Inspection Reports for
Thomson-Hood Veterans Center
100 VETERANS DRIVE, WILMORE, KY, 40390
Back to Facility ProfileDeficiencies (last 3 years)
Deficiencies (over 3 years)
3 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
36% better than Kentucky average
Kentucky average: 4.7 deficiencies/yearDeficiencies per year
4
3
2
1
0
Inspection Report
Complaint Investigation
Deficiencies: 3
Date: Mar 27, 2025
Visit Reason
The inspection was conducted to investigate a complaint regarding resident-to-resident abuse and to assess food service quality and food storage safety at the facility.
Complaint Details
The complaint investigation focused on an incident on 02/14/2025 where Resident R117 entered Resident R134's room and struck him, causing injury. The facility's investigation confirmed the incident and identified failures in supervision and prevention of resident-to-resident abuse.
Findings
The facility failed to protect residents from abuse when one resident struck another causing injury. Additionally, the facility failed to provide palatable, timely meals and failed to store food safely in nourishment rooms, with issues including cold food temperatures, unpalatable meals, and unlabeled or undated food in refrigerators.
Deficiencies (3)
F 0600: The facility failed to protect residents from abuse when Resident R117 struck Resident R134 causing a laceration requiring hospital evaluation and closure with steri-strips. The facility lacked adequate supervision and monitoring of wandering residents to prevent altercations.
F 0804: The facility failed to provide residents with palatable foods served at safe and appetizing temperatures. Observations revealed hot foods served between 90 and 110 degrees Fahrenheit, which is below the USDA recommended 140 degrees F, and residents reported cold, overcooked, and unappetizing meals with inconsistent meal service times.
F 0812: The facility failed to store food safely in nourishment rooms on three units, with observations of unlabeled, undated food items and unclean refrigerators, increasing the risk of cross-contamination.
Report Facts
Temperature of hot foods: 90
Temperature of hot foods: 110
BIMS score: 4
BIMS score: 8
Dates of admission: Apr 10, 2024
Dates of admission: Dec 5, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nurse Shift Program Supervisor | Assessed Resident R117 after altercation and coordinated hospital evaluation | |
| Nurse Aide State Registered (NASR14) | Witnessed and assisted during altercation between residents R117 and R134 | |
| Registered Nurse (RN) House Supervisor | Responded to altercation and assessed Resident R134 | |
| Unit Manager | Provided information on wandering resident supervision policies | |
| Director of Nursing (DON) | Discussed expectations for supervision and prevention of resident-to-resident altercations | |
| Administrator | Provided expectations on resident freedom of movement and supervision | |
| Prep Center Coordinator | Assisted with test trays and temperature checks of food service | |
| Cook One | Described breakfast tray line setup and food preparation | |
| Food Service Operations Manager | Discussed food temperature expectations and nourishment room responsibilities | |
| Registered Nurse (RN) Manager | Discussed expectations for food temperature and meal quality |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Mar 27, 2025
Visit Reason
The inspection was conducted to investigate a complaint regarding a resident-to-resident altercation where Resident 117 struck Resident 134, causing injury.
Complaint Details
The complaint investigation involved 1 of 5 residents for abuse. The facility substantiated that Resident 117 struck Resident 134 on 02/14/2025, causing injury. Resident 117 had a history of wandering and prior altercations. Staff did not witness the beginning of the altercation. The facility maintained one-on-one supervision of Resident 117 after the incident until family arrived.
Findings
The facility failed to protect residents from abuse when Resident 117 entered Resident 134's room and struck him, causing a laceration requiring hospital evaluation. The investigation revealed the facility had policies for monitoring aggressive behavior but lacked sufficient supervision to prevent the incident.
Deficiencies (1)
F 0600: The facility failed to protect residents from all types of abuse including physical abuse. Resident 117 struck Resident 134 causing a laceration that required hospital evaluation and closure with steri-strips.
Report Facts
Residents investigated for abuse: 5
Brief Interview for Mental Status (BIMS) score: 4
Brief Interview for Mental Status (BIMS) score: 8
Dates: Feb 14, 2025
Dates: Mar 27, 2025
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Nurse Shift Program Supervisor | Wrote nursing progress note about the altercation on 02/14/2025 | |
| Licensed Practical Nurse (LPN) | Documented nursing note describing the incident and resident assessment | |
| Nurse Aide State Registered (NASR14) | Interviewed about Resident 117's wandering and behavior during the incident | |
| Nurse Aide State Registered (NASR11) | Interviewed about assisting residents during the altercation | |
| Nurse Aide State Registered (NASR12) | Witnessed Resident 117 hitting Resident 134 | |
| Registered Nurse (RN1) | House supervisor who responded to the incident and assessed Resident 134 | |
| Unit Manager | Interviewed about wandering policies and supervision | |
| Director of Nursing (DON) | Interviewed about supervision expectations and resident safety | |
| Administrator | Interviewed about facility expectations for resident wandering and supervision |
Inspection Report
Complaint Investigation
Deficiencies: 1
Date: Sep 5, 2019
Visit Reason
The inspection was conducted due to a complaint regarding the facility's failure to treat a resident with respect, dignity, and privacy during blood glucose monitoring.
