Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Des Arc Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
The facility failed to maintain cleanliness of the ice machine and scoop holder, as evidenced by residues found during an inspection. The Dietary Manager and Maintenance Supervisor were responsible for cleaning, but lacked a specific policy and cleaning log, potentially compromising safety.
A facility failed to accurately complete the MDS for a resident with a stroke diagnosis. The resident's care plan indicated antiplatelet therapy, but the MDS inaccurately recorded anticoagulant use. A review confirmed the resident received an antiplatelet, not an anticoagulant. The MDS Coordinator acknowledged the coding error.
The facility failed to ensure comprehensive care plans for three residents, as they lacked medication names and black box warnings. One resident's care plan did not reflect their multiple diagnoses and medications, while another's omitted therapy and warnings despite their paraplegia and cognitive impairment. Interviews with staff confirmed the absence of these details in care plans.
The facility failed to maintain infection control for two residents. A resident with a vesicular rash was not placed under contact isolation despite having herpes zoster, and a CNA improperly handled eating utensils without washing hands. The DON confirmed the lack of isolation and improper utensil handling, indicating a breach in infection control protocols.
The facility failed to ensure call lights were within reach for three residents, including those with severe dementia and physical impairments. Observations revealed call lights placed out of reach, and staff confirmed they should have been accessible. The facility lacked a policy on call light placement, contributing to this deficiency.
The facility failed to prepare mechanically altered food to the correct consistency for residents on a mechanical soft diet. During a meal service, pork chops were processed into a thick paste-like consistency, which was inappropriate for residents' dietary needs. The Dietary Manager confirmed the issue and noted the absence of a policy for mechanically altered foods, while the cook did not use the processor machine correctly, affecting eight residents.
A facility failed to update a resident's advance directives in the EMR, resulting in a discrepancy between the resident's care plan and the outdated directive. The resident, with severe cognitive impairment, had a care plan indicating a DNR status, but the EMR showed conflicting instructions. The oversight was identified during an audit, and the DON confirmed the delay in updating the records.
A resident with moderate cognitive impairment was not served a meal tray during dining service, prompting them to call out for their meal. The CNA, LPN, and DON acknowledged that the resident's tray should have been served before leaving the dining room, highlighting a failure to maintain the resident's dignity.
Ice Machine and Scoop Holder Cleaning Deficiency
Penalty
Summary
The facility failed to ensure proper cleaning and maintenance of the internal components of the ice machine and the container for storing the ice scoop, which are critical for safety and infection control to prevent waterborne illnesses. During an observation, a black residue was found on a napkin used to wipe the metal border inside the ice machine, and a pink/beige residue was noted in the corners of the ice scoop drawer. The Dietary Manager acknowledged the importance of cleaning the ice machine to prevent harm and illness, yet the facility lacked a specific policy for the ice machine. The Dietary Manager indicated that the Maintenance Supervisor was responsible for cleaning the ice machine, while the Dietary Department was tasked with washing the scoop holder. However, there was no log for recording the cleaning of the scoop drawer, despite it being on a cleaning schedule. The Maintenance Supervisor stated that the ice machine was cleaned every two weeks or monthly, regardless of the digital indicator light. The lack of a cleaning log and the presence of residues suggest a failure in maintaining the cleanliness of the ice machine and scoop holder, potentially compromising resident safety.
Inaccurate MDS Coding for Anticoagulant Use
Penalty
Summary
The facility failed to complete an accurate Minimum Data Set (MDS) for one resident reviewed for MDS accuracy. The resident, who had a diagnosis of stroke, was noted in the care plan to be on antiplatelet therapy to prevent blood clots. However, the quarterly MDS inaccurately indicated the use of an anticoagulant. A review of the resident's order summary report confirmed that the resident had not received an anticoagulant, but rather an antiplatelet medication. During an interview, the MDS Coordinator confirmed the error, acknowledging that the MDS should have been coded for an antiplatelet instead of an anticoagulant.
Care Plans Lacked Medication Details and Black Box Warnings
Penalty
Summary
The facility failed to ensure that comprehensive care plans were individualized and addressed appropriate care and services for three residents. Resident #37's care plan, dated 10/7/2024, did not include medication names or black box warnings, despite the resident having multiple diagnoses including hypothyroidism, type 2 diabetes, chronic heart failure, schizophrenia, and others. The Order Summary Report for Resident #37 listed several medications, but these were not reflected in the care plan. Similarly, Resident #30's care plan, dated 8/16/2024, also lacked medication names and black box warnings, despite the resident's diagnoses of chronic pain, venous thrombosis, and a mild neurocognitive disorder. The Order Summary Report for Resident #30 included medications for these conditions, but they were not included in the care plan. Additionally, Resident #20's care plan did not include any therapy or black box warnings, even though the resident had a diagnosis of paraplegia and a moderate cognitive impairment. Interviews with the MDS Coordinator and the Director of Nursing revealed that black box warnings were not included in the care plans, although they acknowledged that they should be. The MDS Coordinator also noted that Resident #20 had recently come off therapy, but this was not updated in the care plan, and there were orders for therapy that needed to be discontinued.
