Below average — CMS composite of the measures below.
The next survey window likely opens around May 2027
Estimate from public CMS data, current as of August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Robinson Nursing And Rehabilitation Center Llc during CMS and state inspections, most recent first.
Inaccurate MDS coding and missing discharge assessments affected multiple residents. The MDS staff acknowledged missed discharge MDSs for residents who discharged to another facility, went home, were transferred to the hospital, or died after ER transfer, and also acknowledged incorrect PASRR coding for residents with documented PASRR level II status. The records showed mismatches between the EHR, care plans, and MDS entries, while the DON stated the facility had no specific MDS policy and relied on the RAI manual and an internal checklist.
A resident receiving a nebulizer treatment was left without staff present while the treatment was running, despite no assessment or care plan showing the resident was approved to self-administer. The MA-C stated she started the treatment and went in and out of the room, then left work before it was finished. Staff gave conflicting accounts about whether an MA-C or nurse could start the treatment, while the DON and Administrator stated only a nurse could administer nebulizers and remain with the resident during the treatment.
Missed Significant Change MDS After Hospice Enrollment: A resident with malignant melanoma enrolled in hospice, but the facility did not complete the required significant change MDS within the required timeframe. The EHR showed hospice care was in place and the MDS Coordinator confirmed the assessment was missed; the DON stated the MDS office used a checklist that identified admission and significant change assessments as due within 14 days.
Care Plan Missing Nebulizer Treatment: A resident with COPD, asthma, dementia, and other diagnoses was receiving nebulizer treatments ordered for asthma, but the care plan did not identify the treatments and no self-administration assessment was completed. Surveyors observed the resident using the nebulizer without staff present, and the MDS Coordinator, DON, and Administrator all stated the nebulizer treatment should have been included on the care plan.
Care Plan Missing Monitoring Parameters for Diuretic Therapy: A resident with acute kidney failure and severe cognitive impairment was receiving a diuretic, but the care plan only directed staff to administer the medication and monitor for side effects without listing the specific signs, symptoms, or adverse reactions to observe. The MDS Coordinator stated the information was not included, and the DON stated staff rely on the care plan or closet care plan to guide resident care; the facility also did not have a policy on care plans.
A resident with DM and intact cognition was using a blood sugar sensor device, but the order was not documented on the physician orders or MAR. Staff observed the sensor patch on the resident’s arm, and LPNs said the resident’s blood sugars were checked through the device and the patch was changed every 10 days. Pharmacy records confirmed repeated fills, while the DON and Medical Director acknowledged the device should have been reflected in the physician orders.
Hospice Services Not Care Planned: A resident with malignant melanoma and severe cognitive impairment was receiving hospice care, but the written care plan did not include the most recent hospice plan of care or hospice agency contact information. The MDS Coordinator stated the hospice information should have been care planned but was missed, and the DON stated the facility did not have a hospice care policy.
Two residents with severe cognitive impairment were observed with long, jagged nails and a dark brown substance underneath, potentially fecal matter, indicating a failure in personal hygiene care. Interviews with CNAs suggested the substance could spread infections, and the facility lacked a nail care policy.
A resident's wheelchair was not in good working condition, causing discomfort and potential harm. Despite the resident's reports, the facility failed to replace the wheelchair promptly. The resident, who was on anticoagulant medication, was at risk for skin tears and bruising. Staff interviews revealed inconsistencies in wheelchair inspections, and the facility lacked a policy for equipment maintenance.
A resident with medical conditions including atrial flutter and diabetes was receiving 2 liters of oxygen therapy without a physician's order, contrary to facility policy. The LPN and administrator confirmed the absence of an order, which is required for oxygen therapy as it is considered a medication. This oversight resulted in the therapy not being documented on the Medication Administration Record (MAR).
The facility failed to ensure proper hand hygiene and adherence to manufacturer specifications during food preparation. Dietary staff were observed handling clean equipment and food without washing their hands after touching dirty objects, contrary to the facility's handwashing policy. Additionally, an opened bottle of lemon juice, used in recipes and for cleaning, was not refrigerated as required by the manufacturer. These actions indicate a lack of adherence to professional standards in food handling and storage.
