Citations in Kentucky
Statistics, citations and compliance trends for long-term care facilities in Kentucky.
Statistics for Kentucky (Last 12 Months)
Financial Impact (Last 12 Months)
Latest citations in Kentucky
A resident with moderate cognitive impairment and diagnoses including a femoral neck fracture and pain had Norco delivered to the facility, but the narcotic was not properly signed into the cart or reconciled. When the resident later requested PRN pain medication, none was available, and the facility’s investigation found that an RN failed to complete the narcotic sign-in process and the medication was never located.
A resident with cellulitis and MS, who was Full Code and not on hospice, developed confusion and jerking movements and was found to have a change in condition. The physician ordered labs and other tests, but the labs were not obtained promptly and there was little documented ongoing monitoring for hours. Staff gave conflicting accounts about assessments and the timing of escalation, and EMS was not called until the resident had deteriorated to cardiac arrest; he was transported to the hospital and later pronounced dead.
Failure to Employ a Qualified Full-Time Social Worker: The facility, certified for 226 beds, went for about three months without a qualified SW while the former SSD had left and the new SSD was still in training. Other staff without the required SW qualifications helped with social services tasks, and during this period a resident received a defective discharge notice that lacked sufficient support for the stated discharge reason and did not include accurate appeal information.
A resident with intact cognition and diagnoses including muscle wasting/atrophy and chronic hepatitis C was discharged after the facility issued a notice stating his health had improved and he no longer needed facility services. However, the resident said he was told he had no payor source and did not qualify for the level of care, and records showed the Medicaid LOC denial occurred because the facility failed to submit requested information, not because he no longer needed care. Interviews with the CL, DON, and Administrator confirmed the discharge was based on that denial.
A resident with intact cognition was given a discharge notice stating he no longer needed the facility’s services, but the notice did not include accurate required appeal information. The form lacked correct contact details for the state appeal entity and ombudsman, and the resident later appealed with ombudsman help; the appeal was upheld because the notice was incorrectly completed.
A resident with multiple diagnoses was affected when the facility failed to provide requested Medicaid LOC information needed to determine continuing eligibility and payor source status. KLOCS sent a lack-of-information notice, but no additional information was submitted, the request was denied, and the resident later received a discharge notice based on the denial. Interviews showed the CL handled KLOCS without formal training, the SSD had no knowledge of why the information was not forwarded, and the Administrator was unaware the denial resulted from the facility’s failure to respond.
Failure to Secure and Track a Resident’s Narcotic Medication
Penalty
Summary
The facility failed to maintain professional standards of nursing practice for the storage, tracking, and reconciliation of a scheduled controlled substance for one sampled resident. The resident had been admitted with diagnoses including left femoral neck fracture, muscle wasting and atrophy, and unspecified pain, and the admission MDS reflected a BIMS score of 9, indicating moderate cognitive impairment. Review of the facility policy showed it did not specifically address new narcotic medication security after delivery from the pharmacy, and the DON stated the facility did not have a policy for checking in narcotic medications or a drug diversion policy. The resident’s Norco 7.5 mg 30-count blister pack was delivered to the facility, but it was not properly signed into the medication cart and was later found missing when the resident requested PRN pain medication and none was available. Interviews and the facility’s investigation showed an LPN received the narcotic medication and asked a KMA to assist with logging it in, the KMA placed it in the cart and told the oncoming RN that the RN would need to complete the blue and white narcotic sheets, and RN 2 failed to sign the medication into the cart as requested. The investigation also noted RN 2 had suspicious behavior, had accidentally taken home a resident’s medication on another occasion, and the missing Norco was never located.