Infection Control Deficiencies in LTC Facility
Penalty
Summary
The facility failed to maintain proper infection control processes for two residents. Resident #270, who was admitted with multiple diagnoses including chronic obstructive pulmonary disease and a cerebrospinal fluid drainage device, was not placed under contact isolation despite having a vesicular rash indicative of herpes zoster. The resident's care plan required enhanced barrier precautions due to an indwelling medical device, but the Director of Nursing (DON) confirmed that the resident was not isolated because the blisters were not ruptured and the skin was intact. The APRN had noted a new rash with small vesicles on the resident's right arm, but there was no documentation of this in the nurse's notes, and the antiviral medication order was not followed by isolation precautions. Additionally, a Certified Nursing Assistant (CNA) improperly handled eating utensils for Resident #8 by picking up a fork by the tines without washing her hands after touching trays and opening containers. The CNA acknowledged the mistake when questioned, and the DON confirmed that the fork should have been handled by the handle. These actions demonstrate a failure in adhering to infection control protocols, potentially compromising the safety and sanitary conditions required in the facility.
Failure to Ensure Call Lights Within Reach for Residents
Penalty
Summary
The facility failed to ensure that call lights were placed within reach for three residents, leading to a deficiency in accommodating their needs and preferences. Resident #27, diagnosed with Alzheimer's disease and severe dementia, was observed multiple times with the call light out of reach at the foot of the bed. A Certified Nursing Assistant confirmed that the call light was not within reach, although it should have been. Similarly, Resident #35, who also had severe dementia, was found with the call light located along the wall at the end of the bed, out of reach. A CNA had to adjust the call light to make it accessible, and both an LPN and the Director of Nursing acknowledged that the call light should always be within reach. Resident #270, who was cognitively intact but had physical impairments, was also affected by this deficiency. The resident's call light was found behind a lamp on the nightstand, making it inaccessible. A Registered Nurse had difficulty locating the call light and had to be directed to it by the surveyor. The Rehab Director mistakenly believed the resident had the call light when it was actually the bed control. The facility lacked a policy on the placement of call lights, contributing to the oversight in ensuring residents' call lights were accessible.
Improper Consistency of Mechanically Altered Food
Penalty
Summary
The facility failed to ensure that mechanically altered food was prepared to the correct consistency for residents requiring a mechanical soft diet. During an observed meal service, it was noted that the pork chops intended for residents on a mechanical soft diet were processed into a thick paste-like consistency, which was not appropriate for their dietary needs. This issue was identified during an observation and interview with the Dietary Manager and a cook, who confirmed the inappropriate consistency of the food. The Dietary Manager acknowledged that the facility did not have a policy for mechanically altered foods, which contributed to the improper preparation of the pork chops. The cook responsible for preparing the meal did not use the processor machine correctly, as they did not pulsate the machine to achieve the desired consistency. This oversight had the potential to affect eight residents who required mechanical soft diets, as the thick paste-like consistency could pose a swallowing issue.
Failure to Update Advance Directives in EMR
Penalty
Summary
The facility failed to ensure that the Advance Directives for a resident with severe cognitive impairment were up to date in the electronic medical record (EMR). The resident, who was admitted with diagnoses including hemiplegia, hemiparesis following cerebral infarction, and post-traumatic stress disorder, had a care plan indicating a Do Not Resuscitate (DNR) status. However, the advance directive in the EMR was outdated and marked 'yes' for CPR and other life-sustaining measures, conflicting with the resident's care plan and the wishes expressed by the resident's wife. Interviews and document reviews revealed that the most current advance directive, which confirmed the resident's DNR status, had not been scanned into the EMR until a later date. The Director of Nursing (DON) and medical records staff acknowledged the oversight, noting that an audit had identified the missing document. The facility's policy required that revocations of advance directives be documented in the resident's plan of care and medical record, but this was not adhered to, leading to the deficiency.
Failure to Maintain Resident Dignity During Meal Service
Penalty
Summary
The facility failed to maintain the dignity of a resident during meal service. The incident involved a resident with a history of bipolar disorder and generalized anxiety disorder, who was admitted to the facility in December 2012. The resident was moderately cognitively impaired, as indicated by a BIMS score of 12. During a meal service in the dining room, a CNA served meal trays to all residents except this particular resident. The CNA left the dining room without providing a meal tray to the resident, who then had to call out to receive their meal. Interviews conducted with the CNA, an LPN, and the Director of Nursing confirmed that the resident's meal tray should have been served before leaving the dining room. The CNA acknowledged the oversight, and both the LPN and the Director of Nursing agreed that the resident's tray should have been served before moving on to other tasks. This oversight resulted in a failure to uphold the resident's right to a dignified existence, as outlined in the facility's policy on resident rights and responsibilities.
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Illustrative
What surveyors actually found near you
We read the 23 citations issued within 25 miles in the last 12 months — including the 1 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Des Arc
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Maple Healthcare | 12.7 mi | ★★★★★ | 0 | 0 |
| Chambers Health And Rehabilitation | 18.3 mi | ★★★★★ | 5 | 0 |
| The Springs Of Brinkley | 18.9 mi | ★★★★★ | 9 | 1 |
| The Blossoms At Oakdale Rehab & Nursing Center | 21.7 mi | ★★★★★ | 0 | 0 |
| The Crossing At Riverside Health And Rehabilitatio | 21.9 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.