The facility failed to ensure a safe and clean environment, as surveyors observed stained privacy curtains and damaged furniture in two residents' rooms. CNAs expressed concerns about potential health risks from the stains, which could be fecal matter, and the sharp edges of the damaged chairs. The Nurse Consultant confirmed there was no policy on furniture replacement.
A facility failed to encode and transmit an MDS assessment for a resident following discharge in a timely manner. The resident was discharged, but the MDS discharge assessment was not completed or sent to CMS as required. The MDS Coordinator confirmed the delay, noting the assessment was overdue by 118 days.
A facility failed to accurately code the MDS for a resident with a level II PASRR, despite the resident's care plan and historical forms confirming this status. The MDS Coordinator acknowledged the error, which was due to a misinterpretation of the RAI manual. The incorrect coding could affect the resident's care plan and reimbursement.
A facility failed to develop a care plan for a resident receiving supplemental oxygen, despite documentation on the MDS. The resident had diagnoses including atrial flutter and diabetes. An LPN confirmed the absence of a care plan, and the Administrator acknowledged the need for one. The facility lacked a specific care plan policy, relying on the RAI manual, and the MDS Coordinator noted the oversight was due to the absence of an oxygen order.
The facility failed to maintain clean and sanitary shower rooms, as black residue was found in the grout lines of tiles in two of four shower rooms. A resident with osteoarthritis, requiring assistance with showering, confirmed the presence of black areas in the grout. Staff interviews revealed inconsistencies in cleaning procedures, with different disinfectants used, yet the residue persisted, indicating a lapse in maintaining sanitary conditions.
Inaccurate MDS Coding and Missing Discharge Assessments
Penalty
Summary
The facility failed to ensure resident assessments and MDSs were coded correctly for six residents, resulting in inaccurate records that did not match each resident’s actual status. Review of the records and interviews showed that the MDS coordinator(s) acknowledged several missed or incorrect discharge assessments and PASRR coding entries. The facility also had no specific MDS policy and relied on the RAI manual and an internal daily checklist for MDS coordinators. For Resident #31, the record showed admission for a left patella fracture, left knee ligament sprain, effusion, pain, hypertension, anxiety, and diabetes mellitus. The most recent PPS MDS did not reflect that the resident had discharged to a nursing home closer to family, and the MDS coordinator stated a discharge MDS should have been completed but was not. For Resident #45, admitted with volvulus, depression, and tachycardia, the record showed a transfer to the hospital for possible ileus and later ambulance transport to the ED after abdominal x-ray results; however, the discharge MDS indicated return was anticipated, and the MDS coordinator stated a discharge, return not anticipated should have been completed. For Resident #67, who had seizure disorder, depression, pain, and a BIMS score of 03 indicating severe cognitive impairment, the resident discharged home with family, but the discharge MDS was not completed, which the MDS coordinator confirmed. For Resident #79, with diagnoses including polyneuropathy, anemia, and anxiety, the resident transferred to the ER and died in less than 24 hours, but the discharge MDS was not coded; the MDS coordinator stated the resident died in the hospital and the discharge, return not anticipated was forgotten. For Resident #1 and Resident #51, the annual MDSs did not accurately code PASRR status despite documentation in the chart showing PASRR-related findings and level II determinations, and the MDS coordinators stated they missed those entries.
Nebulizer Treatment Left Unattended
Penalty
Summary
The facility failed to ensure that a resident who had not been assessed to safely self-administer medications was not left alone while receiving nebulizer treatment. Resident #100 did not have a documented assessment for self-administration of nebulizer or breathing treatments, and the care plan did not identify the resident to receive nebulizer treatments. Facility policy stated self-administration of drugs is permitted only when approved by the interdisciplinary team and with a physician's order. During observation, the resident was seen receiving a breathing treatment while holding the nebulizer mouthpiece in their mouth with no staff in the room. The MA-C was observed in the hallway preparing medications for another resident and stated she had started the nebulizer treatment and was going in and out of the room to check on the resident. Later the same day, the resident was again observed in bed with the nebulizer treatment running and no staff present in the room, with the nebulizer tubing lying on the resident's lap while medication was still being administered. Interviews showed conflicting understanding of who could administer and monitor nebulizer treatments. CNA staff stated the MA-C or nurse would start the treatment and then return later to turn it off, and one CNA stated the resident could do their own breathing treatment. An LPN stated the treatment had been delayed earlier because the resident wanted to shower and said either the nurse or MA-C could start the treatment. The DON and Administrator later stated MA-Cs were not permitted to administer nebulizers in the facility and that a nurse was required to remain with the resident during the treatment. The MA-C acknowledged starting the treatment, leaving before it was finished, and not notifying the nurse before leaving work.
