Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Lexington Medical Lodge during CMS and state inspections, most recent first.
Staff failed to provide proper incontinence and catheter care for three male residents, including inadequate cleaning of the genital area, improper handling of urinary drainage bags, and inconsistent hand hygiene. These actions occurred despite residents' medical conditions such as cognitive impairment, chronic kidney disease, and use of indwelling catheters, and were confirmed through staff interviews and direct observation.
Multiple CNAs failed to perform proper hand hygiene and use required PPE during incontinence and catheter care for several residents with complex medical needs, including those on Enhanced Barrier Precautions. Staff were observed changing gloves without hand hygiene, omitting gowns when indicated, and not cleaning all necessary areas during care, despite being aware of facility protocols and having received training.
Two residents with severe cognitive impairment did not receive necessary assistance with ADLs, resulting in one having unshaved facial hair and another with long, dirty fingernails. Staff interviews confirmed responsibility for grooming and nail care, but these tasks were not completed as required by facility policy.
A broken blister pack containing a controlled pain medication was found on a medication cart, with the responsible RN failing to check the integrity of the blister packs during narcotic counts at shift change. The DON confirmed that nurses are expected to check for broken seals and that such incidents should be reported and the medication discarded, but this process was not followed.
A resident with severe cognitive impairment and a history of wound infection and toe amputation did not have wound care dressing changes documented on the TAR for multiple dates, despite physician orders and care plan requirements. Staff and administration confirmed there was no policy for dating or initialing wound dressings, and relied on the TAR for tracking, but missing entries meant wound care could not be verified.
Deficient Incontinence and Catheter Care Leading to Increased UTI Risk
Penalty
Summary
The facility failed to provide appropriate incontinence and catheter care for three residents, resulting in deficiencies related to the prevention of urinary tract infections (UTIs). For one male resident with a history of femur fracture, mild intellectual disability, and risk for skin breakdown, a CNA did not properly clean the resident's penis, scrotum, or pubic area during incontinence care. The CNA only wiped the anal area and groin, neglecting the necessary cleaning of the genital area, and did not perform hand hygiene after glove changes. Another male resident with Parkinson's disease, chronic kidney disease, and a current UTI was observed receiving inadequate catheter and perineal care. The CNA failed to change the surface of the peri-wipes when cleaning the genital area, did not clean the catheter tubing from the tip of the penis downward, and placed the urinary drainage bag on the bed, above the level of the bladder, during care. The CNA also did not perform hand hygiene between glove changes and applied barrier cream with contaminated gloves. A third male resident, dependent on staff for all toileting and transfers and with a Foley catheter, was transferred using a mechanical lift while the urinary drainage bag was placed on his lap and later on the bed, both times above the level of the bladder. During incontinence care and a bed bath, the drainage bag remained on the bed, and staff did not consistently perform hand hygiene between glove changes. Staff interviews confirmed knowledge of proper procedures but acknowledged lapses in practice during the observed care.
Failure to Adhere to Infection Control Protocols During Resident Care
Penalty
Summary
The facility failed to maintain an effective Infection Prevention and Control Program, as evidenced by multiple instances where staff did not adhere to established infection control protocols during resident care. Certified Nursing Assistants (CNAs) were observed not performing hand hygiene at critical points, such as after glove removal, during incontinence care, and before leaving resident rooms. In several cases, CNAs changed gloves without performing hand hygiene, and in some instances, did not use the required personal protective equipment (PPE), such as gowns, when providing care to residents on Enhanced Barrier Precautions due to the presence of indwelling medical devices or wounds. Specific observations included a CNA failing to perform hand hygiene during and after incontinence care for a male resident with a history of femur fracture and mild intellectual disability, and not cleaning all necessary areas during care. Another CNA did not don a gown while caring for a male resident with Parkinson's disease and a urinary catheter, and failed to perform hand hygiene at multiple points during catheter and incontinence care. Additional deficiencies were noted with a female resident with diabetes and a history of thrombosis, where a CNA did not perform hand hygiene after assisting with a mechanical lift transfer and before leaving the room. Similar lapses were observed with a female resident with candidiasis, dementia, and a urinary tract infection, where the CNA did not use a gown, failed to change gloves appropriately, and did not perform hand hygiene after care. Further, during care for a male resident with primary lateral sclerosis and neuromuscular bladder dysfunction, two CNAs failed to perform hand hygiene after glove changes and before leaving the room, despite handling urinary drainage bags and providing incontinence care. Interviews with the involved CNAs and supervisory staff confirmed awareness of the required protocols, including hand hygiene and PPE use, but revealed lapses in practice, often attributed to forgetfulness or oversight. Facility policy required Enhanced Barrier Precautions for residents with wounds or indwelling devices, but these were not consistently followed during observed care activities.
