The Willows at Citation
1376 Silver Springs Drive, Lexington, KY 40511 · Fayette County · (859) 277-0320
54 certified beds, about 51 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2014
Part of a continuing care retirement community Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 185474 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on April 9, 2026, inspectors cited 0 health deficiencies (the Kentucky average is 2.9, the national average 9.2).
None of its 9 health citations since November 2021 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 4.04 hours per resident per day, against 3.95 across Kentucky and 3.86 nationally. Registered nurses accounted for 1.22 of those hours.
38.5% of nursing staff left within the year CMS measured (Kentucky average 46.4%).
CMS links it to Trilogy Health Services, an affiliated group of 127 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
711/21
206/25
004/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 9 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
6D
3E
0F
Potential for minimal harm
0A
0B
0C
April 9, 2026Standard inspection · 0 citations
June 26, 2025Standard inspection · 2 citations
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interview, and review of the facility's policies, it was determined the facility failed to ensure staff observed required hand hygiene practices during the plating of food for the meal service. This deficient practice had the potential to affect 45 current residents who received meals from the kitchen.
- D Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Inspectors wroteBased on interview and record review, the facility failed to provide the resident representative with written notification of the resident's transfer to the hospital for 1 out of 5 sampled residents, Resident (R) 14.
November 4, 2021Standard inspection · 7 citations
- E Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Inspectors wroteBased on observation, interview, and review of facility's policy, it was determined the facility failed to ensure drugs and biologicals stored in the facility were not expired, labeled, and stored in accordance with currently excepted professional principles; and failed to store medications according to appropriate environmental controls to preserve their integrity for two (2) out of two (2) medication storage rooms, and one (1) out of three (3) medication carts. Observation of the [NAME] hall medication room refrigerator revealed the refrigerator's temperature was thirty-two (32) degrees Fahrenheit. Continued observation of the refrigerator's temperature revealed the temperature was thirty-four (34) degrees Fahrenheit (F). There was no covering for the freezer compartment to keep cold air from escaping into the refrigerator portion of the unit. [...]
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation and interview, it was determined the facility failed to ensure proper sanitation procedures to prevent the outbreak of foodborne illness. Observation during the initial kitchen tour revealed two (2) large steam table pans stored wet, leading to the potential for bacterial growth.
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on observation, interview, record review, and review of the Centers for Medicare and Medicaid Services (CMS), Resident Assessment Instrument (RAI) Manual 3.0, it was determined the facility failed to develop and/or implement a person centered Comprehensive Care Plan (CCP) for each resident that included measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs that were identified in the comprehensive assessment for three (3) of eighteen (18) residents; Resident #38, Resident #29, and Resident #12. 1. Review of the CCP for Resident #29 revealed the resident demonstrated exit seeking behaviors and a wander guard would be applied as appropriate. Review of Progress Notes in October 2021, revealed ongoing assessment of need for wander guard; [...]
- D Provide activities to meet all resident's needs.
Inspectors wroteBased on observation, interview, record review and review of facility's policy, it was determined the facility failed to ensure an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, for one (1) of eighteen (18) residents, Resident #38. There was no documented evidence Resident #38 participated in his/her preferred activities in August, September, October or November of 2021. [...]
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, interview, record review and review of the facility's policy, it was determined the facility failed ensure residents received treatment and care in accordance with professional standards of practice, the resident's plan of care and Physicaian's Orders to meet eahc resident's physical, mental and psychosocial needs for one (1) of eighteen (18) sampled resident, Resident #12.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, interview, record review, and review of the facility's policies, it was determined the facility failed to have an effective system in place to ensure each resident received adequate supervision to prevent elopement for one (1) of eighteen (18) residents; Resident #29. On 05/15/2021, the facility assessed the resident to be an elopement risk and to require a wandering system bracelet/device on his/her body. Review of the resident's Progress Notes, Care Plan and interviews with staff revealed the resident had wandering behaviors present; however, State Survey Agency (SSA) observations on 11/02/2021 and 11/03/2021 revealed the resident did not have a wandering system bracelet/device on his/her body per Physician's Orders.
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observation, interview, record review and review of the facility's polciy, it was determined the facility failed to ensure respiratory care was provided consistent with professional standards of practice and the comprehensive care plan for two (2) of eighteen (18) residents. Observations of Resident #35 and Resident #42 on 11/02/2021 and 11/04/2021 revealed their oxygen tubing was unlabeled and there was no signage in place indicating oxygen was in use in accordance with the facility's policy. Further observation of Resident #42 revealed the tubing was crimped and the humidifier was without moisture.
Fire safety inspections
1 fire safety citation on file: 1 on April 9, 2026.
