Health inspection·October 30, 2025

F 0744 Level of Harm - Actual harm Residents Affected - Few assistance of one staff with activities of daily living (ADL), bed mobility, and with stand and pivot transfer from bed to wheelchair using bed rails to transfer. Resident #44 was incontinent of bowel and bladder and required check and change every two hours and required the assistance of one staff with transferring to toilet, using the grab bars in the bathroom. The resident was able to self-propel in a wheelchair. Resident #44 was in her wheelchair in the dining room and denied any needs at this time. Review of Resident #44's nurse progress notes, dated 08/24/25 at 5:36 P.M. and written by Licensed Practical Nurse (LPN) #250, revealed LPN #250 had received a phone call from Resident #44's daughter requesting an update because her brother had visited earlier (that date) and Resident #44 had hit him. Resident #44's daughter requested the resident's urine be tested for a urinary tract infection (UTI).Review of the behavior monitoring log revealed no evidence of resident behaviors prior to 08/24/25 at 8:00 P.M.Review of Resident #44's behavior log flow sheet revealed on 08/24/25 at 8:00 P.M. Resident #44 displayed behaviors of refusing care, frustration/escalation of behavior, being argumentative, scratching, biting, kicking, hitting and pinching. Prior to the behaviors being displayed, the resident was incontinent of her bladder. The behaviors took place in the resident's room and bathroom. The staff attempted the following interventions: approaching the resident calmly and quietly from the front, offering food/drink, assessing her for pain and treating it if indicated, offering or assisting her to the bathroom, offering rest, repositioning, redirecting to a quiet area, approaching 1:1, offering care later, having a different caregiver approach her, and using two caregivers. The interventions were not effective in calming the resident. Further review of the log revealed the nurse was notified of the resident's behavior. There was no progress note to explain this behavioral incident on 08/24/25 at 8:00 P.M. in further detail or any interventions implemented by staff to allow care to be completed.Review of Resident #44's nurse progress notes dated 08/24/25 at 9:42 P.M. and written by LPN #250, revealed the resident was resting in bed and was alert and cooperative with taking her bedtime medications.Review of Resident #44's nurse progress notes dated 08/25/25 at 3:20 A.M. and written by LPN #250, revealed the resident's urine was dipped and was positive for leukocytes, protein, ketones, and specific gravity off from normal. Medical Doctor (MD) made aware.Review of Resident #44's nurse progress notes, dated 08/25/25 at 5:14 A.M. and written by LPN #250, revealed the second shift Certified Nursing Assistants (CNAs) informed this nurse of the resident demonstrating combative behavior with personal care. Night shift CNAs informed the nurse that Resident #44 did not have combative behavior this shift.Review of Resident #44's nurses progress notes, dated 08/25/25 at 12:37 P.M., revealed an interdisciplinary team note written by the Director of Nursing (DON) that stated the resident had an allegation of abuse. Further review revealed LPN #222 and CNA #156 reported Resident #44 had bruising to her bilateral wrists and forearms. Upon bringing this information to this nurse's attention, an investigation was started. Resident #44 was combative with care on 08/24/25, resulting in bruising to (her) bilateral wrists and forearms. The resident was combative with toilet assistance and was combative during visit with son. Resident's son noted behaviors and nursing reached out to the MD for urinalysis due to change in mental status. Skin and pain assessments were completed and revealed bruising was noted to the resident's bilateral wrists and forearms. No signs or symptoms of pain were observed. Resident #44 was pleasant during the investigation and assessments and stated I fell when asked how the bruises were obtained. Resident #44 was cooperative this morning with care and with staff. The local police, MD, and the responsible party were notified. A behavior care plan was in place. Resident #44's care plan was reviewed and updated.Review of Resident #44's skin incident event dated 08/25/25 at 12:30 P.M., and completed by RN #180, revealed the resident had a bruise on her right wrist/arm that measured 4.5 centimeters (cm) in length and (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 2 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few 4 cm in width. The skin incident event indicated that the bruise occurred while the resident was receiving ADL care and having a behavioral outburst.Review of Resident #44's nurses progress notes dated 08/25/25 at 1:59 P.M. an interdisciplinary team note, written by RN Nursing Administration #180, revealed the resident acquired a wound. The location of the wound was bilateral wrists/forearms, and the type of wound was a bruise. An order was placed to monitor the bruised areas. Interventions included staff education and Geri-sleeves (arm protectors) to be worn as tolerated. The root cause of the wound was combative with care. Resident #44 would be followed by the wound team weekly. MD and the responsible party were notified. Resident #44's care plan was updated (This was written as a late entry note on 08/29/25 at 11:01 A.M.).Review of Resident #44's skin incident event, dated 08/25/25 at 3:47 P.M. and completed by RN #180, revealed the resident had a bruise on her left wrist/arm that measured 3.8 