Delayed Monitoring and Transfer After Change in Condition
Penalty
Summary
The facility failed to provide treatment and care in accordance with professional standards of practice for one resident who had a change in condition. The resident was admitted with diagnoses including cellulitis of the right lower limb and multiple sclerosis, was not on hospice, and was Full Code. On the day the change was first identified, the resident was noted to have slight confusion and moderate jerking movements of both hands, and the physician was notified with orders obtained for a urinalysis, CBC, CMP, Covid swab, and chest x-ray. The chest x-ray was completed, but there was no evidence that the ordered labs or Covid swab were obtained promptly or at all before the resident’s death. After the change in condition was identified, the record contained no further progress notes for many hours, and there was no documented ongoing monitoring during that period except for limited blood pressure readings. The facility’s own staff gave differing accounts of the resident’s status and the timing of assessments. One LPN stated that after the physician was notified, vital signs and nursing assessments should have been done every four hours until lab results were received, while another LPN stated the expectation was increased assessments and vital signs after a physician was notified, but the facility did not designate how often. The Medical Director stated he expected staff to assess the resident and obtain vital signs every two hours after a change in condition that warranted a call to him. On the morning the resident deteriorated, staff reported that he was shaky, not feeling well, and not acting normally. Direct care staff stated they notified the nurse early in the shift and again after breakfast that the resident needed to go to the hospital, but the nurse did not send him out at that time. The nurse later stated he assessed the resident, notified the Unit Manager, called the physician, obtained an order to transfer the resident, and then called 911, but he could not provide times for these actions and could not explain the delay before EMS was called at 11:21 AM. EMS found the resident without a heartbeat and provided CPR and intubation before transport. The resident arrived at the hospital in cardiac arrest, remained in asystole, and was pronounced dead shortly after arrival.
Failure to Employ a Qualified Full-Time Social Worker
Penalty
Summary
The facility failed to employ a qualified full-time social worker in a building certified for 226 beds. Review of the facility’s social worker job description showed that a qualified social services worker needed at least a bachelor’s degree in social work or another human services field and one year of supervised social work experience in a health care setting working directly with individuals. Employment records showed that from 03/13/2026 through 06/18/2026, the facility did not have a qualified social services worker. Interviews confirmed that the former Social Services Director left in March 2026, the current Social Services Director was hired in June 2026 and was still in training, and the facility’s Customer Service Liaison and Director of Rehabilitation Services were helping with social services tasks even though they did not meet the minimum qualifications for a social worker. The Regional Director of Operations and the Administrator both confirmed that the facility went for about three months without a qualified social services worker while the owner was recruiting and advertising for the position. The Owner stated that recruiters and sign-on bonuses were used in an effort to fill the role, but a qualified applicant was not obtained until the new social services director was hired the prior month. During the same period, the facility issued Resident 1 a discharge notice dated 05/15/2026, and review of the record found insufficient evidence supporting the stated discharge reason and that the notice did not provide accurate information needed to appeal the planned discharge.
Improper discharge based on inaccurate LOC denial
Penalty
Summary
The facility attempted to discharge a resident without adequate evidence that the stated reason for discharge was accurate. The resident was admitted with diagnoses including muscle wasting and atrophy, chronic hepatitis C, and unspecified signs and symptoms involving the nervous system, and had a BIMS score of 15/15, indicating intact cognition. The facility issued a discharge notice stating the resident’s health had improved sufficiently and that he no longer needed the services provided by the facility, with the discharge effective one month later and signed by the Customer Service Liaison. However, the resident stated that administration told him he needed to discharge because he had no way to pay for his stay and did not qualify for that level of care, while he believed he still needed a higher level of care. Record review showed the discharge decision was tied to a Kentucky Level of Care System denial after the facility failed to submit requested information needed to complete the Medicaid LOC determination. The LOC application documented that the request was not reviewed because necessary information was not submitted, and the denial was due to lack of information rather than a determination that the resident no longer needed services. Interviews with the Clinical Liaison, DON, and Administrator confirmed the discharge was based on the KLOCS denial and that the Administrator was unaware the denial occurred because the facility did not provide the requested information. The facility policy stated residents could only be discharged for specified reasons, including improved health, and that discharge could not be based solely on payment source or a change in payment source.
Defective discharge notice omitted required appeal information
Penalty
Summary
The facility failed to provide a discharge notice that met federal requirements for one resident when it issued a Notice of Resident Transfer or Discharge stating the resident would be discharged because his health had improved sufficiently and he no longer needed the facility’s services. The facility’s policy required the discharge notice to include, in a language and manner the resident could understand, an explanation of the right to appeal, the name, address, and telephone number of the state entity receiving appeal requests, information on how to obtain an appeal form, assistance with completing and submitting the appeal request, and the name, address, and phone number of the state long-term care ombudsman. The resident was admitted with diagnoses including muscle wasting and atrophy, chronic hepatitis C, and unspecified signs and symptoms involving the nervous system, and his MDS showed a BIMS score of 15/15, indicating intact cognition. Review of the discharge notice and a Final Order from an administrative hearing showed the notice did not contain accurate contact information for all required state agencies, including the Cabinet office responsible for appeal requests, correct information on obtaining assistance with an appeal request, and the state long-term care ombudsman’s contact information. The resident stated he appealed with help from the local ombudsman and that the appeal was upheld because the facility failed to include correct appeals and contact information in the discharge notice.
