Little Rock – Parkview Rehabilitation And Healthcare Center
Following are some of the deficiencies found during inspections of this nursing home on 12/19/08, 11/26/08, 8/07/08 and 6/20/08. These reports and others (5/23/08 - 16 pp; 5/1/08 - 169 pp; 2/1/08 – 5 pp;1/9/08 – 4 pp; 11/8/07 – 16 pp; 9/21/07 – 116 pp) can be found at www.arknursinghomeinspectiondeficiencies.com.
Inspection on 12/19/08 (35 pages) 1. PRESSURE SORES: ... The facility also failed to ensure an air mattress and wedge were provided in accordance with the physician’s plan of care to facilitate healing and prevent potential deterioration of an existing pressure ulcer for Resident #3... Pages 21-22.
Inspection on 11/26/08 (20 pages) 1. PRESSURE SORES: ... the facility failed to ensure pressure sores were accurately measured and staged for Resident #5... The facility failed to ensure treatment orders were implemented and failed to ensure pressure relieving devices were utilized in accordance with the Plan of Care for Resident #5...[15 pages containing 49 findings: a-ww] Pages 1-16.
Inspection on 8/07/08 (16 pages) 1. COMPREHENSIVE CARE PLANS: ... the facility failed to ensure the physician’s plan of care was implemented for the following: Resident #12... with physician orders for pulse checks prior to medication administration...Resident #1... with a physician orders for positioning devices. Pages 3-4.
Inspection on 6/20/08. (65 pages) 1. QUALITY OF CARE: ... the facility failed to ensure staff provided urinary catheter care after incontinent bowel movements for Resident #6... the resident... was incontinent of bowel and bladder. b. On 6/17/08 at 1:30 p.m., CNA’s #6 and #2 provided incontinent care to the resident who had been incontinent of feces. The CNA’s did not provide catheter care. c. On 6/19/08 at 9:50 a.m., the resident was incontinent of feces. CNA #7 performed catheter care then provided incontinent care to the resident. The catheter was not re-cleaned by the CNA after the feces were removed. Pages 19-20.
2. PRESSURE SORES: ... the facility failed to ensure interventions were implemented to prevent the development of new pressure ulcers and the deterioration of existing pressure ulcers for Resident #7... The facility failed to ensure residents at risk for pressure ulcers were repositioned at least every 2 hours in accordance with the plan of care and accepted standards of nursing practice and failed to ensure pressure relieving devices at bony prominences were provided to prevent the development of pressure sores for Residents #3 and #9... These failed practices resulted in a pattern of actual harm to Resident #7... c. Nurses’ Notes and Wound Documentation sheets documented the following progression of the pressure ulcer on the left inner knee: 2/8/08 - wound 2 centimeters (cm) by (x) 2 cm acquired. 2/18/08 - wound 1.8 X 1.6 X 0.1 cm with loody drainage, stage II. 3/7/08 - wound 2 X 2.2 X 0.3 cm yellow slough, getting worse, stage II. 3/16/08 - stage III exposed subcutaneous (SubQ) tissues - presents as a deep crater. 3/28/08 - wound 2.3 X 1.8 X 0.3 cm pink with yellow center. 4/4/08 - wound 3.5 X 2.1 X 0.3 cm debrided stage III. 4/11/08 - wound 3.1 X 1.9 X 0.3 cm stage III pink with yellow center. 4/22/08 - wound 2.5 X 2.5 X 0.3 cm. 5/28/08 - wound 2.5 X 2 X 0.3 cm stage III no change. 6/6/08 - wound 3 X 2 X 0.5 cm stage III pink with yellow center. 6/13/08 - wound 2.5 X 2.5 X 0.2 cm. 6/17/08 - Full thickness of skin is lost, exposing the SubQ tissues-presents as a deep crater (pressure stage III left knee). d. On 6/17/08 at 9:55 a.m., 12:20 p.m., 1:15 p.m., 5:40 p.m. and 6:12 p.m., the resident was sitting in her wheelchair without any pillowing between her knees. The resident was observed to keep her knees together whether in the bed or chair. e. On 6/18/08 at 9:05 a.m., the resident was sitting in her wheelchair with no pillowing/bridging device between the knees... g. On 6/18/08 at 11:50 a.m., CNA’s #2 and #3 transferred the resident from the bed to her wheelchair with a mechanical lift. The CNA’s straightened the resident’s clothes, put a lap robe over the resident and propelled her ut to the dining room. The CNA’s did not put a pillow or other device between the resident’s knees to reduce pressure. h. On 6/19/08 at 9:25 .m., CNA #4 was asked to lift the resident’s lap robe to view the dressing on the resident’s left knee. The CNA lifted the lap robe. There was o pillow or other device between the resident’s knees. The CNA put the lap robe over the resident and left the room and did not place a pillow or ther device between the resident’s knees. i. On 6/19/08, the June 2008 Treatment Administration Record (TAR) was reviewed and incorrectly ocumented that the resident’s knees were bridged with a pillow from 7:00 a.m. to 7:00 p.m. from 6/1/08 through 6/19/08. Pages 20-24.
