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 Ruston Nursing And Rehabilitation Center, Llc during CMS and state inspections, most recent first.
A resident with Alzheimer’s disease, dementia, repeated falls, and severe cognitive impairment was care planned to receive total assistance with ADLs, including whirlpool baths three times weekly, shaving on bath days, and eating lunch and supper meals in the dining room. However, surveyors repeatedly observed the resident eating lunch in bed and having long, untrimmed facial hair. An LPN and the DON both confirmed that the resident’s facial hair needed trimming and that the resident was supposed to be bathed and shaved per the care plan and to eat meals in the dining room, confirming that the documented care plan interventions were not implemented.
A resident with dementia and a history of exit-seeking behaviors was able to leave the secured unit through an exterior door with a malfunctioning locking mechanism. The door did not have a functioning wander guard system and could be opened by pushing, allowing the resident to exit unsupervised and reach a nearby highway before being located and returned by staff. The resident's care plan documented the need for supervision and use of a wander guard, and staff interviews confirmed the door's security failure.
A resident with significant mobility and communication impairments, fully dependent on staff for ADLs, was left unsupervised during a bed bath when a CNA turned away to retrieve clothing, having removed a fall mat and used excessive lotion. The resident rolled over a bed bolster and fell, sustaining a head laceration, and was later found to have a right humerus and hip fracture as a result of the incident.
Surveyors found that several residents used wheelchairs or a scooter that were missing armrests or padding, had cracked parts, or had malfunctioning brakes. These issues were confirmed by staff, including an LPN and the DON, and affected residents with conditions such as dementia, Parkinson's, and diabetes. The lack of timely maintenance and repair of this essential equipment was observed over multiple days.
A resident with multiple chronic conditions, including atrial fibrillation, was prescribed Apixaban and identified as being at risk for abnormal bleeding. Although the care plan and physician orders required monitoring for bleeding or bruising, there was no documented evidence that such monitoring was performed or recorded, as confirmed by facility staff.
A resident with severe cognitive impairment and multiple medical conditions, who required substantial assistance with bathing and grooming, was repeatedly observed with poorly groomed and unshaven facial hair. Staff interviews confirmed that shaving should have been included in daily care, but this was not consistently performed.
Nursing staff did not maintain an active wound care order or document tracheostomy stoma care for a resident with severe cognitive impairment and multiple diagnoses. Although staff changed the stoma dressing daily, there was no documentation of the care provided, and the respiratory therapist confirmed the omission. This reflects a failure to ensure staff had the necessary competencies and skills for proper resident care.
A resident with multiple chronic conditions, who was cognitively intact, reported that the food provided was of poor taste, texture, and lacked variety or substitutions. A test tray meal was observed to be tough, overcooked, flavorless, and served cool, confirming the resident's complaints through direct observation and interview.
A resident with flaccid hemiplegia, right hand contracture, and moderate cognitive impairment did not receive required set-up assistance with meals, as staff failed to open food items and beverages or assist with chopping meat, despite care plan interventions. The resident was observed struggling to open items independently and reported that staff do not provide the necessary help, which was confirmed by staff interviews and direct observation.
A resident with multiple chronic conditions was found lying on a draw sheet without bed linen, a situation confirmed by both the resident and a CNA as a frequent issue, especially for those with bariatric beds. The resident had previously reported the problem to nursing staff, but no changes had been made.
A resident with moderate cognitive impairment and a history of falls was unable to self-release a wheelchair seatbelt that was documented as 'self-releasing.' The seatbelt was used as a fall intervention, but the resident could not unbuckle it when asked, and there was no documentation of restraint reduction attempts or reassessments. This resulted in the facility failing to identify and address the seatbelt as a restraint, as required by policy.
A resident with multiple diagnoses and moderate cognitive impairment was using a self-releasing alarming seatbelt as a fall intervention, per physician's orders. The care plan did not address the use of this device as a restraint, and there was no documentation of required quarterly reassessment for restraints, as confirmed by the DON.
The facility failed to protect residents from the misappropriation of their trust fund accounts, with unauthorized withdrawals and suspected forged signatures affecting 32 residents. Discrepancies were identified through a review of trust fund receipt books, revealing irregularities such as forged signatures, unauthorized withdrawals, and altered receipt amounts. This indicates a systemic issue within the facility's management of resident trust funds.
