Arkansas State Veterans Home at North Little Rock

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure foods stored in the freezer, refrigerator and dry storage area were covered, sealed and dated to minimize contamination for food borne illness for residents who received meals from 1 of 1 kitchen; expired dairy products and food items were promptly removed / discarded on or before the expiration or use by date to prevent the growth of bacteria; dietary staff washed their hands between dirty and clean tasks and before handling clean equipment or contamination; meals from 8 of 8 kitchens; [...]

Inspectors wroteBased on observation, interview and record review, the facility to ensure a call light was in reach for 1 Resident #49.

Inspectors wroteBased on observation and interview, the facility failed to ensure the 2023 survey results were located in the State Survey Binder, if. This failed practice had the potential to affect all sampled residents who chose to read the State Survey Binder.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure that 4 Resident's # 3, #26, #30, #75) of 19 sample mix residents had their nails cleaned and trimmed to promote good hygiene, cleanliness, and a sense of wellbeing.

Inspectors wroteBased on record review, interview, and observation, the facility failed to ensure an accident/hazard free environment was provided for 3 (#8, #45 and #56) residents in the case mix. This failed practice had the potential to affect 3 (#8, #49, #47) sampled ambulatory residents who resided in Unit 8. The facility also failed to ensure the residents were free of potential accidents and hazards, as evidenced by failure to ensure that all the end clips were in place on the Hoyer lift. This failed practice had the potential to affect 2 residents, (#26, and #59), of 2 sampled residents who reside in Cottage 1 and are dependent on a Hoyer Lift to transfer.

Inspectors wroteBased on observation and interview, the facility failed to ensure pureed food items were blended to a smooth, lump-free consistency to minimize the risk of choking or other complications for residents who required pureed diets for 1 of 1 meal observed. This failed practice had the potential to affect 1 resident who received a puree diet.

Inspectors wroteBased on observation and interview, the facility failed to ensure a safe environment for 7 residents (#8, #11, 30, #32, #45, #47, #49) sampled residents living in Units 7&8.

Inspectors wroteBased on observation, interview and record review, the facility failed to ensure that 1 Resident #3 in Cottage 1 had a change of condition or a e- interact completed when the resident was sent to the hospital.

Inspectors wroteBased on observations, interview and record reviews, the facility failed to accurately complete weekly nursing assessment (body audit) by failing to document redness to the buttock of 1 sampled Resident (#44) of 8 Residents in Homes 5 and 6 who skin audit completed by Licensed Practical Nurse (LPN) #2. This failed practice had the potential to cause further skin breakdown to Resident 44.

Inspectors wroteBased on observations, interviews, and record review the facility failed to ensure that 1 sampled (Resident #44) of 5 Residents receiving incontinence care in Home 6 received proper incontinence care . This failed practice had the potential to cause skin breakdown, poor hygiene, and/or infection.

Inspectors wroteBased on observation, interviews and record review, the facility failed to ensure an order for 1 (Resident #56) of 5 sampled residents who had physician orders for nebulizers received medication as ordered, and the facility failed to ensure supervision of nebulizer treatments for 1 ( Resident #56) who had nebulizer treatments and the facility failed to ensure inhaler was put in storage bag when not in use for 1 ( Resident #56) who had physician orders for inhalers. On 02/20/24 at 10:45 AM, Licensed Practical Nurse LPN #6 was standing outside of room [ROOM NUMBER] with door shut. The surveyor entered the room and Resident (#56 had a nebulizer mask on face and nebulizer machine running. After Resident #56 completed nebulizer treatment they took mask off and laid it down on table. Surveyor observed inhaler laying on bedside table. Resident #56 stated I keep that there in case I need it. [...]

Inspectors wroteBased on record review, interviews, and policy review, it was determined the facility failed to provide an environment that promoted maintenance or enhancement of the resident's quality of life for 4 (Residents #36, #12, #51, and #27) of four residents reviewed for dignity. Specifically, the facility failed to ensure Resident #51, a resident with known behaviors, did not inappropriately expose their genitalia during meal service and failed to keep Resident #51 out of other residents' rooms to promote privacy and dignity.

Inspectors wroteBased on observations, interviews, record review, and facility policy review, the facility failed to ensure an allegation of abuse was reported to the state survey agency (SSA) within the required timeframe for 1 (Resident #51) of 1 sampled resident reviewed for abuse.

Inspectors wroteBased on observations, interviews, record review, and facility policy review, the facility failed to ensure a resident who required extensive assistance with personal hygiene was regularly offered trimming of nails to maintain good grooming and hygiene for 1 (Resident #40) of 1 sampled resident reviewed for activities of daily living (ADLs).

Inspectors wroteBased on record review, interview, and facility policy review, the facility failed to ensure a physician documented a clinical rationale for continuing a psychotropic medication ordered on an as-needed (PRN) basis beyond 14 days and indicated a duration on the PRN order for 1 (Resident #60) of 5 residents reviewed for unnecessary medications.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure a Licensed Practical Nurse (LPN) washed her hands and/or changed gloves and followed universal precautions and clean technique during an enteral feeding to prevent the potential spread of infection for 1 (Resident #1) of 2 (Residents #1 and #17) who received enteral feedings by the LPN. This failed practice had the potential to affect 2 residents who required enteral feedings in Cottage 2.