Average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of October 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.
Food service staff failed to store and handle food in accordance with professional standards. Surveyors observed unlabeled and undated cups of unidentified liquids in the reach-in refrigerator, an uncovered cup with an unidentified substance exposed to air, and an unsealed, unlabeled storage bag in the freezer. An employee was also observed removing gloves, handling food items, and opening cans without performing hand hygiene or donning new gloves before resuming food prep. Staff stated the last in-service on hand hygiene, dating, labeling, and sealing containers was in May.
Delayed Incontinence Care: A resident who was dependent for toileting and always incontinent of bowel and bladder was found wet in a wheelchair, with a heavily soiled brief and wet clothing. The task record did not show incontinence care during the shift, while the CNA said care was provided after getting the resident up, and the DON stated residents were to be checked every 2 hours and changed if needed.
Improper G-tube Flush and Medication Administration: A resident with a G-tube, hemiplegia, hemiparesis, COPD, and respiratory failure had orders for enteral feeding, water flushes, and meds via the tube. An LPN was observed flushing the tube and giving meds mixed with water by pushing the plunger instead of allowing gravity flow, and the LPN confirmed the action; the DON stated this was not per professional standards.
Unbagged Oxygen Tubing Found for Two Residents: Two residents with oxygen orders were observed with nasal cannulas not in use and left unbagged, one on a bed and one on the floor. Both residents had respiratory-related diagnoses and one was receiving continuous oxygen while the other had PRN oxygen orders. The charge nurse confirmed the tubing should be bagged when not in use, and the DON stated oxygen tubing should be stored in a clear bag when not in use.
A resident with HTN, depression, and hemiplegia had oral meds left in a cup on his bedside table instead of being observed swallowing them. The resident had intact cognition, no order or care plan approval for self-medication or bedside meds, and the CMA stated she failed to watch him take the meds before leaving the room. The LVN and DON stated residents were expected to swallow meds before staff exited and that no meds were to be left at bedside.
Expired insulin lispro pen-injectors were found on the 400-hall nurse cart for four residents with DM, despite opening dates showing the pens were beyond the 28-day use period. The ADON and DON stated nurses were responsible for checking dates, and the DON confirmed insulin expires 28 days after opening and that expired or discontinued meds should be removed from the cart immediately.
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.
Food Storage and Hand Hygiene Deficiencies in Kitchen
Penalty
Summary
The facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety in the kitchen. During an initial walk-through of the walk-in freezer, reach-in refrigerator, walk-in refrigerator, and dry pantry, surveyors observed an unlabeled, undated small plastic cup without a lid containing an unidentified substance exposed to the air in the reach-in refrigerator. They also observed a tray with 12 small cups of a dark unidentified liquid and 6 small cups of a white unidentified liquid, all unlabeled and undated, along with another tray containing 30 small cups of various colors of unidentified liquid with poorly secured lids in the reach-in refrigerator. In the walk-in freezer, a 2-gallon transparent plastic storage bag was observed unsealed and unlabeled with an unidentified item inside. During a separate observation, [NAME] A was seen wearing gloves while preparing food, then removing the gloves, placing a tray of food in the walk-in refrigerator, and opening two cans of soup without putting on new gloves or performing hand hygiene before returning to food preparation. The Dietary Manager stated the facility had one kitchen and one main dining room, and that one of the cooks was in charge when the Dietary Manager was not on-site. Staff interviewed stated the importance of handwashing before and after wearing gloves and that the last in-service on hand hygiene, dating, labeling, and properly sealing food and beverage containers was in May. The facility policy stated food is to be stored, prepared, distributed, and served in accordance with professional standards, and that food in unlabeled or damaged containers shall not be accepted or retained.
Delayed Incontinence Care
Penalty
Summary
The facility failed to ensure a resident who was dependent on staff for toileting and was always incontinent of bowel and bladder received timely incontinence care. The resident’s quarterly MDS reflected diagnoses including cerebrovascular disease, muscle weakness, lack of coordination, and myelodysplastic syndromes, and his care plan required assistance with dressing, toilet use, personal hygiene, and bathing every shift. The task record for the day in question did not show incontinence care during the 6:00 AM to 8:00 PM shift. During observation, the resident was found sitting in a wheelchair in the hallway and was noted to be wet. A family member stated she wanted him changed because another family member was on the way to visit, and said she had sometimes found him wet in the wheelchair. When CNA D later provided care, the resident’s brief was heavily soiled with urine and his pants were wet. CNA D stated she was assigned to the resident and said she had gotten him up in the wheelchair around 6:45 AM and provided incontinent care at that time. The DON stated residents were to be checked every 2 hours and changed if needed, and that residents were not to be left soaking wet with urine.