cm in length and 4 cm in width. The skin incident event indicated that the bruise occurred while the resident was receiving ADL care and having a behavioral outburst.Review of Resident #44's nurses progress notes, dated 08/26/25 at 4:13 P.M. and written by the DON, revealed the resident went out to an appointment (unrelated to the incident). Per MD, new orders for bilateral wrists, forearms and bilateral hands (X-rays). This nurse put in STAT (immediate) X-ray orders and updated the resident's daughter. Per the resident's daughter, the resident is returning with paperwork for laboratory tests and a follow-up appointment.Review of Resident #44's physician's orders revealed an order dated 08/26/25 for x-rays of the resident's right and left forearms, wrists and hands to be completed STAT for the resident having pain reported by the resident's daughter and bruising. There was no pain assessment or documentation of the resident's pain other than the physician orders for the X-ray.Review of Resident #44's nurses progress notes, dated 08/26/25 at 9:14 P.M. and written by LPN #215, revealed x-ray results were received at the facility that revealed no acute fracture or dislocation to the resident's left and right hands and wrists.Review of a SRI Form, Tracking Number 264469 dated 08/25/25, revealed the DON was notified by LPN #222 that Resident #44 had bruising to her bilateral wrists and an investigation regarding physical abuse was initiated.The DON and medical records/Certified Nursing Assistant (CNA) #230 assessed Resident #44 and the resident was found safe and comfortable in (her) environment. The resident stated she received bruising from a fall. Bruising to bilateral wrists and forearms were noted to be inconsistent with a fall. The resident did not voice any care complaints or any needs at this time. Skin and pain assessments were completed with no adverse findings.Further review revealed Resident #44 was noted with combative behaviors on the evening prior. Interviews with staff and residents completed. In interviews with staff, CNA #251 reported in an effort to de-escalate behaviors during incontinence care, he moved the resident's bilateral wrists to redirect the resident during combative behaviors. This was witnessed by CNA #204 and #233, who were all three present for incontinence care provided to the resident. All three CNAs report the appropriate redirections took place during incontinence care.Prior to incontinence care, multiple comfort measures were attempted for redirection of combative behaviors. All CNAs noted to speak in a calm tone and slowly. Resident offered reassurance and bedtime snack. After incontinence care, the resident did not display further combative behaviors.Upon notification the next morning, CNA #251 was suspended. Skin assessments and resident interviews conducted with no adverse findings.All notifications completed including the MD, Power of Attorney, and local police department. Psychosocial follow-ups were completed without any adverse findings. The Administrator interviewed Resident #44 who reported the bruising was from a fall. Abuse education provided to all staff; X-rays were completed in-house with no adverse findings.An allegation of abuse was reported to the local law enforcement. Report number 25-11470 was completed by two (unidentified) officers.The allegation was unsubstantiated (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 3 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few as the evidence was inconclusive. Education was provided on dealing with residents who have dementia, and combative behavior. Resident care plans updated to reflect combative behaviors and behavior logs in place to monitor.Review of the local police department report number 25-11470 dated 08/25/25 revealed the facility nurse manager was made aware of bruising on the arms of a resident and confirmed them describing the marks as in the shape of fingerprints. The resident, who was [AGE] years old and diagnosed with dementia, was asked if she remembered how she sustained the bruising and was unable to recall. The nurse manager stated that after speaking with the staff from the previous night it was learned that the resident became very combative and staff advised they had to restrain the resident's arms to safely perform their duties.Review of CNA #204's statement, from the facility investigation, revealed CNA #204 stated she was asked to assist CNA #233 and CNA #251 with getting Resident #44 from the toilet and into bed as the resident was very combative and irritated. Resident #44 continued to bite, pinch, hit and yell after she was assisted to bed. CNA #204 stated CNA #251 placed his hand on Resident #44's wrist to deflect a hit while CNA #233 was doing her care.Review of CNA #233's statement, from the facility investigation, revealed CNA #233 went and got CNA #251 to help her provide incontinence care for Resident #44 who was kicking and hitting her. CNA #233 stated that CNA #251 placed his hands on Resident #44's wrist to redirect her from hitting them.Review of CNA #251's statement, from the facility investigation, revealed he was asked by CNA #233 to assist with changing Resident #44 because she was kicking, hitting, and scratching. CNA #251stated they attempted to assist the resident to the toilet six to eight times before they placed her in the bed and changed her. Resident #44 continued to attempt to bite and hit and CNA #251 stated that he placed his hands on her wrists and redirected her arms to the trunk of her body whenever she would swing or grab.Further review of the