Inspection Reports for
Gallatin Nursing and Rehab
499 CENTER STREET, WARSAW, KY, 41095
Back to Facility ProfileDeficiencies (last 4 years)
Deficiencies (over 4 years)
4 deficiencies/year
Deficiencies are regulatory findings recorded during state inspections.
15% better than Kentucky average
Kentucky average: 4.7 deficiencies/year
Deficiencies per year
12
9
6
3
0
Inspection Report
Complaint Investigation
Census: 42
Deficiencies: 1
Date: Jan 29, 2026
Visit Reason
The investigation was conducted due to a resident-to-resident incident involving allegations of physical abuse between two residents, R118 and R78.
Complaint Details
The complaint involved a resident-to-resident allegation of physical abuse. The incident was substantiated based on interviews with involved residents and staff, although no witnesses observed the event and no physical injuries were found.
Findings
The facility failed to sufficiently monitor residents for behaviors that might cause reactions in others, resulting in an incident where R78 slapped R118 after being called an expletive. No witnesses observed the incident, and no physical marks were found on R118.
Deficiencies (1)
F 0600: The facility failed to protect residents from all types of abuse, including physical abuse, as evidenced by an incident where resident R78 slapped resident R118 after being called an expletive.
Report Facts
Residents sampled: 42
Residents affected: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN 1 | Licensed Practical Nurse | Led the investigation into the resident-to-resident allegation involving R118 and R78 |
| AA 3 | Activities Assistant | Witnessed the incident aftermath and notified Social Services Director and LPN 2 |
| SSD | Social Services Director | Interviewed residents involved and assessed the incident |
| DON | Director of Nursing | Received reports from staff and confirmed incident details |
| Administrator | Provided summary of incident and resident interactions |
Inspection Report
Routine
Deficiencies: 1
Date: Aug 29, 2024
Visit Reason
The inspection was conducted to assess the facility's compliance with infection prevention and control procedures during medication administration.
Findings
The facility failed to demonstrate acceptable infection control procedures during medication administration for one of three residents observed. Specifically, a Licensed Practical Nurse handled medications with bare hands without sanitizing, posing a risk of infection transmission.
Deficiencies (1)
F 0880: The facility failed to provide and implement an infection prevention and control program. Observation revealed a nurse handled medications with bare hands without sanitizing, risking infection spread.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN6 | Licensed Practical Nurse | Observed handling medications with bare hands during medication administration. |
| Director of Nursing | Director of Nursing | Provided interview statements regarding infection control expectations. |
| Administrator | Administrator | Provided interview statements regarding infection prevention practice expectations. |
Inspection Report
Complaint Investigation
Deficiencies: 10
Date: Jul 19, 2019
Visit Reason
Investigation of alleged resident-to-resident abuse and failure to implement abuse policies and timely reporting.
Complaint Details
Complaint investigation revealed multiple failures related to abuse prevention, reporting, investigation, care planning, medication monitoring, and resident safety.
Findings
The facility failed to protect residents from abuse, failed to develop and implement abuse policies, failed to timely report abuse allegations, failed to thoroughly investigate abuse allegations, failed to submit timely MDS assessments, failed to ensure accuracy of MDS behavior sections, failed to develop and implement comprehensive care plans addressing behavioral symptoms, failed to revise care plans after incidents, failed to provide a safe environment free from hazards, and failed to monitor psychotropic medication use and side effects adequately.
Deficiencies (10)
F 600: Facility failed to protect residents from abuse including physical altercation between residents #46 and #200.
F 607: Facility failed to develop and implement written policies for reporting and investigating abuse allegations affecting residents #41, #46, #49, and #200.
F 609: Facility failed to timely report suspected abuse to State Agencies within required timeframes for residents #41, #46, #49, and #200.
F 610: Facility failed to respond appropriately to all alleged violations of abuse for residents #41 and #46, including failure to thoroughly investigate and document findings.
F 640: Facility failed to submit Minimum Data Set (MDS) assessments timely for Resident #41.
F 641: Facility failed to ensure accuracy and completion of Section E related to behaviors on MDS assessments for Residents #41 and #69.