Improper G-tube Flush and Medication Administration
Penalty
Summary
The facility failed to ensure appropriate care and services for a resident receiving enteral feeding. Resident #103 was a male with diagnoses including hemiplegia, hemiparesis, COPD, and respiratory failure, and his quarterly MDS indicated a BIMS score of 10 and that he had a feeding tube for enteral feedings. His physician orders directed Isosource 1.5 at 70 cc per hour via G-tube and pump, with the G-tube flushed with 250 cc of water every four hours, head of bed elevated 30 to 45 degrees, tube placement checked prior to each feeding, and meds and fluids given per auscultation and residual checked every shift. During observation, LVN B flushed the resident’s G-tube with 60 mL of water by pushing the plunger instead of allowing the fluid to flow by gravity. A few minutes later, LVN B administered medication mixed with 30 mL of water by pushing the plunger rather than using gravity flow. In interview, LVN B confirmed the actions and stated she was nervous because she was being observed. The DON stated LVN B should have flushed the tube by allowing the fluid to flow through by gravity per professional standards of practice. The resident’s care plan identified the need for a G-tube for adequate nutritional intake and included monitoring for abdominal pain, distension or tenderness, nausea, and vomiting.
Unbagged Oxygen Tubing Found for Two Residents
Penalty
Summary
The facility failed to ensure safe and appropriate respiratory care for two residents who had orders for oxygen therapy. Resident #82, a cognitively intact male with diagnoses including acute and chronic respiratory failure with hypoxia, acute upper respiratory infection, and pulmonary hypertension, had an active order for continuous oxygen via nasal cannula and was receiving oxygen treatments and respiratory therapy 7 days a week. During observation, his oxygen nasal cannula was not in use and was lying on his bed unbagged while he was sitting in his wheelchair, and he reported he usually used oxygen when in bed. Resident #114, a cognitively intact female with diagnoses including chronic embolism and thrombosis, hypoxemia, atrial fibrillation, asthma, and chronic respiratory failure, had an active order for oxygen PRN via nasal cannula or mask and was identified as high risk for return to acute status. During observation, her oxygen nasal cannula was not in use and was lying on the floor unbagged, and she could not recall when it fell out of her nose or how long it had been on the floor. The charge nurse confirmed both nasal cannulas were unbagged and stated they were supposed to be bagged when not in use. The DON stated oxygen tubing should be stored in a clear bag when not in use, bags should be changed weekly and as needed, and staff were trained on oxygen management when hired and monthly thereafter; the DON and Administrator also stated they did not have a policy related to proper storage of respiratory equipment.
Medication Left at Bedside Without Being Swallowed
Penalty
Summary
The facility failed to provide pharmaceutical services to meet the needs of Resident #106 by not ensuring that his medication was swallowed before staff left the room. Resident #106 was admitted with diagnoses including hypertension, depression, and hemiplegia, and his quarterly MDS reflected a BIMS score of 13, indicating intact cognition. His care plan and active physician orders did not include any indication that he could self-medicate or keep medication at bedside. During observation, 4 white oval pills and 1 white round pill were found in a medication cup on the resident’s bedside table, and the resident stated that CMA A had left them there and that he would take them later. In interview, LVN A stated he always ensured residents swallowed their medication before leaving the room but could not explain why the medication was left in the cup. CMA A stated the resident asked her to leave the medications on the bedside table, and she failed to watch him take them before leaving or bring them later when he was ready. The DON stated that no medications were expected to be left at bedside and that medication aides and nurses were expected to watch residents swallow their medications before exiting the room.
Expired Insulin Left on Medication Cart
Penalty
Summary
The facility failed to properly label and store insulin lispro in accordance with accepted professional principles for medications on the 400-hall nurse cart. During observation, insulin lispro pen-injectors for Residents #5, #37, #48, and #117 were found with opening dates that were beyond 28 days, yet they remained in the medication cart instead of being discarded after the opening period had expired. Resident #5 was a re-admitted male with a BIMS score of 13 and a diagnosis of diabetes mellitus. His care plan identified diabetes medication as ordered by the doctor and fasting serum blood sugar monitoring. His physician order included insulin lispro subcutaneous solution pen-injector, to be given per sliding scale two times a day for type 2 diabetes. Resident #37 was a re-admitted male with a BIMS score of 14 and diabetes mellitus, with care plan interventions for diabetes medication and monitoring for signs and symptoms of hyperglycemia and hypoglycemia. His physician order included insulin lispro subcutaneous solution pen-injector to be given per sliding scale before meals and at bedtime. Resident #48 was an admitted male with a BIMS score of 11 and diabetes mellitus, with care plan interventions for diabetes medication and fasting serum blood sugar monitoring. His physician order included insulin lispro subcutaneous solution pen-injector to be given per sliding scale two times a day. Resident #117 was a re-admitted male with a BIMS score of 14 and diabetes mellitus, with care plan interventions for diabetes medication, fasting serum blood sugar monitoring, and monitoring for signs and symptoms of hyperglycemia and hypoglycemia. His physician order included insulin lispro subcutaneous solution pen-injector to be given per sliding scale before meals and at bedtime. The ADON stated nurses were responsible for checking medication dates and removing discontinued medications, and the DON stated insulin should be dated because it expires 28 days after opening and that expired or discontinued medications should be removed from the cart immediately.
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 | ★★★★★ | 15 | 0 |
| Princeton Medical Lodge | 8.4 mi | ★★★★★ | 7 | 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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