Nightingale at Crossett

Inspectors wroteBased on observation, interview, record review and facility policy review, the facility failed to ensure expired food was removed from a resident's bedside cooler for 1 (Resident #9) of 1 sampled resident reviewed for bedside snacks; failed to ensure cake product stored in the freezer was not mushy and unpalatable, other foods were covered or sealed to decrease the potential for cross contamination; dietary staff thoroughly washed their hands and changed gloves when contaminated and before handling food and clean equipment to decrease the potential for food borne illness for residents receiving food from 1 of 1 kitchen; expired food items and spices were promptly removed/discarded on or before the expiration or use by date; hot food items were maintained at the required temperatures on the steam table to prevent potential food borne illness. [...]

Inspectors wroteBased on record review and interview, the facility failed to ensure the facility assessment included pertinent information to assure the necessary care and resources were allocated to meet the needs of the residents in 1 of 1 facility. This deficient practice had the potential to affect all residents of the facility

Inspectors wroteBased on observation, interview, record review, and facility document review. the facility failed to ensure an indwelling catheter tube was secured to a resident's leg for 1 (Resident #41) of 1 sampled resident who was reviewed for an indwelling catheter and failed to ensure that 1 sampled (Resident #25) resident received proper incontinence care.

Inspectors wroteBased on record review, interviews, and facility policy review, the facility failed to ensure and provide pharmaceutical services which included accurate administration of all drugs and/or biologics to 1 (Resident #11) sampled resident.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure meals were prepared and served according to the planned written menu to meet the nutritional needs of the residents for 1 of 2 meals observed. This failed practice had the potential to affect residents who received pureed diets and residents who had mechanical soft diets from 1 of 1 kitchen according to a list provided by the Dietary Service Manager.

Inspectors wroteBased on observation, record review, interview and facility policy review, the facility failed to ensure staff followed Enhanced Barrier Precautions(EBP) for a resident with a Percutaneous Endoscopic Gastrostomy (PEG) tube (a feeding tube inserted through the belly and into the stomach) for 1 (Resident #1) of 1 sampled resident reviewed for enhanced barrier precautions and failed to ensure that 1 sampled (Resident #25) resident received proper incontinence care.

Inspectors wroteBased on observations, interviews, record review, and facility policy review, the facility failed ensure that 1 (Resident #25) sampled resident's dignity was maintained while receiving care.

Inspectors wroteBased on observation, interview, record review, and facility policy review, the facility failed to ensure residents had access to their personal funds through the week and on weekends.

Inspectors wroteBased on record review and interviews, the facility failed to notify the proper state authority when aware that one (Resident #5) sampled Resident had a new diagnosis of a mental disorder.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure nail care was consistently provided to promote good grooming and personal hygiene for 1 (Resident #18) resident reviewed for activities of daily living (ADL) care.

Inspectors wroteBased on observation, record review, interview, and facility policy review, the facility failed to ensure a Percutaneous Endoscopic Gastrostomy (PEG) tube (a feeding tube inserted through the belly and into the stomach) was checked to verify the tube was in the stomach before use for 1 (Resident #1) of 1 sampled resident reviewed for a PEG tube.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure dented can was discarded to prevent bacteria growth food item stored in in the freezer was covered and sealed to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; staff washed their hands between dirty and clean tasks and before handling clean equipment or contamination; and hot food items were maintained at or above 135 degrees Fahrenheit on the steam table while awaiting service to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. These failed practices had the potential to affect 52 residents who receive meals from the kitchen (Total census: 52) as documented on a list provided by the Dietary Supervisor on 10/20/2023 at 08:36 AM.

Inspectors wroteBased on observation and record review the facility failed to provide a safe, comfortable, home like environment for 10 sampled residents (R#1,R#6,R#7,R#12,R#21,R#25,R#28,R#32,R#50,R#158). This failed practice had the potential to affect 37 residents that are capable of ambulating or self-propelling in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure written notification of transfer/discharge to the hospital was provided to the resident and/or resident's representative, and state ombudsman, to protect the rights of 1 resident (#56) of 4(Resident #13, #17, #32, #56) sampled residents who were went to the hospital in the last 90 days. 1. Resident #56 had a diagnosis of Heart Failure, Atherosclerotic Hearth Disease of Native Coronary Artery Without Angina Pectoris, and Rheumatoid Arthritis. The Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 6/17/2023 documented the resident scored 11 (moderately impaired cognition) on the Brief Interview for Mental Status (BIMS), required extensive physical assistance of 1 person for bed mobility, transfers, walking in room, dressing, toilet use and personal hygiene and was occasionally incontinent. a. [...]

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure the Minimum Data Set [MDS] assessment accurately reflected a level II Preadmission Screening and Resident Review [PASARR] evaluation with recommendations to facilitate the ability to plan, coordinate and provide necessary care for 1 (Resident #34) of 2 sampled residents (R#17,R#34). This failed practice had the potential to affect 13 residents who had a level II PASRR.

Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident received antibiotics as ordered by the physician. This failed practice affected 1 resident (R#32) and had the potential to affect 5 sampled residents (R#6,R#21,R#32,R#34,R#158) of 22 residents receiving antibiotics for infection over the last 3 months.

Inspectors wroteBased on observation, interview, and record review the facility failed to maintain an effective infection control program designed to provide a safe, and sanitary environment by ensuring staff removed gloves between resident rooms, and performed hand hygiene after handling personal inanimate objects, and personal care items between 2 enhanced precaution rooms. This failed practice had the potential to affect 15 residents residing on rooms 19-28.