Lincoln Hills Of New Albany

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview, the facility failed to ensure residents' meal trays were removed in a timely manner for 6 of 7 residents reviewed for dignity. (Residents 38, 43, 104, 122, 109, and 74)Findings include: 1. During an observation and interview, on 12/1/25 at 10:00 a.m., Resident 38 was sitting up in her wheelchair with her breakfast tray sitting in front of her on the bedside table. She had not eaten any of her breakfast. She held a butter knife in her hand and indicated she was trying to get started eating her breakfast. During an interview, on 12/3/25 at 10:05 a.m., Resident 38 indicated the staff normally left the breakfast tray on her bedside table. She was asleep when they brought it. They would let her know it was there. The resident had not yet eaten any of her breakfast. She indicated she was going to eat it soon. During an observation, on 12/03/2025 12:02 p.m., Resident 38 received her lunch. As Certified Nurse Aide (CNA) 4 left the resident's room, she indicated the…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review and interview, the facility failed to ensure the kitchen was maintained in a clean and sanitary condition and the disposal of expired food. This deficient practice had the potential to affect 120 of 120 residents residing in the facility.Findings Include:During an observation of the facility kitchen, on 12/1/25 at 9:30 a.m., the following was observed: - Fifty small condiments containers were observed with ranch dressing in them. The expiration date on the containers was 11/18/25. - The kitchen floor had several black and brown dried substances on the floor tile (the floor appeared greasy) and food debris was scattered on the floor. - The knob to the oven door was missing and the Dietary Manager located it underneath the oven. the Dietary Manager indicated the knob was loose and frequently fell off. - There was a brown greasy streak running down the full length of the oven door and onto the floor. During a second observation of the facility kitchen, on 12/3/25 the following was observed: - The kitchen floor had several black and brown dried…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review and interview, the facility failed to ensure a resident's plan of care was revised for 1 of 3 residents reviewed for dementia care. (Resident 121)Findings include:During an observation on 12/5/25 at 11:30 a.m., the resident was seen in the hallway propelling his wheelchair to the activities room from C Hall which was not a locked unit. The resident indicated that he felt good today and was ready to be out of his room.The record for Resident 121 was reviewed on 12/2/25 at 8:30 a.m. The resident's diagnoses included, but were not limited to, personal history of traumatic brain injury, bipolar disorder, memory deficit following other cerebrovascular disease, history of falls, and chronic obstructive pulmonary disease.A care plan, dated 4/12/24, indicated the resident had a diagnosis of dementia, that negatively impacts the resident's cognition and judgement, causing the resident to require a locked, structured unit. The goal, dated 2/14/26, was for the resident to remain on locked unit until their clinical and psychosocial needs no longer required a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on interview and record review, the facility failed to ensure a plan of care was in place timely, for a resident's non-compliance with a fall intervention related to the use of hipsters for 1 of 3 residents reviewed for care plans. (Resident D) Findings include: The clinical record for Resident D was reviewed on 2/27/25 at 9:28 a.m. The resident's diagnoses included, but were not limited to, vascular dementia and abnormalities of the gait. The care plan, dated 7/22/24, indicated the resident was at risk for falls. The resident was to wear hipsters (help reduce the risk of injuries from a fall, such as hip fractures, through impact-absorbing foam pads) at all times as the resident would allow to decrease risk of injury with falls. The progress note, dated 2/20/25 at 9:24 p.m., indicated the resident was walking in the dining room and fell over onto her left hip. The residents' hipsters were not on. The nurse practitioner was notified and a new order received for an x-ray. The progress note, dated 2/21/25 at 1:26 a.m., indicated the resident was sent to the hospital due to a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and interview, the facility failed to promptly resolve the grievances made by the Resident Council and discussed the resolutions/responses at the next Resident Council meeting during 3 of 9 Resident Council meetings. (February, April, and August 2024) Findings include: During the Resident Council meeting on 9/24/24 at 9:55 a.m., with 13 residents whom the Activities Director indicated were alert and oriented. The residents voiced that they had the meetings and voiced their concerns, and then that was the last they heard. They never knew what the outcome was to their concerns. They indicated it was not discussed in the next month's meeting. 