Missed Significant Change MDS After Hospice Enrollment
Penalty
Summary
The facility failed to ensure a significant change MDS was completed within 14 days of the effective date of hospice service election for one resident. Resident #84 was admitted with a diagnosis that included malignant melanoma of the skin, and the record showed an order dated 01/20/2025 for hospice to evaluate and admit the resident. The CMS RAI Manual states that a Significant Change in Status Assessment is required when a terminally ill resident enrolls in hospice, with the ARD within 14 days of the hospice election date. Review of the resident’s EHR did not show that a significant change MDS was completed after the resident was admitted to hospice services. The quarterly MDS later reviewed showed the resident had hospice care while a resident and had a BIMS score of 07, indicating severe cognitive impairment. During interview, the MDS Coordinator stated the resident was receiving hospice services as of January 2025, confirmed a significant change MDS was not completed for the hospice enrollment, and stated it was missed. The DON stated the MDS Coordinators used the RAI manual and provided a daily checklist that listed admission and significant change assessments as having 14 days to complete from the admission date or change noted date.
Care Plan Missing Nebulizer Treatment
Penalty
Summary
The facility failed to develop and implement a comprehensive person-centered care plan for Resident #100 that included measurable objectives and timeframes related to nebulizer treatments. Resident #100 had diagnoses including type 2 diabetes mellitus, acute embolism and thrombosis, dementia, COPD, asthma, tachycardia, depression, anxiety disorder, and edema. The quarterly MDS showed a BIMS score of 8, indicating moderate cognitive impairment, and did not indicate oxygen therapy. Review of the progress notes showed a physician's order for the resident to inhale medication using a nebulizer three times a day for asthma, but the EMR contained no assessment for self-administering a nebulizer or breathing treatment, and the care plan last reviewed on 03/20/2026 did not identify that the resident received nebulizer treatments. During observation, the resident was seen using a nebulizer without staff present in the room. At one point, the resident was holding the nebulizer mouthpiece in their mouth while no staff were present, and later was observed in bed with the nebulizer treatment running and the tubing laying on their lap while white smoke came from the end of the tubing, again with no staff present. The MAC stated she had started the nebulizer treatment and was going in and out of the room checking on the resident, and stated MACs were allowed to start and stop breathing treatments after additional expanded scope training. The MDS Coordinator stated the care plan did not reflect the nebulizer treatment and should have included it, and stated the resident had started breathing treatments in February 2026 but the initial, updated, and quarterly care plans did not include the nebulizer/breathing treatment. The Administrator and DON stated the nebulizer should be on the care plan, and the DON stated the MDS Coordinator was responsible for ensuring medications were on the care plan.
Care Plan Missing Monitoring Parameters for Diuretic Therapy
Penalty
Summary
The facility failed to ensure Resident #84’s comprehensive care plan was revised to include the signs, symptoms, and adverse reactions staff were to monitor related to diuretic therapy. Resident #84 was admitted with diagnoses that included acute kidney failure, had a quarterly MDS showing a BIMS score of 07 indicating severe cognitive impairment, and was receiving a diuretic as a high-risk medication. The care plan, last reviewed on 04/17/2026, identified that the resident was on diuretic therapy related to kidney failure and included interventions to administer the medication as ordered and monitor for side effects, but it did not specify what signs, symptoms, or adverse reactions staff were to observe for. The Order Summary Report showed the resident had an order for a diuretic medication, but the physician’s order did not include monitoring parameters for signs, symptoms, or adverse reactions. The FDA label for the medication stated patients receiving the therapy should be observed for signs or symptoms of fluid or electrolyte imbalance, including dryness of mouth, thirst, weakness, fatigue, hypotension, and oliguria. During interview, the MDS Coordinator stated she did not see this information on the care plan and could not explain why it was not included, and stated it should be on the care plan so all staff would know what signs to look for. The DON stated staff review the care plan or closet care plan to know how to care for residents, and also stated the facility did not have a policy on care plans.