facility investigation, date of event 08/25/25, revealed the root cause of the bruises to be CNA #251 attempted to grab the resident's wrists to calm the resident and get the resident to stop hitting at staff. As a result of grabbing the resident's wrists, bruises formed this morning and were noted by CNA and LPN.Review of the employee file for CNA #251 revealed a hire date of 01/02/25 with completed training for abuse prevention, recognizing and reporting on 06/14/25, abuse and neglect: resident abuse on 08/18/25 and challenging behaviors in dementia care on 06/25/25. Further review of CNA #251's employee file revealed he was placed on suspension pending investigation on 08/25/25. After the investigation was completed, CNA #251 was discharged , effective 08/28/25, for a customer service violation. This document was signed by previous Administrator #500.Review of the resident's medical record and facility investigation, including the SRI did not indicate the resident was unsafe or why care had to be provided at that time and the resident's wrists held to prevent her from hitting three staff who were in the room providing care when she typically required one staff assistance with ADLs. There was no evidence that the three CNAs notified the nurse, LPN #250, of the resident's behavior and the resident's wrists being held to provide care.In an interview on 10/21/25 at 4:15 P.M., the DON stated Resident #44 had one bruise on each wrist and the bruises did not look like fingerprints as stated in the police report and she did not know where they got that or that Resident #44 was restrained. The resident had stated that the bruises were from a fall; however, the resident needed assistance to transfer and would not have been able to get herself up off the floor if she fell. The DON stated she knew the resident had not fallen recently and she started the investigation. The DON stated the staff made multiple attempts to change Resident #44 prior to this attempt but were unsuccessful. She stated the facility staff are trained to step away but she felt the staff needed to complete incontinence care for this resident, even though she was refusing the care and was combative. The DON stated CNA #251 was terminated for not coming to work or calling off on (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 4 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few 08/30/25 and 08/31/25.In an interview on 10/21/25 at 4:30 P.M. Business Office Manager (BOM) #177 stated she was not on the 08/28/25 phone call made to CNA #251 and was not sure who was present; however, she was aware that he did not answer his phone. BOM #177 verified there was no paperwork to confirm CNA #251 did not call or not show up for work on 08/30/25 or 08/31/25 in CNA #251's employee file and the paperwork in the file stated that he was terminated on 08/28/25 for a customer service violation.In an interview on 10/22/25 at 12:24 P.M., CNA #233 stated that on 08/24/25 she attempted to change Resident #44, who became combative, so she walked away and then came back after about 10 minutes. On her second attempt, the resident hit her in the face. She then went to ask CNA #251 for help, and he and CNA #204 went with her to change the resident about 10 minutes later. While they were changing Resident #44, CNA #251 redirected the resident's arms away from them so they could change her. Resident #44 continued to try to hit, kick and bite them. CNA #233 stated she could not remember how CNA #251 redirected the resident or her hands. CNA #233 stated this occurred around 9:00 to 9:30 P.M. as they were attempting to do last checks before shift change. The nurse was aware that the resident was being combative. When asked how this situation would have made her feel if someone did the same to her, the CNA stated it would have upset her and made her angrier than she already was.A follow-up phone interview with the DON on 10/24/25 at 2:22 P.M. with the Administrator present, confirmed the resident did have a diagnosis of Alzheimer's Disease and dementia and staff received annual training on care of residents with dementia. The DON shared staff were trained to step away from residents who refused care and give them time and re-approach the resident later, but in this situation with Resident #44, she had refused care all day and no one had changed her (due to incontinence), and they wanted to ensure the resident had received incontinence care. The DON confirmed the medical record contained a progress note dated 08/24/25 at 11:26 A.M. that indicated the resident was cooperative with ADLs provided by one staff and would stand pivot to transfer using grab bars to the toilet and did not indicate the resident had refused care on the date of the incident. The DON further stated around 3:00 to 4:00 P.M. the resident started getting more combative with care and the resident was obviously not very happy. The DON stated the nurse working would have been administering medications at the time of the incident and would have been available to assist the staff if needed and there were not any safety issues for other residents. The DON was unaware if the staff had requested assistance from the nurse (LPN #250), but she remembered talking with the nurse, but she could not remember if the nurse provided her with a statement (as it was not part of the investigation provided). The DON stated she was not the manager who discharged CNA #251. Lastly, the DON verified the staff needed to provide care to the resident; however, her expectation would be for staff not to lay their hands on a resident in