Inspection Reports for
The Blossoms at Fort Smith Rehab & Nursing Center

The facility was found deficient in multiple areas including allowing a resident to self-administer medications without clinical appropriateness, failure to consistently implement physician orders for position and mobility, medication administration errors including improper insulin pen use and incorrect medication given, and failure to follow proper infection control precautions during wound care.

The facility was found deficient in allowing a resident to self-administer medications without clinical appropriateness, inconsistent implementation of physician orders for position and mobility, medication administration errors including improper insulin pen priming, and failure to follow proper infection control precautions during wound care.

The facility failed to notify the State Designated Authority and obtain a PASARR II evaluation for a sampled resident admitted from a psychiatric facility. Additionally, the facility did not employ a certified social worker despite having more than 120 beds, and lacked a policy for social worker staffing.

The facility failed to coordinate with the State Designated Authority by not obtaining a PASARR II evaluation for Resident #3 upon admission and failed to hire a certified social worker despite having more than 120 beds. The facility lacked policies and procedures regarding these requirements.

The complaint investigation focused on verbal abuse allegations involving Residents #2 and #3. The allegations were substantiated with evidence from interviews, staff disciplinary records, and policy reviews. Staff failed to report abuse immediately as required, and the alleged perpetrator was not removed promptly to protect residents.

The facility failed to ensure staff reported allegations of verbal abuse to the Administrator within two hours as required. Interviews and record reviews revealed incidents involving CNA #3 yelling at Residents #2 and #3, and failure by LPN #1 to immediately report the abuse. Staff received abuse training but failed to follow reporting protocols, resulting in disciplinary actions.

The complaint investigation was substantiated. The facility failed to report allegations of verbal abuse within the required timeframe. Staff interviews and disciplinary records confirmed the incidents and failures in reporting.

The facility failed to ensure staff reported allegations of verbal abuse to the Administrator within two hours as required. Interviews and record reviews revealed that CNA #3 yelled at residents #2 and #3, and LPN #1 failed to report the incident immediately. Disciplinary actions were taken against LPN #1 for failure to report. The facility policy mandates immediate reporting and removal of alleged perpetrators to protect residents.

The facility was found deficient in multiple areas including failure to provide toilet paper and paper towels in women's secured unit bathrooms, improper management of resident personal funds, unsafe wheelchair transport techniques, unsecured cigarettes accessible to residents, unsanitary conditions in the women's secure unit shower, lack of fitted sheets for beds, failure to provide perineal care during brief changes, improper medication administration by crushing non-crushable iron tablets, unsafe laundry cart transport causing resident injury, and failure to properly check feeding tube placement prior to medication and flush administration.

The facility was found deficient in multiple areas including failure to provide toilet paper and paper towels in women's secured unit bathrooms, failure to provide perineal care during brief changes, improper medication administration (crushing iron tablets labeled 'Do Not Crush'), unsafe wheelchair and laundry cart transport techniques, inadequate management of resident personal funds, unsafe storage and access to cigarettes, unclean shower facilities, broken floor tiles, and failure to properly check feeding tube placement prior to medication administration.

The facility was found deficient in ensuring residents had call lights within reach, providing adequate care for activities of daily living including incontinence care, and maintaining a safe environment by securing doors to rooms containing chemicals and sharps. Deficiencies were noted with minimal harm or potential for actual harm to residents.

The facility was found deficient in ensuring residents had call lights within reach, providing adequate care for activities of daily living including incontinence care, and maintaining a safe environment by securing doors to rooms containing chemicals and sharps. Deficiencies were noted with minimal harm potential affecting a few or some residents.

The facility was found deficient in maintaining resident dignity and privacy, protecting residents from abuse, ensuring adequate supervision to prevent accidents, proper medication storage and administration, food safety and sanitation practices, and infection prevention including hand hygiene during care and meal service.

The facility was found deficient in multiple areas including failure to maintain resident dignity and privacy, failure to protect residents from abuse, inadequate supervision to prevent accidents, improper medication storage, food safety violations, and poor infection control practices including inadequate hand hygiene during care and meal service.

The facility was found deficient in ensuring accurate Minimum Data Set (MDS) assessments, comprehensive and timely care planning including trauma-informed care, completion of discharge summaries, notification of physicians regarding catheter complications, and proper food handling and storage practices. Several residents' care plans were incomplete or not updated to reflect current needs, and dietary staff failed to follow proper hygiene and food safety protocols.

The facility failed to ensure accurate Minimum Data Set (MDS) assessments, comprehensive and timely care plans including trauma-informed care, completion of discharge summaries, proper catheter care including physician notification of infection signs, and safe food handling practices including prevention of cross-contamination and proper hand hygiene by dietary staff.

The complaint investigation found that the facility did not report the incident involving Resident #1 within the required 2-hour timeframe. The incident involved positional asphyxia and death. The facility's Administrator stated the report was not completed after a meeting, and the coroner and detective initially suggested other causes of death such as cardiac-related events. The facility policy requires immediate reporting of suspected abuse or neglect resulting in serious bodily injury.

The facility failed to report an incident involving Resident #1 who was found unresponsive with positional asphyxia due to his neck positioned between the bottom rails of his mechanical bed. The facility did not complete the required report after the incident, despite policy requirements for timely reporting and investigation of abuse or neglect.

The complaint investigation found the facility failed to report an incident resulting in serious bodily injury within the required 2-hour timeframe. The incident involved Resident #1 who died from positional asphyxia. The facility initially started a report but decided not to complete it after a meeting. The coroner and detective initially suggested the death might be cardiac related or due to stroke or seizure.

The facility failed to report an incident involving Resident #1 who was found unresponsive with positional asphyxia caused by his neck positioned between the bottom rails of his mechanical bed. The facility did not complete the required report after a meeting, despite policy requiring reporting within 2 hours for serious bodily injury.

The facility failed to ensure appropriate treatment and physician notification for residents with skin abrasions and rashes, proper catheter care to prevent infections, and consistent administration of oxygen therapy at physician-ordered rates. Several residents had untreated skin issues, leaking catheters without proper orders, and oxygen/nebulizer equipment not properly managed.

The visit was complaint-related, focusing on allegations of inadequate treatment for skin conditions, catheter care, and oxygen therapy management. The report documents multiple interviews with nursing staff and observations confirming failures in care and communication with physicians.

The facility failed to ensure physician notification and appropriate interventions for residents with skin abrasions and rashes, proper care and containment of indwelling catheters, and consistent administration of oxygen therapy at physician-ordered rates. Several residents had untreated skin issues, catheter care deficiencies, and improper storage of respiratory equipment.