Life Care Center Of Lagrange

Medication assessment was completed for medication left at the bedside for 1 of 7 residents

a cup with one 500 mg acetaminophen tablet and a cup of water in front of Resident 5. LPN 2 left the room and did not maintain visual observation when Resident 5 consumed the acetaminophen tablet.A record review for Resident 5 began on 4/23/2026 at 1:19 PM.

Diagnoses included gout, pain in both legs, depression, post-traumatic stress disorder, and dysphagia (difficulty swallowing).A review of Resident 5's current quarterly MDS, dated [DATE], indicated their BIMS (Basic Interview for Mental Status) score was 15 (cognitively intact).A review of physician orders, dated 2/1/26 at 11:13 PM, indicated one 500 mg acetaminophen tablet was scheduled to be administered three times a day for pain.

The order did not indicate Resident 5 was able to self-administer the medication.A review of clinical assessments, dated 1/1/25-4/24/26, indicated a Resident Medication Self-Administration Assessment had not been completed for Resident 5.In an interview, on 4/22/2026 at 11:40 AM, the Director of Nursing indicated staff were to watch the administration of medication for each resident.

Residents may administer their own medication when a Self-Administration Assessment had been completed and was determined to be appropriate for an individual resident, or when an order was in place for a resident to self-administer a specific medication.A current policy, dated 12/1/07, provided by the Director of Nursing, indicated staff administering medication were to observe the resident's consumption of the medication.410 IAC (Indiana Administrative Code 3.1-11(a)

155343 04/24/2026

Life Care Center of Lagrange 0770 North 075 East Lagrange, IN 46761

bed-hold policies.

interview and record review, the facility failed to ensure bed hold policy notification was provided to

include: Resident 5's record was reviewed on 4/23/26 at 9:45 AM.

Diagnoses included chronic kidney disease, diabetes and seizure disorder.Resident 5's quarterly Minimum Data Set, (MDS) dated [DATE], indicated their Brief Interview for Mental Status (BIMS) score was 15 (no cognitive deficit).A progress note, dated 1/23/26 at 6:30 PM, indicated a physician had ordered Resident 5 to be transferred to the hospital for evaluation.

The progress note indicated Resident 5 was not responding.An Indiana Bed Hold Notification, signed and dated by Resident 5 on 1/23/26, indicated the resident did not request their bed to be held during their absence.In an interview, on 4/23/26 at 10:11 AM, the Administrator indicated Resident 5 was the responsible party for themselves.

The Administrator indicated Resident 5's sister was their durable power of attorney.

The Administrator indicated Resident 5's sister was their emergency contact.In an interview, on 4/23/26 at 11:30 AM, the Administrator indicated Resident 5's sister should have been contacted if the resident was not responding.2. Resident 57's record was reviewed on 4/23/26 at 10:10 AM.

Diagnoses included atrial fibrillation, (irregular heartbeat) lumbar fracture, lumbar spine wound dehiscence, (split open) and malnutrition.Resident 57's discharge Minimum Data Set (MDS), dated [DATE], indicated their Brief Interview for Mental Status (BIMS) score was 5 (severe cognitive impairment).Resident 57's care plan, dated 3/2/26, indicated the resident had severe cognitive impairment.A progress note, dated 3/3/26 at 1:52 PM, indicated Resident 57 had been transferred to the hospital.

The progress note indicated the bed hold policy was sent with the Emergency Medical Technician.

The progress note indicated Resident 57's emergency contact had been made aware of the hospital transfer.

The progress note did not indicate Resident 57's emergency contact had been made aware of the facility's bed hold policy.A Transfer Form, dated 3/3/26, indicated Resident 57's emergency contact had been made aware of the resident's transfer to the hospital.

The transfer form did not indicate the emergency contact had been made aware of the bed hold policy.An Indiana Bed Hold Notification, signed and dated by Resident 57 on 3/33/26, indicated the resident did not request their bed to be held during their absence.In an interview, on 4/23/26 at 11:30 AM, the Administrator indicated Resident 57 was cognitively impaired.

The Administrator indicated Resident 57's emergency contact should have been notified of the bed hold policy.No facility policy was available for review at the time of exit from the facility.