Inspection Report Summary
The most recent inspection on May 29, 2025, found that the facility had corrected previously cited deficiencies as of May 19, 2025, following a revisit survey. Prior inspections had identified issues related to residents' rights accommodations, infection prevention and control, and fire safety standards including delayed egress doors and smoke barriers. Inspectors cited deficiencies involving call light accessibility, arbitration agreement explanations, catheter care, equipment disinfection, medication pass procedures, food handling, and electrical safety concerns such as the use of portable space heaters and power strips. There were no complaint investigations or enforcement actions listed in the available reports. The correction of deficiencies by the most recent inspection indicates improvement from earlier findings.
Deficiencies (last 1 years)
Deficiencies are regulatory violations found during state inspections.
Deficiencies per year
| Description | Severity |
|---|---|
| Failure to ensure residents had the right to reasonable accommodation of needs and preferences, including call light accessibility and bed comfort for sampled residents. | SS=D |
| Failure to ensure binding arbitration agreements were properly explained, optional, and included required language about rescinding within 30 days for reviewed residents. | SS=E |
| Failure to establish and maintain an infection prevention and control program, including catheter care, equipment disinfection, medication pass procedures, and food handling. | SS=E |
| Failure to ensure delayed egress door released within 15 seconds as required by NFPA standards. | SS=D |
| Failure to maintain smoke barriers to restrict smoke transfer due to unsealed cable penetrations in smoke barrier walls. | SS=E |
| Failure to prohibit portable space heaters in healthcare occupancies or ensure heating elements do not exceed 212°F. | SS=D |
| Failure to maintain power strips and extension cords in accordance with NFPA standards, including improper use of power strips for personal electronics and overloading. | SS=E |
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse 1 | Licensed Practical Nurse | Interviewed regarding call light accessibility and catheter care |
| Director of Nursing | Director of Nursing | Interviewed regarding expectations for call light accessibility and catheter care |
| Administrator | Administrator | Interviewed regarding call light accessibility, arbitration agreements, infection control, and door release issues |
| Maintenance Manager | Maintenance Manager | Interviewed regarding delayed egress door release and power strip usage |
| Physical Therapy/Occupational Therapy Assistant | PTA/OTA | Observed and interviewed regarding gait belt disinfection |
| Kentucky Medication Aide 1 | KMA | Observed and interviewed regarding blood pressure cuff disinfection and medication pass procedures |
| Registered Nurse 1 | RN | Interviewed regarding equipment disinfection and food handling |
| Cook | Cook | Observed with badge resting in food and interviewed about badge policy |
| Dietary Manager | Dietary Manager | Interviewed regarding badge policy and food contamination |
| Infection Preventionist | Infection Preventionist | Interviewed regarding infection control policies and catheter care |
| Social Services Director | Social Services Director | Interviewed regarding resident bed comfort and follow-up |
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