 21, 2023

  Based on record review and interview, the facility failed to ensure proper antibiotic stewardship was completed for two (#8 and #30) of two residents reviewed for antibiotic use. The Resident Census and Conditions of Residents form, dated 6/19/23, documented a census of 39. Findings: A facility Policy and Procedure for Proper Antibiotic Stewardship Program, read in part .the proper use of antibiotics while ensuring the safety and well-being of the residents .specific criteria, McGeer criteria, the facility has adopted for assisting in prescribing antibiotics .follow the McGeer criteria for assisting in the diagnosis of infections that require antibiotics . 1. […]

• No harm, potential for more than minimal, patternF656Jun 1, 2022

  Based on record review, observation, and interview, the facility failed to develop and implement a comprehensive care plan for one (#3) of 13 residents whose care plans were reviewed. The administrator identified five residents who were assessed for smoking. Findings: Res #3 had diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . A SMOKING ASSESSMENT, dated 02/22/21, documented the resident had requested or expressed a desire to smoke. The assessment documented the resident was independent with smoking and understood the smoking policy. The care plan, dated 11/22/21, did not include the resident was a smoker or a smoking plan of care for the resident. On 05/26/22 at 1:08 p.m., the resident was observed outside in the facility smoking area. […]