Every fire safety citation1 citation
- D Ensure proper usage of power strips and extension cords.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Kentucky | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 4.04 | 3.95 | 3.86 |
| Registered nurses | 1.22 | 0.79 | 0.69 |
| All nursing staff on weekends | 3.88 | 3.49 | 3.42 |
| Nurse aides | 1.87 | ||
| Licensed practical nurses | 0.96 | ||
| Nursing staff turnover (share who left in a year) | 38.5% | 46.4% | 45.8% |
| Registered nurse turnover | 46.2% | 41.8% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.01 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.11 on weekdays and 3.88 on weekends, 6% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.01 in April to June 2025 to 4.04 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 4.04 | 1.22 | 4.11 | 3.88 | 0.0% | 0 of 90 | 51 |
| Oct to Dec 2025 | 4.18 | 1.25 | 4.27 | 3.96 | 0.0% | 0 of 92 | 49 |
| Jul to Sep 2025 | 4.07 | 1.08 | 4.19 | 3.76 | 0.0% | 0 of 92 | 49 |
| Apr to Jun 2025 | 4.01 | 1.02 | 4.15 | 3.64 | 0.0% | 0 of 91 | 50 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Kentucky, Jan to Mar 2026 | 3.85 | 0.71 | 4.04 | 3.40 | 3.2% | 0.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Kentucky | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 9.1 | 13.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.5 | 0.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.6 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 5.0 | 3.9 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.7 | 1.6 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.4 | 4.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 7.9 | 16.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 22.3 | 24.2 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 4.5 | 13.7 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.2 | 1.9 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.0 | 2.1 | 1.8 |
Owners and operators
Legal business name: TRILOGY HEALTHCARE OF FAYETTE III LLC. CMS links this home to Trilogy Health Services, a group of 127 nursing homes averaging 4.2 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Trilogy Management Services LLC | 5% or greater direct ownership interest | Organization | 100% | 06/01/2026 |
| Barney, Leigh | Managing control - governing body | Individual | 11/01/2019 | |
| Davis, David | Managing control - governing body | Individual | 08/21/2017 | |
| Trilogy Management Services LLC | Operational/managerial control | Organization | 06/03/2026 | |
| Bailey, Adam | Operational/managerial control | Individual | 02/27/2023 | |
| Corbin, Kathy | Operational/managerial control | Individual | 11/01/2023 | |
| Fightmaster, Lisa | Operational/managerial control | Individual | 11/01/2023 | |
| Wiemann, Charlotte | Operational/managerial control | Individual | 10/01/2025 | |
| Barney, Leigh | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 06/16/2026 | |
| Bailey, Adam | Adp of the SNF | Individual | 10/14/2025 | |
| Wiemann, Charlotte | Adp of the SNF | Individual | 11/04/2025 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 4 problems in this area, most recently on November 4, 2021: "Provide activities to meet all resident's needs."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 2 problems in this area, most recently on June 26, 2025: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 1 problem in this area, most recently on June 26, 2025: "Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 1 problem in this area, most recently on November 4, 2021: "Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs."
Other nursing homes nearby
- Homestead Post Acute Lexington, 3.5 mi · 3 of 5 stars · 8 citations
- Pine Meadows Post Acute Lexington, 3.7 mi · 2 of 5 stars · 16 citations
- Lexington Country Place Lexington, 4.1 mi · 1 of 5 stars · 9 citations
- Cambridge Nursing & Rehabilitation Center Lexington, 4.1 mi · 2 of 5 stars · 10 citations
- The Willows at Hamburg Lexington, 4.7 mi · 2 of 5 stars · 10 citations
- Lexington Premier Nursing & Rehab Lexington, 5.8 mi · 1 of 5 stars · 42 citations
- Mayfair Manor Lexington, 5.9 mi · 1 of 5 stars · 27 citations
- Bluegrass Care & Rehabilitation Center Lexington, 7.1 mi · 3 of 5 stars · 12 citations
Kentucky contacts for a concern about a nursing home
These are the official offices in Kentucky. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Kentucky Office of Inspector General, Division of Health Care, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Kentucky State Long-Term Care Ombudsman Program, Nursing Home Ombudsman Agency of the Bluegrass, (800) 372-2991. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Kentucky OIG Nursing Home Inspection Findings, where Kentucky publishes its own records on licensed homes.
Common questions
- What is The Willows at Citation's Medicare star rating?
- CMS rates The Willows at Citation 5 out of 5 stars overall, with 4 for health inspections, 4 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did The Willows at Citation get at its last inspection?
- 0 health deficiencies at the standard inspection on April 9, 2026. The Kentucky average is 2.9.
- Has The Willows at Citation been fined?
- CMS lists no fines in the last three years.
- Does The Willows at Citation accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns The Willows at Citation?
- CMS lists 11 owners and managers, and links the home to Trilogy Health Services. Legal business name: TRILOGY HEALTHCARE OF FAYETTE III LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.