Missing Physician Order for Blood Sugar Sensor Device
Penalty
Summary
The facility failed to ensure a physician's order for a sensor device used to check blood sugar results was entered on Resident #99's physician orders and medication administration record. Resident #99 was admitted with diabetes mellitus and had a quarterly MDS showing a BIMS score of 15, indicating the resident was cognitively intact. The care plan noted that the resident was resistant to care, including refusing blood sugar checks and refusing finger pricks if the sensor device was not available. Review of the June 2026 order summary and MAR did not show an order for the sensor device, even though the resident had been using the device and staff observed the sensor patch on the resident's left upper arm on multiple occasions. During interviews, LPNs stated that Resident #99 used a sensor device to check blood sugars, that the results appeared on the resident's phone, and that the patch was changed every 10 days. One LPN stated she did not see an order in the chart and later said it was a habit to give the resident the sensor without having a physician order. Pharmacy staff confirmed the sensor device had been filled repeatedly and said the order was written by Doctor #9. The DON stated the resident had received the sensor order from an outside physician and was not sure how nurses knew when to change the sensor because it was not on the MAR or physician orders. The Medical Director stated that if the resident was using a sensor device, it should be on the physician orders.
Hospice Services Not Included in Resident Care Plan
Penalty
Summary
The facility failed to ensure Resident #84’s written plan of care included the most recent hospice plan of care and a description of the services the LTC facility would provide to maintain the resident’s highest practicable physical, mental, and psychosocial well-being. Resident #84 was admitted with a diagnosis that included malignant melanoma of the skin, and a physician’s order dated 01/20/2025 directed hospice to evaluate and admit the resident. The record did not include information identifying the diagnosis for hospice admission or contact information for the hospice agency. The quarterly MDS with an ARD of 04/15/2026 showed the resident had a BIMS score of 07, indicating severe cognitive impairment, and also indicated the resident received hospice care while a resident. Review of the care plan last reviewed on 04/17/2026 showed no information about hospice services or hospice agency contact information. During interview, the MDS Coordinator stated the resident was receiving hospice services as of January 2025 and that hospice information should have been care planned, but it was missed. The DON stated staff were expected to review the care plan daily and that the MDS Coordinator was responsible for adding hospice information, and also stated the facility did not have a hospice care policy.
Failure to Provide Adequate Nail Care for Residents
Penalty
Summary
The facility failed to provide adequate personal hygiene care, specifically nail care, to two residents who were dependent on assistance for activities of daily living. Resident #83, who has severe cognitive impairment and multiple diagnoses including dementia and schizophrenia, was observed on two occasions with long, jagged nails and a dark brown substance underneath them. Similarly, Resident #87, also with severe cognitive impairment and diagnosed with Alzheimer's Disease and Vascular Dementia, was observed with a dark brown substance under and on top of their fingernails. These observations were made during a survey conducted in early January 2025. Interviews with CNAs revealed that the brown substance under the residents' nails could potentially be fecal matter, which poses a risk of spreading infections such as clostridium difficile. The facility's Nurse Consultant confirmed that there was no existing policy for nail care, indicating a systemic issue in maintaining personal hygiene standards for residents who are unable to care for themselves. This lack of policy and oversight contributed to the deficiency observed by the surveyors.