1. The Resident Council meeting, held on 2/2/24, indicated the following concerns were not addressed by the responsible department or resolved: - Resident 34 was missing clothes. - Residents were tired of the same menu. The kitchen needed to cut back on the salt in the food. No response to these concerns could be located. During the meeting, the residents voiced concerns about not getting their clothes back. The Director of…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and interview, the facility failed to ensure the residents received their mail on Saturdays when it was delivered to the facility. This deficient practice had the potential to affect 109 residents currently residing in the facility. Findings include: During the Resident Council meeting on 9/24/24 at 9:55 a.m., with 13 residents whom the Activities Director indicated were alert and oriented. The residents voiced that they were not receiving any mail on Saturdays. They indicated they knew it was being delivered to the facility as they had seen the mailman come in. During an interview with the Activities Director on 9/30/24 at 9:15 a.m., he indicated the mail during the week was passed by him. If the Friday mail came in late in the afternoon, he would go ahead and pass it before he left for the day. The mail was being delivered to the facility on Saturdays, but someone had to sort through it and remove the mail the residents were not supposed to receive such as bills. He did not know who did the sorting on Saturday, but any mail that came in on Saturday was not…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review and interview, the facility failed to ensure narcotics were documentated on the Controlled Drug Record of the administered narcotics for 6 of 68 residents observed for medication storage on the C and E Hall medication carts. (Residents 104, 21, 60, 26, 3, and 54) Findings include: 1. During an observation on 9/25/24 at 1:53 p.m., of the C Hall medication cart, the following were identified: a. Resident 104's oxycodone 10 mg (milligrams) Controlled Drug Record had a count of 7 tablets left. The resident's medication card contained 6 tablets of the oxycodone. The last dose signed out on the Controlled Drug Record was on 9/25/24 at 2:44 a.m. The clinical record was reviewed on 9/29/24 at 1:20 p.m., the physician's order, dated 9/20/24, indicated the resident received the oxycodone 10 mg every 4 hours as needed for pain. The resident's September MAR (Medication Administration Record) indicated the resident's last dose of oxycodone 10 mg was administered on 9/25/24 at 12:38 p.m., by LPN (Licensed Practical Nurse) 3. b. Resident 21's hydrocodone/APAP…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review, and interview, the facility failed to ensure a hot liquid assessment was completed for a resident with a decline in function for 1 of 4 residents reviewed for accidents. (Resident 80) Findings include: During an observation on 9/23/24 at 12:30 p.m., Resident 80's lunch tray was sitting on the table within the resident's reach. No staff were in the resident's room. The resident was able to pull the tray close to him and pick up his spoon. He attempted to pick up his peaches. Due to the resident's bilateral hand contractures, he was unable to pick up the small bowl of peaches. He attempted to pick up a peach with his spoon and was unable to do so. The record for Resident 80 was reviewed on 9/24/24 at 11:00 a.m. The resident's diagnoses included, but were not limited to, moderate intellectual disabilities, limitation of activities due to his disability, contracture of the right hand, contracture of the left hand, contracture of muscle on the right hand, contracture of the muscle on the left hand, and abnormal posture. The Quarterly Minimum Data Set…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review, and interview, the facility failed to ensure appropriate interventions, supervision, and care were provided for a resident with dementia related behaviors for 1 of 3 residents reviewed for Dementia Care. (Resident B) Findings include: The record for Resident B was reviewed on 12/18/23 at 9:15 a.m. The diagnoses included, but were not limited to, Alzheimer's disease, dementia with other behavioral disturbance, severe with anxiety, colostomy status, need for assistance with personal care, attention and concentration deficit, and mild cognitive impairment of uncertain or unknown etiology. The care plan, dated 11/15/22, indicated the resident required care and assistance