order to provide care and the nurse should have been aware of what was happening so care could have been provided to the resident the safest way possible and not by causing bruises to the resident's wrists and arms. The DON shared she was informed CNA #251 was terminated for failure to report to work. The DON stated the CNA was terminated while she was on vacation and she could only provide the information that was told to her which was he was a no call, no show on 08/30/25 and 08/31/25. The DON acknowledged this was after the aide was terminated but had no additional information to provide.A phone interview on 10/26/25 at 2:42 P.M. with LPN #250 revealed she no longer worked at the facility (she was from a sister facility, and she was no longer needed). The LPN verified she was the nurse working the night of 08/24/25 and Resident #44's daughter reported the resident struck her (the resident's) son while he visited that afternoon. Further interview with LPN #250 revealed she was unaware of any concerns related to the resident's care and evening shift staff reported Resident #44 was combative, but they were eventually able to assist the resident to bed (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 5 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few and get her changed. The staff did not report CNA #251 held/guided/redirected the resident's hands at her sides while the other staff provided care as this would not have been appropriate and she would have contacted the DON to report an allegation of physical abuse. Further interview revealed if she had been aware the resident was combative or resistant to care, she would have told them to give her space, offer the resident a snack, provide a diversional activity but to never continue with care. The LPN stated the resident had spurts of being grouchy but staff knew that and it was not unusual but since she struck out at her son, LPN #250 and another nurse did check her urine and notified the physician (later in the shift). Lastly, LPN #250 stated she felt bad for Resident #44 being forced to receive care and it would have upset her and made her angry if she received care she clearly did not want and held her down against her will.An additional interview on 10/28/25 at 9:38 A.M. with the DON verified CNA #204 and CNA #233 were still employed and received no disciplinary action related to the incident with Resident #44. The DON stated CNA #204 and CNA #233 reported to the nurse that Resident #44 was striking out but CNA #204 and CNA #233 did not feel Resident #44 had been abused. The DON stated staff received abuse and dementia training through Relias (a cloud-based learning management system (LMS) designed to deliver, manage, and track online training primarily for the healthcare, human services, and long-term care sectors). The DON verified there was no additional training or in person training because of the incident that occurred on 08/24/25 with Resident #44. The DON was not sure what time the incident was reported to the nurse but believed the care for Resident #44 occurred around 6:00 P.M. The DON stated all the staff were trained to report any suspicions of abuse even if they were unsure if actual abuse occurred.An interview on 10/28/25 at 10:35 A.M. with former interim Administrator #500 revealed she was the facility administrator from approximately July through the end of August 2025 and said the DON typed the SRI which was an injury of unknown origin. Resident #44 reported she had fallen but the DON did not believe the resident fell. Administrator #500 stated CNA #251 was not terminated due to the investigation. She stated no one could contact CNA #251 so she completed the termination form and indicated the reason was a customer service violation which was a blanket reason for many terminations.An interview on 10/28/25 at 10:58 A.M. with CNA #204 revealed Resident #44 was irritated on 08/24/25. CNA #204 verified she had not been assigned to provide care for Resident #44 that day, but she assisted CNA #233 and CNA #251 with getting Resident #44 off the toilet. Resident #44 had not been changed and really needed changed. Resident #44 was hitting and biting staff. CNA #204 stated she believed the nurse was aware because Resident #44 was yelling and everyone could hear the resident. CNA #204 could not remember what Resident #44 was yelling. CNA #204 verified Resident #44 did not want staff to provide incontinent care. When asked if Resident #44 had behaviors, CNA #204 stated Resident #44 would say she wanted to go home, like multiple other residents did. CNA #204 stated CNA #251 acted as a barrier and placed his hands out across Resident #44. CNA #251 took more of the hits from Resident #44 than CNA #204 and CNA #233. CNA #204 went back to provide care to the residents she was assigned to after incontinence care was done. CNA #204 thought the nurse checked Resident #44 after care was done and she believed the incident occurred around 8:30 P.M. or 9:00 P.M. because last checks on residents were being done.Review of the facility assessment updated on 09/04/25 revealed the facility would supply training/education on abuse, neglect and exploitation, person centered care and dementia management care. The assessment revealed the facility accepted residents with psychiatric/mood disorders such as impaired cognition, mental disorder, bipolar disorder, post-traumatic stress disorder, anxiety disorder, behavior that needs interventions, and schizophrenia. The facility also accepted residents with neurological system disorders which included Parkinson's