Deficiency in Wheelchair Maintenance and Resident Safety
Penalty
Summary
The facility failed to ensure that a resident's wheelchair was in good working condition, leading to potential harm. The resident, who was cognitively intact and used a wheelchair for mobility, reported that the wheelchair was digging into her legs and scraping her skin. Despite informing the staff about the issue, the resident had not received a replacement wheelchair. Observations revealed that a cap was missing from the frame of the wheelchair, causing it to press into the resident's leg. The resident had a history of type 2 diabetes, restless legs syndrome, and was on anticoagulant medication, which increased her risk for skin tears and bruising. Interviews with facility staff revealed inconsistencies in the inspection and maintenance of wheelchairs. The Administrator stated that wheelchairs are inspected every shift, but was unsure why a new wheelchair had not been ordered. The Lead CNA mentioned that wheelchairs are inspected nightly and on shower days, but was only informed about the issue the day before. The facility lacked a policy for wheelchairs or equipment, contributing to the oversight. A skin assessment conducted after the resident received a new wheelchair showed no damage to her skin.
Lack of Physician's Order for Oxygen Therapy
Penalty
Summary
The facility failed to ensure that a resident receiving oxygen therapy had a physician's order for the treatment. Resident #37, who had medical diagnoses including atrial flutter, opioid dependency, and diabetes, was observed receiving 2 liters of oxygen via nasal cannula. The facility's policy, revised in 2016, mandates that oxygen therapy should only be administered with a written order from a licensed physician. However, during an observation and subsequent interviews, it was discovered that there was no physician's order for the oxygen therapy being administered to Resident #37. On multiple occasions, the resident was observed with the oxygen concentrator set at 2 liters, but when asked, the LPN could not find any corresponding physician's order. The LPN mentioned that the resident was placed on oxygen following a chest X-ray but acknowledged the absence of a formal order. The facility administrator confirmed that oxygen therapy requires a physician's order as it is considered a medication, and the nursing staff is responsible for ensuring such orders are in place. The lack of an order meant that the oxygen therapy did not appear on the Medication Administration Record (MAR) for documentation.
Failure in Hand Hygiene and Food Storage Practices
Penalty
Summary
The facility failed to ensure proper hand hygiene and adherence to manufacturer specifications during food preparation and handling, as observed during two meals. Dietary staff were seen handling clean equipment and food without washing their hands after touching dirty objects. For instance, a dietary aide used a water hose to spray leftover food from dishes, contaminating his hands, and then handled clean equipment without washing his hands. Another dietary staff member handled cooked turkey and clean pans without washing her hands, and later contaminated gloves while preparing food. These actions were contrary to the facility's handwashing policy, which requires handwashing before starting work and after touching dirty items. Additionally, the facility did not follow manufacturer specifications for storing food items. An opened bottle of lemon juice, which should have been refrigerated according to the manufacturer's instructions, was found on a shelf above the food preparation counter. This lemon juice was used both for cleaning the grill and in recipes. The dietary manager and staff confirmed the use of the lemon juice but did not ensure it was stored correctly. These deficiencies highlight a lack of adherence to professional standards in food handling and storage, as outlined in the facility's policies.
Facility Fails to Maintain Safe and Clean Environment
Penalty
Summary
The facility failed to maintain a safe, functional, and comfortable environment for its residents, as evidenced by observations made during facility rounds. On two separate occasions, surveyors noted that privacy curtains in two rooms were stained with dark brown substances, with one curtain having dark brown lumps. Additionally, the furniture in these rooms was found to be damaged, with chairs exhibiting peeled vinyl and sharp, rough edges. These conditions were observed in rooms occupied by residents, potentially exposing them to unsanitary conditions and physical harm. Interviews with Certified Nursing Aides (CNAs) revealed concerns about the potential health risks associated with the stained curtains and damaged furniture. CNA #12 mentioned that the stains could be from a milkshake or fecal matter, which could pose a danger due to germs like Clostridium difficile (C-Diff) or hepatitis. CNA #10 echoed these concerns, suggesting that the stains could be feces and highlighting the risk of disease transmission. Both CNAs noted that the sharp edges of the damaged chairs could cause skin tears and harbor germs. The Nurse Consultant confirmed the absence of a policy on furniture replacement, indicating a lack of procedural guidance to address such issues.
Failure to Timely Transmit MDS Assessment Post-Discharge
Penalty
Summary
The facility failed to encode and transmit a Minimum Data Set (MDS) assessment for a resident following their discharge in a timely manner. The resident was discharged on September 13, 2024, but as of January 9, 2025, the MDS discharge assessment had not been completed or transmitted to the Centers for Medicare & Medicaid Services (CMS). This delay was confirmed by the MDS Coordinator, who acknowledged that the discharge information should have been entered within seven days of the resident's discharge. The assessment was overdue by 118 days at the time of the review.