A resident discovered a $490 discrepancy in his trust fund account and reported it to the administrator, suspecting misappropriation. The facility failed to report the suspicion of a crime to law enforcement within the required 24-hour period, instead notifying authorities only after completing an internal investigation, which was not in compliance with section 1150B of the Act.
Failure to Implement Person-Centered Care Plan Interventions
Penalty
Summary
The deficiency involves the facility’s failure to implement a comprehensive, person-centered care plan for a resident with Alzheimer’s disease, dementia with mood disturbance, repeated falls, hypothyroidism, and hyperlipidemia. The resident’s Quarterly MDS showed a BIMS score of 7, indicating severe cognitive impairment, and documented a need for substantial/maximal assistance with showering/bathing and personal hygiene. The resident’s care plan identified an actual fall with minor injury related to poor balance and included an intervention for the resident to eat lunch and supper meals in the dining room. The ADL care plan documented that the resident required total care with all ADLs, including bathing, and specified that the resident was to receive a bed bath on Monday, Wednesday, and Friday, as needed, and be shaved on bath days. Despite these documented interventions, surveyor observations on multiple dates showed the resident in bed eating lunch rather than in the dining room, and with long facial hair that had not been shaved or trimmed. An LPN reported that the resident had received a whirlpool bath the previous day, and during a joint observation with the surveyor, confirmed that the resident’s facial hair needed trimming. The DON also confirmed, during observation and care plan review, that the resident was care planned to receive a whirlpool bath three times per week, be shaved on bath days, and eat lunch in the dining room, and acknowledged that these care plan interventions were not being implemented for this resident.
Failure to Maintain Secured Unit Door Results in Resident Elopement
Penalty
Summary
The facility failed to maintain the door locking mechanism on an exterior door in the secured unit, which resulted in a resident with a known history of dementia, behavioral disturbances, and high elopement risk being able to exit the building unsupervised. The resident had a documented pattern of exit-seeking behaviors and had previously followed staff out of the secured unit on multiple occasions. Despite these behaviors and the resident's care plan indicating the use of a wander guard and the need for supervision, the door in question did not have a functioning wander guard locking mechanism and could be opened by pushing on it, as confirmed by staff interviews and direct observation. On the day of the incident, the resident was able to push open the door, which did not sound an alarm or prevent exit, and left the facility grounds. Staff members did not immediately realize the resident had left, and the resident was only discovered missing after being seen outside by a staff member returning from an appointment. The resident was ultimately found on a nearby highway, out of sight from the facility, and was returned by a staff member who located him in her car. Interviews with staff confirmed that the door's magnetic locking mechanism was loose and not functioning properly at the time of the incident. The resident involved had a history of psychiatric symptoms, including hallucinations, delusions, and agitation, and had been assessed as a high risk for elopement. Documentation showed repeated incidents of exit-seeking and confusion, with multiple notations in the medical record of the resident attempting to leave or expressing intent to do so. The failure to ensure the security of the door and to provide adequate supervision directly contributed to the resident's ability to elope from the secured unit.
Resident Fall Due to Inadequate Supervision During Bed Bath
Penalty
Summary
A deficiency occurred when a resident, who was dependent on staff for all activities of daily living due to conditions including functional quadriplegia, aphasia, and impaired mobility, was not provided adequate supervision during a bed bath. The resident's care plan required one-person assistance for bathing, bed bolsters, and fall mats on both sides of the bed due to a high risk for falls. Despite these interventions, the assigned CNA removed the fall mat from the left side of the bed and raised the bed to provide care. After completing the bed bath, the CNA turned away from the resident to retrieve clothing from the closet, leaving the resident unsupervised and unsecured in bed. While the CNA was turned away, the resident rolled over the bed bolster and fell from the left side of the bed onto the floor, resulting in a laceration to the forehead. The resident was not moved until EMS arrived and was subsequently transferred to the emergency room for treatment of the head injury. The resident returned to the facility with staples in place for the laceration. Several days later, after the responsible party noticed swelling and discoloration in the resident's right leg and foot, the resident was sent to the hospital again and diagnosed with a right humerus fracture and a right hip fracture, both attributed to the fall. Interviews and documentation confirmed that the CNA acknowledged turning away from the resident during care and admitted to using excessive lotion, which made the resident slippery. The CNA also recognized that all necessary items should have been within reach before starting the bed bath and that the resident should not have been left unsupervised. Staff interviews and record reviews further corroborated that the required fall prevention measures were not maintained at the time of the incident, directly leading to the resident's fall and subsequent injuries.