disease, Alzheimer's disease, and non-Alzheimer's dementia. (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 6 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few Services provided by the facility included managing the medical conditions and medication-related issues causing psychiatric symptoms and behavior, identify and implement interventions to help support individuals with issues such as dealing with anxiety, and care of someone with cognitive impairment. The staff training/education and competencies to provide the level and types of support and care needed for the resident population included: resident rights to ensure that staff members are educated on the rights of the resident and the responsibility of a facility to properly care for its residents. Training also included identification of resident changes in condition, including how to identify medical issues appropriately and how to determine if symptoms represent problems in need of intervention. Abuse, neglect, and exploitation training included activities that constitute abuse, procedures for reporting incidents of abuse, and care/management for persons with dementia and resident abuse prevention. Competencies included caring for person with Alzheimer's or other dementia.Review of the policy titled Abuse Prevention Program Policy and Procedure, reviewed 01/2025, revealed each resident had the right to be free from abuse, neglect and corporal punishment of any type by staff or anyone. The facility will provide a safe resident environment and protect residents from abuse. Abuse, is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation of an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psycho-social well-being. Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain or mental anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology. All staff are expected to be in control of their own behavior, are to behave professionally, and should appropriately understand how to work with the nursing home population.Atrium Center facilities care for diverse populations including, among others, residents with dementia, mental disorders, intellectual disabilities, ethnic/cultural differences, speech/language challenges, and generational differences. The facility assumes the responsibility of ensuring the safety and well-being of each resident they admit.Staff are held accountable to their actions to meet the Medicare and Medicaid requirements for participation by providing care in a safe environment. Atrium will not consider striking a combative resident an appropriate response in any situation. It is also not acceptable for any staff member to claim his/her action was reflexive or a knee-jerk reaction and was not intended to cause harm. Retaliation by staff is abuse, regardless of whether harm was intended, is unacceptable and must be cited.Characteristics of Increased Risk of Abuse include but are not limited to verbally aggressive behavior, such as screaming or cursing, insulting or intimidating; physically aggressive behavior such as hitting, kicking, grabbing, scratching, pushing/shoving, biting, spitting, threatening gestures, throwing objects; resistive to care and services.Review of the Dementia Care: Challenging Behaviors and Direct Care Staff training, dated 2023 and provided to facility staff as the required dementia care training revealed Dementia is a common chronic condition affecting older adults. Some individuals with dementia experience behaviors such as restlessness, wandering, agitation, physical aggression, and shouting. This course discusses how to prevent and manage these types of behaviors. It also discusses factors affecting the behaviors of individuals with dementia. Without knowledge of dementia and management of dementia-related behaviors, the quality of life of individuals with dementia declines.The goal of this course is to educate direct care workers in post-acute care settings on identifying and managing challenging behaviors in older adults with dementia.Memory loss and cognitive changes are the most common symptoms of dementia. Individuals with dementia may feel angry, confused, and sad. Older adults may show behaviors that create challenges (continued on next page) FORM CMS-2567 (02/99) Previous Versions Obsolete Event ID: Facility ID: 366013 If continuation sheet Page 7 of 8 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 366013 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/30/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Lexington Court Care Center 250 Delaware St Lexington, OH 44904 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0744 Level of Harm - Actual harm Residents Affected - Few FORM CMS-2567 (02/99) Previous Versions Obsolete for caregivers. Not every person with dementia will experience every behavior discussed in this course. Dementia-related behaviors may include (but not limited to): Delusions, hallucinations, physical or verbal aggression, yelling.Individuals with dementia can experience episodes of aggression which can be physical or verbal. This type of behavior can occur suddenly for no known reason or result from a situation that has become frustrating to the older adult with dementia.The best strategy for managing dementia-related behaviors caused by physical health factors is notifying your immediate supervisor of these issues. By doing this, you will help identify and treat the problem that is causing the behavior. This deficiency is an incidental finding discovered during the complaint investigation. Event ID: Facility ID: 366013 If continuation sheet Page 8 of 8