Below average — CMS composite of the measures below.
The next survey window likely opens around March 2027
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 The Blossoms At Breckenridge Rehab & Nursing Cente during CMS and state inspections, most recent first.
Unsanitary Covered Bathtubs in Resident Bathrooms: A facility failed to maintain a clean, safe, and homelike environment when shared bathroom tubs were left covered with unsecured wood while the tubs underneath remained dirty and unsanitary. Staff found one tub with brown staining and cracked residue and another with wooden blocks and black matter described as rodent droppings. Housekeeping, the Housekeeping Supervisor, the Housekeeping Regional Manager, the DON, and the Administrator all acknowledged the conditions were not acceptable, and housekeeping reported the tubs under the covers had not been cleaned.
A resident with moderate cognitive impairment and a history of wandering, assessed as high risk for elopement, was inadequately supervised and left the secure unit. The resident was later found by bystanders off facility grounds, confused and with minor injuries, after staff were unable to locate them during routine rounds. Documentation and interviews indicated the resident likely exited through a door that did not close completely or by following someone out, and there was a delay in notifying the physician and administration.
Two residents in an LTC facility were subjected to abuse by staff members. One resident, with significant cognitive impairment, was physically assaulted by an LPN, resulting in a scalp hematoma and unresponsiveness. Another resident was struck by a CNA while being assisted to the bathroom. Both incidents highlight the facility's failure to protect residents from abuse and ensure their safety.
A facility failed to report an alleged abuse incident involving a resident with severe cognitive impairment to the state agency within the required timeframe. A CNA was found to have 'popped' the resident on the buttocks, leading to immediate suspension and an investigation. Despite the facility's policy requiring prompt reporting, the notification was delayed by more than 24 hours, resulting in a deficiency.
A facility failed to include a comprehensive care plan for a resident with PTSD, despite the resident's severe impairment and need for assistance with daily activities. The care plan did not address the PTSD diagnosis, and staff interviews revealed a lack of clarity in ensuring all active diagnoses were included. The facility's policy required care plans to be current and informative, but this was not achieved for the resident.
The facility failed to maintain proper food storage and cleanliness standards, with uncovered and undated food items, unsanitary kitchen conditions, and improper hand hygiene practices by dietary staff. Observations included contaminated gloves during food preparation, dirty air vents, and an ice machine with residue, indicating non-compliance with professional standards.
The facility's assessment was incomplete, missing key personnel involvement and lacking a comprehensive staffing plan. The assessment did not include signatures from the medical director, DON, and direct care staff, nor did it account for all personnel resources and their competencies. The Administrator, completing the assessment for the first time, did not consult the medical director.
A facility failed to store a resident's acid reducer liquid medication in the refrigerator as required. The medication, intended for administration via a PEG tube, was found in a medication cart instead of being refrigerated, despite instructions to do so. A surveyor and an RN confirmed the improper storage during a review.
The facility did not serve meals according to the planned menu, resulting in residents on pureed diets receiving only half the required portion of pureed chili. A dietary staff member used a #8 scoop (1/2 cup) instead of the required two scoops (1 cup) and admitted to not checking the menu.
Unsanitary Covered Bathtubs in Resident Bathrooms
Penalty
Summary
The facility failed to maintain a safe, clean, comfortable, and homelike environment for three residents by allowing bathtubs in shared bathrooms to remain covered with unsecured wooden boards or blocks while the tubs underneath were dirty and not properly maintained. Resident #1 and Resident #16 shared a bathroom with a bathtub covered by an unsecured quarter-inch plywood board. When the board was removed, the tub had orangish-brown stains across the floor and flaky, cracked areas, especially beneath the water spout. The Maintenance Director stated the board had been placed over the tub because of a prior blockage that caused gray water lines to back up into the bathtub, and he acknowledged the board did not make the resident area feel homelike and could be a source of infection. Resident #37’s bathroom tub contained four wooden blocks and numerous black oval-shaped pieces of matter in the tub. Housekeeping staff described the tub as filthy, unsanitary, and not homelike, and stated it had black material in it that looked like rat feces. The Housekeeping Supervisor also described the tub as terribly filthy and confirmed the condition was unacceptable and unsanitary. The Housekeeping Regional Manager stated the tub looked like rodent droppings, the cover was not attached to the tub, and the condition was not acceptable. Staff interviews showed that housekeeping was responsible for cleaning the bathtubs, but housekeeping staff reported they had not cleaned the tubs under the wooden covers and had not received instructions about the covers. The DON stated she had seen the wooden covers on the bathtubs but had not looked inside them and believed they were bolted down. The Administrator stated he was unaware of the wooden covers until that week and described the tubs as dirty and not acceptable for resident living areas. Review of grievance logs from September 2025 through February 2026 revealed no reported bathtub issues.