for his colostomy with a potential for complications. The interventions included, but were not limited to, change the ostomy as ordered, provide care as ordered, report abdominal distention or discomfort, erythema, edema, tenderness, or drainage to stoma. The Social Services note, dated 1/25/23 at 8:50 a.m., indicated the resident had increased confusion. He was stating he was…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and interview, the facility failed to ensure the physician was notified when a resident's blood sugar readings fell outside the physician ordered parameters for 1 of 3 residents reviewed for notification of change. (Resident 104) Findings include: The record for Resident 104 was reviewed on 8/25/23 at 11:29 a.m. The diagnoses included, but were not limited to, type 2 diabetes mellitus with hyperglycemia and hypoglycemia, type 1 diabetes without complications, nutritional anemia, and dependence on renal dialysis. A care plan, dated 6/4/23, indicated the resident had the potential for hypoglycemia or hyperglycemia and diabetic complications related to diabetes mellitus. The goal was for the resident to be free of unrecognized hypoperglycemia or hyperglycemia. The approaches included, but were not limited to, administer accu checks (blood sugar checks) and any insulin coverage per physician's order; and to report any signs of hypoglycemia or hyperglycemia. The Quarterly Minimum Data Set (MDS) assessment, dated 6/27/23, indicated the resident was cognitively…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review, and interview, the facility failed to follow appropriate infection control guidelines related to perineal care for 3 of 6 residents with a history of urinary track infections reviewed for bowel and bladder. (Residents 76, 42, and 35) Findings include: 1. During an observation of perineal care for Resident 76 on 8/29/23 at 9:39 a.m., CNA (Certified Nurse Aide) 9 performed hand hygiene and applied gloves from her pocket. A wet soapy washcloth was obtained and with 4 swipes of the same area of the washcloth the labial area was cleaned. She obtained a wet washcloth and with 3 swipes of the same area of the washcloth she rinsed the creases. She obtained a wet washcloth and with 2 swipes of the same area of the washcloth she rinsed the labial area. The resident was rolled onto her left side and a wet soapy washcloth was obtained. With 11 swipes of the same area of the washcloth she cleaned the buttocks and anal area with a back-and-forth motion. Stool was observed on the washcloth. She obtained a wet soapy washcloth with 5 swipes of the same area of…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure appropriate pain management interventions were implemented for 1 of 2 residents reviewed for pain. (Resident 102) Findings include: The record for Resident 102 was reviewed on 8/24/23 at 10:00 a.m. The diagnoses included, but were not limited to, unspecified pain (present on admission on [DATE]), low back pain (added on 7/14/23), and intercostal pain (added on 7/18/23). The physician's order, dated 5/29/23, indicated staff were to administer the resident's hydrocodone-acetaminophen 5/325 mg (milligram) every 4 hours as needed for pain. The physician's note, dated 5/26/23 at 10:31 p.m., indicated the physician was contacted for a controlled substance refill, a bridge supply was ordered until the primary team evaluated the resident. The physician indicated they discussed non-pharmacological pain management options, however, did not indicate what they were. The admission MDS (Minimum Data Set) Assessment, dated 6/2/23, indicated the resident was…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on record review and interview, the facility failed to ensure the physician was notified when a dialysis resident's weight was above the physician-ordered set parameters for 1 of 7 dialysis residents currently residing in the facility. (Resident 104) Findings include: The record for Resident 104 was reviewed on 8/25/23 at 11:29 a.m. The diagnoses included, but were not limited to, metabolic syndrome, diabetes mellitus with hyperglycemia and hypoglycemia without coma, nutritional anemia, and end stage renal disease with dependence on renal dialysis. A care plan, dated 6/4/23 with a last review date of 8/28/23, indicated the resident was at nutritional risk related to the carbohydrate controlled diet, fluid restricted diet and an altered BMI (body mass index).The goal was for the resident to tolerate the carbohydrate controlled/fluid restricted diet. The approaches included, but were not limited to, monitor/record weight routinely and notify the physician and Registered Dietitian of significant weight changes. A care plan, dated 6/4/23 with a last review date of 8/28/23,…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.