F 656: Facility failed to develop and implement comprehensive person-centered care plans addressing behavioral symptoms and psychotropic medication monitoring for Residents #3, #7, #18, #53, and #69.
F 657: Facility failed to revise comprehensive care plans within 7 days of assessment for Residents #46, #57, and #200 after incidents including resident-to-resident altercations and self-injury.
F 689: Facility failed to provide a safe environment and adequate supervision to prevent accidents for Resident #57 who sustained scalp lacerations from unsupervised shaving with razors.
F 758: Facility failed to implement gradual dose reductions and non-pharmacological interventions prior to psychotropic medication use and failed to monitor psychotropic medication side effects and behaviors for Residents #3, #7, #18, #53, #57, and #69.
Report Facts
Residents sampled: 21
Residents affected by abuse findings: 4
Residents affected by care plan failures: 5
Residents affected by medication monitoring failures: 6
MDS late submission: 1
Minutes for resident checks: 15
Number of pages: 45
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #6 | Licensed Practical Nurse | Witnessed resident altercation and wrote witness statement. |
| LPN #8 | Licensed Practical Nurse | Provided care and reported on resident shaving incidents. |
| SRNA #6 | State Registered Nurse Aide | Provided care to Resident #57 and reported supervision needs. |
| Director of Nursing | Director of Nursing | Oversaw investigations and care plan expectations. |
| Administrator | Facility Administrator | Responsible for facility compliance and oversight. |
| Social Services Director | Social Services Director | Responsible for care plan revisions and abuse investigations. |
| MDS Coordinator | MDS Coordinator | Responsible for MDS assessment submissions and accuracy. |
Inspection Report
Complaint Investigation
Deficiencies: 4
Date: May 10, 2018
Visit Reason
The investigation was conducted due to complaints regarding failure to properly assess and document a resident's fall, failure to provide scheduled personal hygiene care, failure to investigate falls promptly, and failure to remove expired medications from medication carts.
Complaint Details
The complaint investigation focused on Resident #50's fall on 03/19/18, which was not properly assessed or reported by nursing staff, resulting in delayed diagnosis of fractures. Additional complaints included failure to provide scheduled personal hygiene care to Residents #48 and #84, failure to promptly investigate falls and implement interventions, and failure to remove expired medications from medication carts.
Findings
The facility failed to ensure licensed staff followed professional standards in assessing and documenting a resident's fall, resulting in delayed treatment for fractures. The facility also failed to provide scheduled personal hygiene care to residents, failed to promptly investigate falls and implement interventions, and failed to remove expired medications from medication carts.
Deficiencies (4)
F 0658: The facility failed to ensure licensed staff assessed and documented a resident's fall, resulting in delayed treatment for fractures and pain.
F 0677: The facility failed to provide scheduled toileting and incontinent care to a resident, increasing risk for skin breakdown.
F 0689: The facility failed to promptly investigate a resident's fall, implement interventions, and communicate the fall, resulting in delayed treatment for fractures and pain.
F 0761: The facility failed to remove expired medications from a medication cart, exposing residents to potential ineffective treatment.
Report Facts
Residents sampled: 22
Falls for Resident #50: 3
BIMS score for Resident #50: 13
BIMS score for Resident #84: 13
Scheduled showers missed: 1
Medication carts observed: 6
Expired inhaler date: 2017
Employees mentioned
| Name | Title | Context |
|---|---|---|
| LPN #7 | Licensed Practical Nurse | Named in failure to assess and report resident fall |
| LPN #5 | Licensed Practical Nurse | Named in resident pain assessment and reporting |
| CNA #8 | Certified Nursing Assistant | Witnessed resident fall and reported pain after fractures discovered |
| CNA #10 | Certified Nursing Assistant | Witnessed resident fall and reported pain after fractures discovered |
| CNA #11 | Certified Nursing Assistant | Witnessed resident fall and reported pain after fractures discovered |
| DON | Director of Nursing | Interviewed regarding fall investigation and facility policies |
| ADON | Assistant Director of Nursing | Interviewed regarding fall investigation and facility policies |
| LPN #2 | Licensed Practical Nurse | Responsible for medication cart with expired inhaler |
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