Failure to Prevent Elopement of High-Risk Resident from Secure Unit
Penalty
Summary
A deficiency occurred when a resident with moderate cognitive impairment and multiple psychiatric and neurological diagnoses, including non-Alzheimer's dementia, psychotic disorder, schizophrenia, and Parkinsonism, was not adequately supervised and eloped from a secure unit. The resident had a documented history of wandering and was assessed as high risk for elopement, with care plan interventions specifying placement on a secure neighborhood and a goal of no elopement episodes. However, the care plan form did not delineate specific interventions, and the resident was observed wandering the halls, expressing a desire to leave, and was later found missing from the unit. Staff were unable to locate the resident during routine rounds, and a search of the unit and facility grounds was initiated. The resident was eventually found by bystanders nearly a mile from the facility, appearing confused and lying in the grass, and was attended by EMS, police, and fire department personnel. The LPN retrieved the resident from EMS care and returned them to the facility, noting minor injuries such as skin tears to both hands and an elevated temperature due to the hot weather. The resident's physician was notified of the incident after the resident's return. Interviews and documentation revealed that the resident likely exited the secure unit through a door that did not close completely or by following another person out, as the resident did not have the capacity to use the keypad code. The facility's disaster plan for elopement was not fully implemented at the time of the incident, and there was a delay in notifying the physician and administration. The lack of specific care plan interventions and inadequate supervision contributed to the resident's ability to leave the secure unit and the facility grounds.
Failure to Protect Residents from Abuse
Penalty
Summary
The facility failed to protect two residents from abuse, resulting in a deficiency related to the residents' right to be free from abuse. One resident, identified as Resident #5, experienced both emotional and physical abuse at the hands of an LPN. The incident began when the LPN was observed making loud and aggressive statements towards the resident. Shortly thereafter, the LPN was seen wheeling the resident out of their room with a blood-soaked towel held to the resident's face. The resident was later found unresponsive, with a scalp hematoma and dried blood in their mouth and nose, leading to a diagnosis of physical assault. The resident had a history of significant cognitive impairment and was known to have poor safety awareness, with a potential for physical aggression due to dementia and schizoaffective disorder. Despite these known conditions, the resident's care plan did not address their diagnosis of post-traumatic stress disorder. The facility's failure to adequately address the resident's mental health needs and ensure a safe environment contributed to the incident of abuse. Another resident, identified as Resident #3, was also subjected to abuse by a CNA. The CNA was reported to have struck the resident on the buttocks multiple times while trying to get them to go to the bathroom. This incident was witnessed by an LPN who heard the resident's cries of pain. The resident, who also had significant cognitive impairment, confirmed the abuse during an interview. The facility's inability to prevent these incidents of abuse highlights a significant deficiency in ensuring the safety and well-being of its residents.
Removal Plan
- Licensed Practical Nurse (LPN) #3 was suspended via phone pending further investigation of alleged abuse.
- Licensed Practical Nurse was terminated via phone and did not return to work.
- Resident #5 was transferred to emergency room (ER) upon assessment from Night Nurse and Director of Nursing.
- In-service/Education started for all staff on Abuse to prevent serious harm, serious injury, serious impairment or death. If education is not provided via phone or in person, staff will be educated on Abuse Policy and Procedures prior to the start of their shift by In-service and education on Abuse Policy and Procedure, the types of abuse and when to report. Follow up is completed by verifying employee signatures to in-service document and compare to Employee Roster, as well as staff interviews.
- All 21 residents on 400 hall secured unit were assessed by the night nurse, due to alleged abuse with no negative findings, and was verified with follow up by the Director of Nursing/Chief Nursing Officer. The night nurse and two 3/11 shift Certified Nursing Assistants (CNA's) were verified no other residents witnessed the incident.
- Director of Nursing/Designee will begin assessing other 64 residents per census roster for needs of mental health services with follow up from Psychosocial Services.
- Body Audits on remaining 20 residents on 400 hall secured unit completed by treatment nurse with no negative findings. Treatment Nurse/Designee will complete other 64 residents body audits per census roster.
Failure to Timely Report Alleged Abuse Incident
Penalty
Summary
The facility failed to report an alleged abuse incident involving a resident to the proper state agency within the required time frame. The incident involved a resident with a diagnosis of schizoaffective disorder and severe cognitive impairment, as indicated by a Brief Interview for Mental Status (BIMS) score of 07. On the morning of the incident, a nurse heard a noise that sounded like a slap and upon investigation, found a CNA had 'popped' the resident on the buttocks with the back of her hand to encourage the resident to go to the bathroom. The CNA was immediately suspended, and an investigation was initiated. The facility's policy required that such incidents be reported to the mandated state agency within two hours if they involved abuse. However, the notification was sent more than 24 hours after the incident occurred. The Administrator confirmed awareness of the incident on the day it happened and acknowledged the delay in reporting. Despite the immediate suspension of the CNA and the completion of a body audit and assessment of the resident, the facility did not meet the required reporting timeframe, resulting in a deficiency.
