Ouachita Healthcare and Rehabilitation Center

Inspectors wroteBased on interview and record reviews, the facility failed to ensure it notified the resident's representative of a significant change in the resident's physical, mental, or psychosocial status by failing to notify the responsible party of significant changes for 2 (#1, #2) of 3 sampled residents.

Inspectors wroteBased on observations, record reviews, and interviews, the facility failed to ensure respiratory care was provided in accordance with professional standards of practice for 3 (#36, #84 and #169) of 5 residents reviewed for respiratory care. The facility failed to:1) Change oxygen tubing, and humidified water bottles per the policy for 2 (#36, #84), and2) ensure the BiPAP nasal prongs were stored properly when not in use for Resident #169.

Inspectors wroteBased on observations and interviews, the facility failed to store, prepare, distribute and serve food in accordance with professional standards. According to S2DON the facility provided meals from the kitchen to 159 residents.

Inspectors wroteBased on observations, record reviews and interviews, the facility failed to maintain and establish an infection prevention and control program designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections for 2 (#9 and #13) of 2 residents reviewed for infection control, by having staff not utilize appropriate PPE while caring for residents on EBP.

Inspectors wroteBased on observations and interviews, the facility failed to maintain a safe, clean, comfortable and homelike environment for 1 (#106) of 1 sampled resident reviewed for environmental concerns. The facility failed to ensure that residents' wheelchairs were clean and maintained in good repair.

Inspectors wroteBased on record review and interviews, the facility failed to develop a comprehensive care plan related to the need for counseling and mental health services for 1 (#3) of 2 residents reviewed for PASARR.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure the resident's call light was within reach for 3 (#102, #141 #143) of 3 residents observed with call lights out of reach and were high risk for falls.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure resident personal privacy was maintained during care for 1 (#102) of 1 residents observed exposed to the hallway during care.

Inspectors wroteBased on observations and interviews, the facility failed to provided a resident who is unable to carry out activities of daily living received the necessary services to maintain good personal hygiene for 2 (#14,#63) of 3 (#14,#25,#63) residents reviewed for ADL (Activities of Daily Living), by failing to ensure residents #14 and #63 received assistance with personal hygiene.

Inspectors wroteBased on record review, observations and interviews, the facility failed to provide necessary care and services for the provision of respiratory care in accordance with professional standards. The facility failed to ensure oxygen was administered as ordered by the physician for 2 (#48, #138) of 3 (#29, #48, #138) residents reviewed for oxygen therapy.

Inspectors wroteBased on record review, observation, and interview the facility failed to ensure the menus were followed for 7 of 7 (#5, #39, #63, #72,# 80,#104, and # 127) pureed diets by not serving pureed cornbread as per the menu.

Inspectors wroteBased on observation and interview the facility failed to store and distribute and serve food in accordance with professional standards for food service safety. There were 168 diets served from the kitchen.

Inspectors wroteBased on observation and interview the facility failed to ensure mechanical equipment was in safe operating condition by having the manual can opener with metal shavings. There were 168 diets served from the kitchen.

Inspectors wroteBased on observation and interview, the facility failed to maintain an effective pest control program so that the facility is free of pests by having ants in the dry pantry area. This failed practice had the potential to affect the 168 residents receiving meals from the kitchen.

Inspectors wroteBased on observation and interview the facility failed to treat each resident with respect and dignity and care for each resident in a manner and in an environment that promotes or enhances his or her quality of life for 2 (#143, #14) of 2 residents.

Inspectors wroteBased on record review and interviews, the facity failed to document a discharge summary when a resident was discharged from the facility for 1 (#160) of 3 (#34, #160, and #213) sampled residents reviewed for discharge.

Inspectors wroteBased on observations and interviews, the facility failed to maintain a sanitary environment and to help prevent the development and transmission of communicable diseases and infections by, having employee's personal items lying on top of and in direct contact with tables that were designed for the folding of clean clothing and linen items.

Inspectors wroteBased on observation, interviews, and record reviews, the facility failed to provide services that met professional standards during medication administration for 1 (#90) of 2 (#46 and #90) sampled residents. The facility failed to follow policies and procedures to ensure safe medication administration practices.

Inspectors wroteBased on observation, interviews, and record review, the facility failed to accurately obtain pharmaceutical services, including supplying routine medications with the appropriate strength as ordered by the physician for 1 (#90) of 2 (#46 and #90) residents observed during medication administration pass.

Inspectors wroteBased on observation, record review and interview the facility failed to ensure: 1) dietary orders were followed for 2 (#38, #62) of 2 (#38, #62) residents having orders for mighty shakes and 2) dietary preferences were followed for 1 (#73) of 1 (#73) resident reviewed for dining.

Inspectors wroteBased on observations and interviews, the facility failed to store, prepare, distribute, and serve food under sanitary conditions. This had the potential to affect all residents who received meals from the kitchen.

Inspectors wroteBased on record review and interview, the facility failed to ensure all medical records regarding the resident's code status consistently reflected the resident's wishes for 1 (#77) of 38 residents reviewed in the initial pool screening for advanced directives.

Inspectors wroteBased on record review, observation and interviews, the facility failed to ensure that a resident received treatment and care in accordance with professional standards of practice and the comprehensive person centered care plan. The facility failed to address resident #69's positioning needs in a timely manner.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure pharmaceutical services was provided to meet the needs of each resident that were consistent with state and federal requirements and reflect current standards of practice by failing to ensure medications were not left at the bedside for 1 (#38) of 1 (#38) residents with medications observed at the bedside.

Inspectors wroteBased on record review, observations, and interviews, the facility failed to ensure all patient care equipment was maintained in safe operating condition by failing to repair a wheelchair lap tray in a timely manner for 1(#69) resident reviewed for positioning.

Inspectors wroteBased on observations, record reviews, and interviews, the facility failed to protect the residents' right to be free from sexual abuse by other residents. The facility failed to ensure residents were free from sexual abuse for 1 (#1) of 3 (#1, #2, and #3) sampled residents. The facility implemented corrective actions which were completed prior to the State Agency's investigation, thus it was determined to be Past Noncompliance.