ARKANSAS CONVALESCENT CENTER
LOCATED: 6301 SOUTH HAZEL, PINE BLUFF, AR 71603

ARKANSAS CONVALESCENT CENTER was cited by the DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES for the following deficiencies:

PLEASE NOTE: The following highlighted quoted text is only a portion of the full report/survey submitted by DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES. The full report/survey can be found here.

FACILITY FAILED TO GIVE RESIDENTS PROPER TREATMENT TO PREVENT NEW BED (PRESSURE) SORES OR HEAL EXISTING BED SORES.

LEVEL OF HARM –ACTUAL HARM

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Complaint # (AR 793), Complaint # (AR 805) and Complaint # (AR 825) were substantiated (all or in part) with these findings: Based on observation, record review and interview, the facility failed to ensure necessary treatment and services were provided to promote the healing of pressure ulcers for Residents #1, #3, #7 and #8:

The facility failed to ensure pressure ulcer treatments were promptly initiated and were provided at the frequency ordered by the physician to promote healing and prevent potential deterioration for 2 (Residents #3 and #8).

The facility failed to ensure the physician was promptly consulted regarding newly identified pressure ulcers or deterioration of existing pressure ulcers to allow the physician to determine if a change in treatment was needed for 2 (Residents #3 and #8) of 7 (Residents #1, #3 and #5 through #9) case mix residents who had pressure ulcers.

The facility failed to conduct and document thorough pressure ulcer assessments on at least a weekly basis, to include measurements, staging and condition of the wound and surrounding tissue to facilitate the ability to track healing progress or deterioration of pressure ulcers for 2 (Resident #3 and 8) of 7 (Residents #1, #3 and #5 through #9) case mix residents who had pressure ulcers. The facility failed to ensure planned pressure relief interventions were consistently implemented to decrease the potential for development of new pressure ulcers and to prevent deterioration in existing pressure ulcers for 2 (Residents #1 and #3) of 7 (Residents #1, #3 and #5 through #9) case mix residents who had pressure ulcers of 7 (Residents #1, #3 and #5 through #9) case mix residents who had pressure ulcers. These failed practices resulted in patterns of actual harm to Residents #3 and #8, who experienced deterioration in existing pressure ulcers and development of new pressure ulcers, and had the potential to cause more than minimal harm to 4 residents who had pressure ulcers, as documented on a list provided by the Director of Nursing on 11/17/15.

The facility also failed to ensure a [DEVICE] (vac) was applied as ordered by the physician to promote healing for 1of 1 (Resident #7) case mix residents who had pressure ulcers and physician orders [REDACTED]. This failed practice had the potential to cause more than minimal harm for 1 residents with pressure ulcers and physician orders [REDACTED].

On 11/13/15 at 12:20 p.m., the Treatment Nurse, with the DON present, was asked if she had completed the treatments for the resident that morning. The Treatment Nurse stated she changed the dressings just before lunch, around 12 noon. The Treatment Nurse stated she had from 6:00 a.m. until 2:00 p.m. to change the dressing for her shift. The Treatment Nurse was asked, if a treatment is BID, should there be specific time (scheduled)? The Treatment Nurse stated, No, we don’t put a time frame; its 6 to 2 (6:00 a.m. to 2:00 p.m.) and 2 to 10 (2:00 p.m. to 10:00 p.m.). The Treatment Nurse was asked, if you change the dressing at noon, and the 2 to 10 shift comes on and changes the dressing at 3:00 p.m. that would be 3hours between dressing changes. The Treatment Nurse stated, the treatment is BID. The DON stated, that’s something we are going to have to work on. The Treatment Nurse was asked, regarding the pressure ulcer on the left lateral ankle, when was the onset date of this the pressure ulcer? The Treatment Nurse stated, it occurred a few days before he went to the Wound Clinic; he was going on 10/27/15. The area was at first just bleeding and then it got a little bit larger. Treatment Nurse was asked if she had called the Physician upon identification of this pressure ulcer. The Treatment Nurse stated, No, he was scheduled for the wound clinic. The Treatment Nurse was asked if she had performed a treatment to this wound and stated she had used a previous order to provide treatment to the left lateral ankle wound. The Treatment Nurse was asked if she had obtained measurements of the pressure ulcer when it was discovered. The Treatment Nurse stated, No, he was scheduled to go to the wound clinic in a few days. The Treatment Nurse was asked, You did not notify the Physician of a new Pressure Ulcer, did not obtain measurements when you discovered the Pressure Ulcer, (you) performed a treatment without a Physician order [REDACTED].? The Treatment Nurse stated, He (resident) was going to the Wound Clinic in a few days. The Treatment Nurse was asked, when the area started on the left ankle, did you assess to determine what could have been causing the pressure on the left lateral ankle? The Treatment Nurse stated, there was an in-service on offloading and positioning the first part of October. The Treatment Nurse was asked if she had assessed the heel lift boot for pressure points on the ankle. The Treatment Nurse stated, no.

Personal Note from NHA-Advocates: NHAA shares with all the families of loved ones who are confined to nursing homes the pain and anguish of putting them in the care of someone else. We expect our loved ones to be treated with dignity and honor in the homes we place them. We cannot emphasize enough to family members of nursing home residents; frequent visits are essential to our loved ones’ well-being and safety. This nursing home and many others across the country are cited for abuse and neglect.

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