The Blossoms at North Little Rock Rehab & Nursing

Inspectors wroteBased on record review and interview, the facility failed to ensure residents were free from significant medication errors related to omitted antiseizure medication administration for one (Resident #2) of three residents reviewed for medication administration.

Inspectors wroteBased on observation, interview and facility policy review, the facility failed to ensure dietary staff washed their hands and changed their gloves before handling food items and clean equipment; the ice machine was maintained in clean and sanitary conditions; walls were free of accumulations of dust to ensure meals were prepared in clean, sanitary conditions for two of two meals observed.

Inspectors wroteBased on observation, interview, facility document review, and policy review, the facility failed to ensure Enhanced Barrier Precautions (EBP) were utilized for two (Resident #1 and Resident #202) of two residents reviewed for Enhanced Barrier Precautions.

Inspectors wroteBased on observation and interview, the facility failed to ensure foods stored in the refrigerator was covered and sealed to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; expired food items were promptly removed from stock to prevent potential food borne illness for residents who received meal trays from 1 of 1 kitchen; foods were dated the day received or opened to assure first in, first out usage to prevent potential for food bone illness, and dietary staff washed their hands before handling clean. equipment or food items to prevent potential food borne illness for residents who received meals from 1 of 1 kitchen. These failed practices had the potential to affect 96 residents who received. meals from the kitchen.

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 2 of 2 meals observed. This failed practice had the potential to affect 6 residents who received pureed diets.

Inspectors wroteBased on observations, interviews and policy review, the facility failed to ensure Resident or Resident representative was invited to a comprehensive care plan meeting for 1 (Resident #45) of 98 residents who receive a care plan.

Inspectors wroteBased on observation and interview, the facility failed to ensure residents had a clean and homelike environment.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure kitchen equipment was clean and in good condition, dietary staff washed their hands and changed gloves between dirty and clean tasks and before handling clean equipment or food items to minimize the potential for food borne illness for residents who received meals from 1 of 1 kitchen; and opened containers of food were refrigerated after opening when required. The failed practices had the ability to effect 96 residents who received their meals from 1 of 1 kitchen as documented on a list provided by the Dietary Consultant on 02/23/23 at 3:02 PM.

Inspectors wroteBased on observation, record review, and interview the facility failed to ensure a safe, clean, comfortable, and homelike environment was maintained for 2 (Residents #16 and #23) of 17 [Residents #11, #13, #16, #21, #23, #29, #33, #34, #35, #38, #55, #56, #59, #62, #78, #82 and #142) sampled residents reviewed.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure bathing services were regularly provided to maintain good hygiene for 2 (Resident #66 and #78) of sampled residents who were dependent on staff for bathing and failed to ensure fingernails were cleaned and groomed to promote good personal hygiene and grooming for 1 (Resident #16) of 23 (Residents #1, #2, #11, #16, #23, #25, #29, #33, #34, #38, #39, #45, #48, #50, #55, #56, #59, #62, #65, #78, #80, #82 and #85) sampled residents who were dependent on staff for fingernail care. This failed practice had the potential to affect 29 residents who were dependent on staff for bathing/showers and 93 residents' who were dependent on staff for nail care as documented on list provided by the Director of Nursing (DON) on 02/23/23 at 3:45 pm.

Inspectors wroteBased on observation, and interview, the facility failed to ensure all mechanical and electrical equipment in the kitchen was maintained in safe operating condition. The failed practice had the ability to affect 92 residents who receive their meals from the kitchen according to a list provided by the Administrator on 02/24/23 at 9:00 AM.

Inspectors wroteBased on observation, record review, and interview, the facility failed to consider the residents' food preferences and serve items listed on the meal ticket for 1 (Resident #66) of 1 sampled resident. This failed practice had the potential to affect 92 residents who received a meal tray from the kitchen as documented on a list provided by the Administrator on 02/24/23 at 9:00 AM.

Inspectors wroteBased on record review, and interview, the facility failed to ensure a Baseline Care Plan was developed within 48 hours of admission to include the minimum healthcare information necessary to provide for the resident's care needs to promote continuity of care and minimize the potential for adverse events after admission for 1 (Resident #142) of the 4 (Residents #21, #69, #71 and #302) sampled residents who were admitted to the facility in the past 30 days as documented on the MDS (Minimum Data Set) Resident Matrix provided by the MDS Coordinator on 02/22/23 at 10:43 AM.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure nursing staff assessed and obtained treatment orders for a laceration with sutures to promote healing and prevent potential infection for one (Resident #59) of 1 sampled resident who had sutures and required suture care and removal.

Inspectors wroteSurveyor: [NAME] Based on observation, interview, and record review, the facility failed to provide incontinence care to promote a healthy and an odor free environment for 1 (Resident #2) of 3 (Residents #2, #23 and #48) sampled residents who had urinary catheters. This failed practice had the potential to affect 3 residents who had a foley catheter as documented on a list provided by the Nurse Consultant on 02/24/23.

Inspectors wroteBased on observation, interview, and record review, the facility failed to take actions directed at the Performance Improvement Plan (PIP) by not implementing those actions, measure the success of those actions, and track performance of those actions to ensure improvements goals were met and sustained. The failed practice had the ability to affect all 93 residents who resided in the facility according to the Census and Conditions of Residents provided by the Minimum Data Set (MDS) Coordinator on 02/22/23 at 10:43 AM.