Excelcare at Lewes: Resident Abuse Violation - DE
Excelcare at Lewes delayed reporting one incident by 17 hours and completely failed to report another allegation, according to the Centers for Medicare and Medicaid Services inspection completed November 14.
The first case involved a resident who experienced what staff called a "psychotic episode" on November 3 at 9:00 PM. During the episode, the resident made physical contact with three other residents. Staff didn't report the incident to state authorities until 2:39 PM the following day.
Assistant Director of Nursing E3 told inspectors she learned about the incident around 9:00 PM on November 3, but wasn't informed about the resident-to-resident physical contact until she conducted staff interviews on November 4. She acknowledged the facility submitted the report late because they "wanted to submit accurate data regarding the incident."
The resident who had the psychotic episode had been admitted to the facility just three months earlier, on July 28.
CNA E6 confirmed to inspectors that the incident occurred at approximately 9:00 PM on November 3, corroborating the timeline that showed the 17-hour reporting delay.
The second case involved a married couple, both residents at the facility. The wife, identified as R6, alleged that her husband R7 had choked her. But management never learned of the allegation, and it was never reported to state authorities.
R6 had been admitted to the facility on October 27, just a week before the incident involving the resident with the psychotic episode. Her husband R7 was also a resident.
CNA E7 told inspectors that R6 stated her husband choked her, and that this allegation was reported to a nurse. But E7 couldn't recall the exact date of the allegation.
LPN E11 confirmed that E7 had reported the choking allegation, and that it was passed along to the nursing supervisor working that day. E11 said the standard process was for allegations to be reported to supervisors, who would then report to management.
But the allegation never reached management.
Social Worker E4 confirmed that an interdisciplinary team meeting occurred to discuss R6. During that meeting, staff discussed R6 making what they characterized as "false statements" about R7. The family mentioned R6's history of making allegations during the meeting, but E4 remained "unsure of the occurrence of them."
Assistant Director of Nursing E3, who was present at the team meeting, told inspectors that R6's family mentioned she had a history of making allegations about R7. But E3 said she wasn't aware that R6 had alleged R7 choked her, and that staff never reported any abuse allegation to her.
The team meeting had focused on moving R6 to a different unit because R7's presence in the room prevented privacy for R6's roommate, according to a progress note dated November 3.
Federal regulations require nursing homes to report suspected abuse, neglect, or theft to state authorities within two hours of the incident or allegation. The facility failed this requirement in both cases reviewed by inspectors.
In the first case, the 17-hour delay meant state investigators couldn't respond immediately to protect other residents from potential harm. In the second case, the complete failure to report meant state authorities never learned of the choking allegation.
The inspection was conducted as a complaint investigation, suggesting someone reported concerns about the facility's handling of abuse allegations to federal authorities.
During the investigation, inspectors reviewed seven residents' records for abuse-related issues. They found reporting failures involving two residents, representing nearly 30 percent of the cases they examined.
The facility's corporate nursing home administrator E1, Director of Nursing E2, and Assistant Director of Nursing E3 were present when inspectors reviewed the findings during an exit conference on November 14 at 3:15 PM.
Both cases involved residents who had been admitted to the facility within the past few months. The resident who had the psychotic episode had been there since July 28. R6, who alleged her husband choked her, had been admitted on October 27.
The breakdown in reporting appeared to stem from different causes in each case. For the psychotic episode, management knew about the incident but chose to delay reporting while they gathered what they considered complete information. For the choking allegation, the report never moved beyond front-line staff to reach management.
CNA E7's inability to recall the exact date of R6's choking allegation suggested the incident may have occurred days or weeks before the inspection, meaning the reporting failure lasted even longer than the 17-hour delay in the first case.
The facility's handling of R6's allegations appeared complicated by staff and family perceptions that she had a history of making false statements about her husband. But federal regulations don't provide exceptions for allegations deemed potentially false - all suspected abuse must be reported within two hours so state investigators can determine validity.
The inspection found the facility failed to protect residents through proper reporting procedures, potentially leaving them vulnerable to continued abuse while allegations went uninvestigated by state authorities. Both cases involved multiple residents - the psychotic episode affected three people beyond the resident having the episode, while the choking allegation involved a married couple living in the same facility.
The findings represent a minimal level of harm with few residents affected, according to the inspection classification. But the failure to report suspected abuse within required timeframes violated federal regulations designed to ensure rapid response to protect vulnerable residents from ongoing harm.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Excelcare At Lewes LLC from 2025-11-14 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
EXCELCARE AT LEWES LLC in LEWES, DE was cited for abuse-related violations during a health inspection on November 14, 2025.
The first case involved a resident who experienced what staff called a "psychotic episode" on November 3 at 9:00 PM.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.