Failure to Maintain Safe and Functional Wheelchairs and Mobility Equipment
Penalty
Summary
The facility failed to maintain mechanical, electrical, and patient care equipment in safe operating condition, specifically regarding wheelchairs and a scooter used by five residents. Observations revealed that several wheelchairs were missing armrests or armrest padding, had cracked armrests, or had malfunctioning brakes. For example, one resident's wheelchair was missing the right armrest, another had both armrests missing, and a third had a cracked armrest. Additionally, one resident reported that the wheelchair brakes did not work properly, which was confirmed by demonstration. Another resident's electric scooter had a torn seat cushion. These deficiencies were confirmed through multiple observations by surveyors and interviews with facility staff, including LPNs and the DON. The residents affected had various medical conditions, including Parkinson's disease, Alzheimer's disease, dementia, quadriplegia, hemiplegia, end stage renal disease, and diabetes. Some residents were cognitively intact, while others were cognitively impaired, and their levels of assistance required for activities of daily living varied. The deficiencies were identified over several days through direct observation and staff confirmation, indicating a lack of timely maintenance and repair of essential mobility equipment for these residents.
Failure to Monitor for Bleeding in Resident on Anticoagulant
Penalty
Summary
A deficiency was identified when the facility failed to ensure that a resident's medication regimen was free from unnecessary drugs by not monitoring for active bleeding or bruising in a resident receiving an anticoagulant. The resident had diagnoses including chronic kidney disease, chronic diastolic congestive heart failure, and atrial fibrillation, and was prescribed Apixaban (Eliquis) for atrial fibrillation. The care plan specifically identified the resident as being at risk for abnormal bleeding and/or bruising due to anticoagulant use, with interventions requiring monitoring for signs of active or internal bleeding and prompt physician notification if such symptoms were observed. Despite these documented orders and care plan interventions, a review of the resident's medical record revealed no evidence that monitoring for active bleeding, bruising, or symptoms of internal bleeding was performed or documented. This lack of documentation was confirmed during an interview with the facility's clinical operations/regional support staff, who acknowledged the absence of monitoring records for the resident in question.
Failure to Provide Necessary ADL Assistance for Personal Hygiene
Penalty
Summary
A deficiency was identified when a resident with severe cognitive impairment and multiple medical conditions, including unspecified psychosis, end stage renal disease, right hand contracture, type 2 diabetes mellitus, and dependence on renal dialysis, did not receive necessary assistance with activities of daily living (ADL) to maintain good personal hygiene. The resident was documented as requiring substantial to maximal assistance with bathing and grooming, as indicated in the quarterly Minimum Data Set (MDS) assessment. Despite this, repeated observations over several days showed that the resident's facial hair was poorly groomed and unshaven while seated in a wheelchair at the nurses station and while lying in bed. Interviews with facility staff, including an LPN and a CNA, confirmed that the resident was supposed to receive a bed bath daily, which included shaving, and that the resident should have been shaved during the night shift bath. However, the observations indicated that this aspect of care was not consistently provided, resulting in the resident not being neatly groomed or shaved as required.
Failure to Ensure Competent Tracheostomy Stoma Care and Documentation
Penalty
Summary
Nursing staff failed to ensure appropriate competencies and skills in caring for a resident with a tracheostomy stoma. The resident, who had a history of depression, schizoaffective disorder, diabetes, chronic cough, and an old tracheostomy, was admitted with severe cognitive impairment. The care plan indicated that the neck stoma dressing should be changed per treatment order. However, review of the resident's physician orders revealed there was no active wound care order for the tracheostomy stoma, and the order had been removed from the active orders and electronic treatment administration record in late February. Despite the absence of an active order, observations showed the resident had a dressing over the anterior throat, and interviews confirmed that staff were changing the stoma dressing daily. There was no documentation in the electronic medical record of the tracheostomy stoma care being performed. The respiratory therapist acknowledged providing the care but confirmed that she failed to document the treatments. This lack of orders and documentation demonstrated a failure to ensure staff had the necessary competencies and skills to meet the resident's needs.
