Following are some of the deficiencies found during inspections of this nursing home on 9/11/08, 12/06/07, 9/20/07 and 1/12/07.  These reports and one on 1/27/05 – 11 pages, can be found at www.arknursinghomeinspectiondeficiencies.com.

Inspection on 9/11/08 (31 pages)
1. NUTRITION: …the facility failed to ensure nutritional interventions were implemented to maintain parameters for Resident #10 who experienced a significant weight loss… Pages 17-18.

Inspection on 12/06/07 (17 pages)
1.  COMPREHENSIVE CARE PLANS: ...the facility failed to ensure Physician orders for fluid restriction were followed for Resident #9... due to a diagnosis of Congestive Heart Failure.  Page 1.

2.  PRESSURE SORES: ...the facility failed to ensure a catheter was positioned in a manner to decrease the potential for skin breakdown for Resident #5... Page 5

3.  ACCIDENTS AND SUPERVISION: ...the facility failed to ensure a restraint was applied correctly to minimize the potential for injury for Resident #11... a personal alarm was implemented per manufacturer's guidelines to prevent the recurrence of falls for Resident #7... Page 8.

4.  INFECTION CONTROL – LINENS ...the facility failed to ensure that contaminated linens and/or incontinent briefs were not placed on the floor for Resident #7... and staff did not hold clean linens against their uniforms.  Pages 15-16.

Inspection on 9/20/07  (40 pages)
1. ABUSE:...the facility failed to ensure interventions were developed and implemented to assure freedom from abuse for Residents #1 and #2 who resided on the locked unit.  Page 1.

2.  STAFF TREATMENT OF RESIDENTS: ...the facility failed to ensure all allegations of abuse were thoroughly investigated, resident protection was provided to prevent further abuse and all allegations of abuse were reported to the local law enforcement agency and the Office of Long Term (OLTC) in accordance with State Law for Residents #1 and 2 who had an allegation of abuse... Pages 13-15.

Inspection on 1/12/07 (24 pages)  
1.  INFECTION CONTROL: ...the facility failed to ensure a safe, sanitary environment was maintained to prevent the development and transmission of disease and infection for Residents # 2 and 3 ... Resident # 3 ... was incontinent of bowel and bladder and had a Stage 2 pressure ulcer.  On 1/8/07 at 4:30 p.m., CNA # 6 entered the resident's room and stated she was going to get the resident up for supper. The resident was in bed. CNA # 6 pulled back the covers. The resident was clothed only in a t-shirt. The incontinent pad was urine soaked. The bottom half of the t-shirt was wet. The CNA donned gloves and sprayed periwash on a rag. Using the same surface of the rag, the CNA wiped the anterior thighs and suprapubic area using a back and forth motion. The penis, scrotum and the groin area was not cleansed. The CNA did not wash the buttocks.  The CNA put a pull up incontinent brief and pants on the resident and pulled them up the thighs with the resident lying on his left side. She then folded. the incontinent pad under the resident and rolled him back onto his back on the bare mattress. The resident reached down and held his penis in both hands and urinated. The urine streamed over the resident's hands and down both sides of his pelvis onto the mattress and the incontinent pad that was still partially under him.. CNA # 6 stated, "He's wetting again". The CNA did not do any additional incontinent care. CNA attempted to sit the resident up but was unable to and stated, "I'm going to get some help." CNA # 6 put the call light on and  CNA # 5 entered the room. CNA # 6 removed her gloves and CNA's # 5 and # 6 assisted the resident to stand up, pulled up the incontinent brief and the pants and transferred him to the wheelchair. CNA # 6 removed the resident's wet t-shirt by grabbing the wet tail of the shirt with her bare hands and pulling it off over the resident's head, picked out a new t-shirt from the drawer and assisted the resident into it, picked the resident's cap up from the nightstand and placed it on his head and then opened the door to the corridor without washing her hands.  CNA # 5 sat down on the wet mattress and attached the resident's restraint to the wheelchair. The resident was rubbing his urine soaked hands together and lacing his fingers as if washing his hands while he was being transported by CNA #6 to the dining room. The CNA did not wash her hands after completing  incontinent care or prior to transporting the resident to the dining room. The resident was placed at the table. A glass of water was sitting on the table. The resident rubbed his hand around the rim of the glass and then picked it up to drink. Surveyor intervened and instructed staff that resident needed to have hands washed and glass replaced with a fresh one.  Resident # 2... was incontinent of bowel and bladder.  On 1/9/07 at 11:35 a.m., CNA #1 and 2 provided incontinent care for the resident. CNA's #1 and #2 removed the resident's sweat pants and disposable brief. CNA #1 cleansed the resident's right buttock and rectal area from the front to back with a disposable wipe and peri wash. CNA #1 noted that the feeding tube was disconnected from the gastrostomy tube and reconnected the two ends, touching the ends that connect with her dirty gloves. The CNA's turned the resident to the right side and cleansed the resident's left buttock and rectal area front to back with a disposable wipe and peri wash. The CNA's turned the resident on her back and CNA # 1 noted the feeding tube became disconnected from the gastrostomy tube again and reconnected it with the same dirty gloves a second time. The CNA's put a clean disposable brief and sweat pants on the resident wearing the same dirty gloves. The resident's pubic area, groin, labia, or urethral areas were not  cleansed. The CNA's were asked if the brief they removed from the resident was wet with urine and they both stated, "yes".  Pages 21-24.