Failure to Provide ADL Assistance for Grooming and Hygiene
Penalty
Summary
The facility failed to provide necessary assistance with activities of daily living (ADLs) for two residents who were unable to perform these tasks independently. One resident, a female with severe cognitive impairment, cerebrovascular accident, dementia, and hypertension, was observed lying in bed with long, scattered white facial hair on her chin and upper lip. She expressed a desire to have the facial hair removed but was unable to do so herself. Staff interviews confirmed that it was the responsibility of CNAs to remove facial hair for female residents if the resident agreed, and that the charge nurse was responsible for ensuring residents were groomed. The resident's care plan indicated she was totally dependent on staff for personal ADLs, including grooming and hygiene. Another resident, a female with severe cognitive impairment, cerebral palsy, seizure disorder, and anxiety, was observed in a wheelchair with long fingernails (approximately 0.7 cm) and clear brown matter underneath. She required substantial to maximal assistance with personal hygiene and was unable to answer questions. Staff acknowledged that her fingernails were long and dirty, and stated that both CNAs and charge nurses were responsible for nail care, with nurses handling nail care for residents with diabetes. The facility's policies on nail care and shaving emphasized the importance of cleanliness, infection prevention, and dignity, but these were not followed for the residents in question.
Failure to Ensure Proper Pharmaceutical Services and Medication Security
Penalty
Summary
The facility failed to provide adequate pharmaceutical services to meet the needs of each resident, as evidenced by a broken blister pack containing Tramadol 50 mg Hcl for one resident on the nurses' cart in Hall 100. During an observation and record review, it was found that one blister seal was broken, although the pill remained inside. The responsible RN stated that while narcotic counts were performed at shift changes, the blister packs themselves were not checked during these counts. The RN was unaware of when or how the blister pack seal was broken and did not know who might have damaged it. According to the facility's policy, nurses are responsible for checking medication blister packs for broken seals during narcotic counts at shift changes. The DON confirmed that if a blister pack seal is broken, the pill should be discarded due to the risk of drug diversion and infection control concerns. The DON also stated that nurses are expected to check for broken seals during shift changes and that the facility pharmacist conducts monthly audits of medication carts. The facility's policy requires immediate reporting and reconciliation of any discrepancies in narcotic counts, but the broken seal was not identified or reported as required.
Failure to Document Wound Care Dressing Changes in Medical Records
Penalty
Summary
The facility failed to maintain medical records in accordance with accepted professional standards and practices for a resident who required wound care dressing changes. Specifically, there was no documentation of wound care dressing changes on the Treatment Administration Record (TAR) for several dates, despite physician orders and care plan interventions requiring daily wound assessment and documentation. The resident involved was an elderly female with severe cognitive impairment, a history of dementia, wound infection, cellulitis, and a right toe amputation. Her care plan included monitoring and documenting the wound daily for signs of infection, drainage, skin breakdown, and impaired circulation. During observation, it was noted that the resident's wound dressing was not dated, timed, or initialed. Interviews with nursing staff and administration revealed that the facility did not have a policy requiring wound dressings to be dated, timed, or initialed, and staff relied on the TAR to determine when the last dressing change occurred. However, the lack of documentation on the TAR for the specified dates meant that staff could not verify when wound care was last provided. The facility's wound care policy required documentation of wound assessment, treatment, and effectiveness, but this was not consistently followed.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Farmersville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Farmersville Health And Rehabilitation | 1.3 mi | ★★★★★ | 1 | 0 |
| Princeton Medical Lodge | 8.4 mi | ★★★★★ | 5 | 0 |
| Wylie Oaks Healthcare And Rehabilitation | 12.7 mi | ★★★★★ | 2 | 0 |
| Royse City Medical Lodge | 13.7 mi | ★★★★★ | 6 | 0 |
| North Park Health And Rehabilitation Center | 14.1 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.