Complaint Details
The complaint was substantiated. The investigation found that Licensed Practical Nurse (LPN) #9 performed blood glucose testing in a public area without privacy and disclosed results aloud, violating Resident #43's rights.
Findings
The facility failed to provide privacy and dignity to Resident #43 during blood glucose testing by performing the procedure in a public hallway and disclosing results aloud. Staff interviews confirmed lack of training and improper practices violating resident rights.
Deficiencies (1)
F 0550: The facility failed to honor the resident's right to dignity, privacy, and confidentiality by performing blood glucose testing for Resident #43 in a public hallway and disclosing results aloud in front of others.
Report Facts
Residents Affected: 1
Employment Duration: 8
BIMS Score: 11
Resident Sample Size: 36
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse (LPN) #9 | Named in privacy violation during blood glucose testing | |
| Unit Manager (UM) | Provided interview regarding staff expectations and LPN #9's conduct | |
| Staff Development Coordinator (SDC) | Provided interview about staff training and competencies | |
| Director of Nursing (DON) | Provided interview about expectations for resident care and privacy | |
| Administrator | Provided interview about facility expectations for dignity and care |
Inspection Report
Annual Inspection
Deficiencies: 4
Date: Dec 6, 2018
Visit Reason
The inspection was conducted as a comprehensive annual survey to assess compliance with regulatory requirements for nursing home care.
Findings
The facility was found deficient in multiple areas including failure to notify the physician of elevated blood glucose levels for a diabetic resident, failure to develop and revise comprehensive care plans for residents with specific needs, and improper storage and handling of food items in nourishment refrigerators.
Deficiencies (4)
F 0580: The facility failed to notify the Medical Provider when Resident #114 had blood glucose levels above 400 on 11/16/18 and 11/18/18, contrary to facility policy requiring notification via secure communication.
F 0657: The facility failed to develop and revise comprehensive care plans for two residents, including Resident #35 who refused care and Resident #114 with hyperglycemia, lacking documented interventions to address these issues.
F 0684: The facility failed to provide appropriate treatment and care to Resident #114 by not marking elevated blood glucose levels in the documentation system to notify the physician for timely medication adjustments.
F 0812: The facility failed to store and distribute food safely; nourishment refrigerators contained unlabeled, undated, and expired food items, violating facility policies on food storage and safety.
Report Facts
Blood glucose readings: 567
Blood glucose readings: 523
Blood glucose readings: 410
Blood glucose readings: 435
Blood glucose readings: 334
Expired milk cartons: 15
Residents sampled: 31
Residents affected: 1
Residents affected: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Licensed Practical Nurse #1 | Licensed Practical Nurse | Signed nursing note on 11/18/18 regarding Resident #114's blood glucose readings |
| Licensed Practical Nurse #2 | Licensed Practical Nurse | Interviewed regarding Resident #114's blood glucose levels and notification process |
| Roosevelt Unit Manager | Unit Manager | Interviewed about notification expectations for high blood glucose levels |
| Advance Practice Registered Nurse | APRN | Runs daily report for elevated glucose levels and expects notification for levels above 400 |
| Director of Nursing | Director of Nursing | Interviewed about facility policy and expectations for notification and care plan revisions |
| Administrator | Facility Administrator | Interviewed about expectations for staff to follow policies on notification and care plans |
| Nurse #7 | Nurse | Interviewed about Resident #35's refusal behaviors and care planning |
| Unit Manager | Unit Manager | Interviewed about care plan revisions for Resident #35 |
| Registered Nurse/[NAME] Unit Nurse Manager #3 | Registered Nurse/Unit Nurse Manager | Interviewed about nourishment refrigerator maintenance and food labeling |
| Aide #1 | Nurse Aide | Responsible for ordering and stocking nourishment refrigerators |
| Aide #2 | Nurse Aide | Responsible for ordering and rotating food stock in nourishment refrigerators |
| Aide #3 | Nurse Aide | Responsible for ordering food items and stocking nourishment refrigerator |
| Registered Nurse/[NAME] Nurse Manager #4 | Registered Nurse/Unit Nurse Manager | Interviewed about food stocking and rotation practices |
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