Failure to Provide Medicaid Eligibility Information
Penalty
Summary
Medically related social services were not provided to help a resident achieve the highest possible quality of life when the facility failed to assist with legal and/or financial matters related to Medicaid eligibility. The resident was admitted with diagnoses including muscle wasting and atrophy, chronic hepatitis C, and unspecified signs and symptoms involving the nervous system. Facility records showed that a Medicaid level of care reassessment was due, and the Kentucky Level of Care System sent a lack-of-information notification requesting additional information needed to determine the resident’s continuing eligibility and payor source status. No additional information was submitted on the resident’s behalf, and the request was denied for lack of information under Kentucky Administrative Regulations. As a result of that denial, the resident was determined not to meet the level of care needed, and the facility later issued a discharge notice stating the resident’s health had improved sufficiently to no longer need the facility’s services. Interviews showed the Clinical Liaison handled KLOCS submissions without formal training, did not recall receiving the request for additional information, and did not know why the facility never responded. The former Social Services Director stated she did not work with KLOCS and had no knowledge of why the requested information was not forwarded to Medicaid, and the Administrator stated she was unaware the denial occurred because the facility failed to submit the requested information.
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Compliance trends in Kentucky
Data through May 2026Comparisons below measure the most recent period Jun 2025 – May 2026 against the prior period Jun 2024 – May 2025 (two equal 12-month windows). The most recent 2 months are excluded because CMS is still publishing them.
Top tags by month · last 24 months
dashed = still reportingMonthly citation counts for the 5 most-cited tags. The dashed tail is the 2-month reporting lag.
Frequency movers
Biggest change in how often each tag is cited, as a rate per 100 inspections (so it isn't skewed by survey volume): Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025. Only tags with at least 20 citations in both periods are shown.
Severity movers
Tags whose average scope/severity shifted the most: Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025. The number is the average severity on the A–L scale (A=0…L=11); the letter is the band it falls in. A rise means the same tag is being cited at a more serious level — note the average can move enough to rank here while staying within the same letter. Same 20-citation minimum applies.
Care domain movers
Citations grouped into CFR care domains — F-tags by their §483 regulatory section (CMS State Operations Manual, Appendix PP) — measured as a rate per 100 inspections: Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025. Share is the domain's portion of citations this period; avg severity is the mean scope/severity letter and immediate jeopardy the percentage cited at J–L, both over the current period. Domains with at least 20 citations in both periods are shown; the sparkline tracks the last 12 months (left = oldest).
Immediate jeopardies · this period
Citations at the most serious scope/severity — J–L, immediate jeopardy, residents placed at risk of serious harm or death — over Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025. "Surveys with an IJ" counts distinct health inspections that had at least one.
Survey activity · by month
faded/dashed = still reportingCitations each month split into complaint-driven (unscheduled, triggered by grievances) vs standard surveys — bars, left axis — with the number of inspections as a line on the right axis. Rising inspections signal more scrutiny; a rising complaint share means more off-cycle surveys. The most recent 2 months are still being reported.
Deficiency-free survey rate
Share of health surveys that found zero deficiencies — the odds of a clean survey. Jun 2025 – May 2026 vs the prior period Jun 2024 – May 2025; the most recent 2 months are still being reported (dashed).
Penalties · by month
faded = still reportingTotal civil money penalty dollars imposed on the state's facilities each month — how hard the state is enforcing. The most recent 2 months are still being reported, and penalties often lag citations by several months.
Emerging tags
Tags that weren't established last period but surged — an early warning, distinct from movers (which track already-common tags). Criteria: fewer than 20 citations in the prior period, but at least 10 this period and 2.5× their prior volume. The sparkline shows monthly counts over the last 12 months (left = oldest).
Trusted data from CMS and state health departments
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