Inaccurate MDS Coding for PASRR Level II
Penalty
Summary
The facility failed to ensure the Minimum Data Set (MDS) accurately reflected the preadmission screening and assessment resident record (PASRR) for a resident with a level II PASRR. The resident, diagnosed with paranoid schizophrenia, bipolar disorder, and diabetes, had an annual MDS assessment indicating a Brief Interview for Mental Status (BIMS) score of 14, suggesting cognitive intactness. However, section A1500 of the MDS incorrectly indicated that the resident did not have a level II PASRR. This discrepancy was noted despite the resident's care plan and historical forms confirming the level II PASRR status. The MDS Coordinator acknowledged the error, stating that the incorrect coding was due to a misinterpretation of the RAI manual, which guides the MDS coding process. The coordinator confirmed that the MDS is crucial for driving the resident's care plan and can impact reimbursement.
Failure to Care Plan Oxygen Therapy for Resident
Penalty
Summary
The facility failed to develop and implement a care plan for a resident who was receiving supplemental oxygen. The resident, who had diagnoses including atrial flutter, opioid dependency, and diabetes, was observed receiving two liters of oxygen. Despite this, there was no care plan in place addressing the oxygen therapy. A Licensed Practical Nurse (LPN) confirmed the absence of a care plan and acknowledged the importance of having one to guide staff on the appropriate oxygen level, the reason for its use, and necessary interventions. The deficiency was further highlighted during an interview with the facility's Administrator, who confirmed that oxygen therapy should be included in the care plan as it directs staff on resident care. The facility did not have a specific care plan policy but followed the Resident Assessment Instrument (RAI) manual. The MDS Coordinator noted that the lack of an order for oxygen led to the oversight in care planning, despite the oxygen therapy being documented on the Minimum Data Set (MDS).
Deficiency in Shower Room Sanitation
Penalty
Summary
The facility failed to maintain a clean and sanitary condition in two of the four shower rooms, as evidenced by the presence of black residue in the grout lines of the shower tiles on the floor and walls. This deficiency was observed by the surveyor and confirmed by interviews with residents and staff. The facility's policy required housekeeping to disinfect the shower rooms in the morning and at the end of the day, but the presence of black residue indicated a failure to adhere to these procedures. A resident with a diagnosis of osteoarthritis of the left hip, who required partial to moderate assistance with showering, confirmed the presence of dark, black areas in the grout on the floor tiles and the base of the shower. The resident used all the showers in the halls and required a shower chair due to their inability to stand. This resident's observations were consistent with the surveyor's findings of black residue in multiple shower stalls across different halls. Interviews with staff, including a CNA and housekeepers, revealed inconsistencies in the cleaning process. The CNA reported sanitizing the showers with soap and a purple spray solution, while the housekeepers described using a pink bathroom disinfectant and a floor cleaner with a dark blue label. Despite these efforts, the black residue persisted, suggesting that the cleaning procedures were either inadequate or not properly executed. The housekeeping supervisor confirmed that showers were cleansed twice daily with a disinfectant, but the presence of black residue indicated a lapse in maintaining the required sanitary conditions.
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Illustrative
What surveyors actually found near you
We read the 79 citations issued within 25 miles in the last 12 months — including the 2 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.
Illustrative
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Illustrative
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Nursing homes near North Little Rock
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lakewood Health And Rehab, Llc | 2.1 mi | ★★★★★ | 0 | 0 |
| The Blossoms At North Little Rock Rehab & Nursing | 2.7 mi | ★★★★★ | 1 | 0 |
| Arkansas State Veterans Home At North Little Rock | 2.7 mi | ★★★★★ | 0 | 0 |
| Premier At The Springs | 3.8 mi | ★★★★★ | 1 | 0 |
| Sherwood Nursing & Rehabilitation Center, Inc | 5.1 mi | ★★★★★ | 4 | 1 |
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