Failure to Address PTSD in Resident Care Plan
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident diagnosed with post-traumatic stress disorder (PTSD), among other conditions. The resident, who also had schizoaffective disorder bipolar type, nightmare disorder, and type 2 diabetes mellitus, was assessed as severely impaired on the Brief Interview for Mental Status (BIMS) and required moderate to substantial assistance with daily activities. Despite these needs, the care plan initiated did not address the resident's PTSD diagnosis, which is a significant oversight given the potential impact on the resident's mental health and behavior. Interviews with facility staff, including an LPN and the Director of Nursing, revealed a lack of clarity and responsibility in ensuring that the care plan addressed all of the resident's active diagnoses. The LPN responsible for completing care plans was unaware of the need to include interventions for PTSD, and the Director of Nursing indicated that active diagnoses should be identified within the care plan itself. The facility's policy stated that care plans should be current and inform staff of residents' needs, strengths, goals, and approaches, yet this was not reflected in the care plan for the resident in question.
Deficiencies in Food Storage, Sanitation, and Hand Hygiene
Penalty
Summary
The facility failed to maintain proper food storage and cleanliness standards in the kitchen and storage areas. Observations revealed that opened food items such as salt, mashed potatoes, and grits were not covered or dated, and opened gallons of barbeque and stir fry sauces were not refrigerated as per manufacturer specifications. Additionally, the kitchen environment was not maintained in a sanitary condition, with grease stains on equipment, food crumbs on the floor, and missing or damaged ceiling tiles and door frames. Dietary staff did not adhere to proper hand hygiene practices, as observed during meal preparations. Staff members were seen contaminating gloves and handling food without washing their hands after touching dirty objects. This occurred during the preparation of desserts, salads, and other food items, indicating a lack of compliance with the facility's hand hygiene policy, which requires handwashing before food preparation and handling. The facility also failed to maintain equipment in a clean and sanitary condition. One of the ice machines had a wet black residue on the panel, which was easily transferred to a paper towel, indicating it was not cleaned regularly. Air vents in the dishwashing room were stained and dirty, and the maintenance schedule for cleaning the ice machine was not sufficient to ensure cleanliness. These deficiencies highlight a lack of adherence to professional standards for food storage, preparation, and sanitation.
Incomplete Facility Assessment Lacks Key Information
Penalty
Summary
The facility failed to ensure that its facility-wide assessment included all necessary information to allocate resources and meet the needs of its residents. The assessment, completed on 05/15/2024, lacked the involvement of key personnel such as the medical director, director of nursing, and direct care staff, as their signatures were missing on the review page dated 08/22/2024. Additionally, the assessment did not include a staffing plan addressing the needs for each resident unit and shift, nor did it account for all personnel resources, including management, direct care staff, volunteers, and contracted employees, along with their education and competencies. During an interview on 11/21/2024, the Administrator, who completed the assessment for the first time, admitted to not consulting the medical director. The Administrator stated that the purpose of the assessment was to ensure overall quality of care for the residents. The facility's policy and procedure for the assessment, which was undated, indicated that the assessment's intent was to evaluate the resident population and identify necessary resources for providing person-centered care.
Improper Storage of Refrigerated Medication
Penalty
Summary
The facility failed to properly store a bottle of acid reducer liquid medication for a resident, as observed during a survey. The medication, which was intended for administration via a percutaneous endoscopic gastrotomy (PEG) tube, was found in the 100-hall medication cart instead of being refrigerated as per the pharmacy instructions. The bottle had a blue sticker indicating it should be refrigerated, but it was not cold and lacked condensation, suggesting it had not been stored correctly. The deficiency was identified during a review of the medication cart by a surveyor and a registered nurse (RN). The RN confirmed that the medication was administered to the resident around 6:00 AM each morning and acknowledged that the medication should have been refrigerated. The facility's Medication Storage Policy and Procedure, provided by the Director of Nursing, outlined the requirement for proper medication storage according to CMS guidelines, but the policy was not dated.
Failure to Serve Meals According to Planned Menu
Penalty
Summary
The facility failed to ensure that meals were prepared and served according to the planned, written menu, which is necessary to provide nutritionally balanced meals for residents. On November 19, 2024, during the supper meal, residents on pureed diets were supposed to receive two #8 scoops (1 cup) of pureed chili. However, a dietary staff member used a #8 scoop (1/2 cup) to serve a single portion of pureed chili to all residents on pureed diets, instead of the required two scoops. During an interview, the dietary staff member confirmed that he used the gray scoop (#8), equivalent to 1/2 cup, and admitted that he had not looked at the menu before serving.
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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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Nursing homes near Little Rock
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Presbyterian Village, Inc | 0.2 mi | ★★★★★ | 0 | 0 |
| The Blossoms At Woodland Hills Rehab & Nursing Cen | 1.2 mi | ★★★★★ | 2 | 1 |
| The Green House Cottages Of Poplar Grove | 1.4 mi | ★★★★★ | 0 | 0 |
| Briarwood Nursing And Rehabilitation Center,inc | 1.6 mi | ★★★★★ | 0 | 0 |
| The Springs Of Barrow | 2 mi | ★★★★★ | 4 | 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.