Unpalatable Food and Inadequate Serving Temperature
Penalty
Summary
The facility failed to ensure that food was palatable and served at an appetizing temperature. A cognitively intact resident with multiple medical diagnoses, including type 2 diabetes, cerebral vascular disease, and chronic obstructive pulmonary disease, reported that the food was terrible, citing poor taste, texture, and lack of choices or substitutions. A test tray was requested and observed to leave the kitchen at 12:02 p.m. and was served at 12:23 p.m. The meal consisted of BBQ pork loin, beans, vegetable medley, corn bread, and cake. The pork loin was found to be tough, and the vegetable medley was overcooked, mushy, lacked flavor or seasoning, and the food was cool to taste. These findings were based on direct observation, record review, and resident interview.
Failure to Provide Meal Set-Up Assistance for Resident with Mobility and Cognitive Impairment
Penalty
Summary
A deficiency was identified when staff failed to provide necessary set-up assistance with meals for a resident with flaccid hemiplegia, right hand contracture, and moderate cognitive impairment. The resident's care plan, based on occupational therapy recommendations, required staff to assist with meal tray set-up, including opening seasoning packets and beverages. Observations revealed that a CNA delivered the resident's lunch tray but did not provide the required set-up assistance, leaving items unopened. The resident was seen repositioning the tray and opening a pepper packet with his teeth, and he reported that staff do not help him open items or chop his meat, which he finds difficult. Further observation during breakfast showed that the resident's milk carton and other fluids remained unopened after he had consumed part of his meal. When notified, an LPN confirmed that while the resident feeds himself, staff are supposed to open his drinks. The deficiency was reported to the facility's executive director, as the staff did not follow the care plan interventions for meal set-up assistance, resulting in the resident not receiving reasonable accommodation for his needs.
Failure to Provide Bed Linen for Resident
Penalty
Summary
A deficiency was identified when a resident with diagnoses of type 2 diabetes, cerebral vascular disease, and chronic obstructive pulmonary disease was observed lying on a draw sheet without bed linen on their bed. The resident, who was cognitively intact and required two-person physical assistance for bed mobility, transfers, and toilet use, reported that the lack of bed linen was a frequent problem and that previous reports to nursing staff had not resulted in any change. A certified nursing assistant confirmed that the absence of bed linen was a recurring issue, particularly for residents using bariatric beds. The executive director was notified of the situation after the observation.
Failure to Identify and Address Wheelchair Seatbelt as a Restraint
Penalty
Summary
The facility failed to ensure that a resident was free from the use of physical restraints, as required by policy and regulation. Specifically, a resident with moderate cognitive impairment and a history of falls was observed using a wheelchair seatbelt that was documented as 'self-releasing.' However, during an observation with the Director of Nursing Services (DNS), the resident was unable to unbuckle the seatbelt when asked, and stated he could not complete the task. The seatbelt was being used as a fall intervention, and the resident's medical record included diagnoses such as chronic obstructive pulmonary disease, osteoporosis, and schizoaffective disorder. Despite the facility's policy stating that only seatbelts which can be easily unfastened by the resident are not considered restraints, there was no documentation of restraint reduction attempts or reassessments for this resident. The lack of documentation and the resident's inability to self-release the seatbelt resulted in the facility failing to identify and address the seatbelt as a restraint, contrary to their own policy and regulatory requirements.
Failure to Revise Care Plan for Resident Using Restraint
Penalty
Summary
The facility failed to ensure that the care plan was revised for a resident who was using a restraint. According to the facility's Restraint Evaluation and Restraint Reduction Policy, all residents using a restraint are to be evaluated and re-evaluated approximately every quarter, and care plan updates should occur quarterly or when there is a change in goals or approaches. For one resident with diagnoses including chronic obstructive pulmonary disease, history of falling, osteoporosis, and nicotine dependence, the quarterly Minimum Data Set (MDS) assessment indicated moderate cognitive impairment and the use of a chair alarm, but did not document the use of a wheelchair seatbelt. Physician's orders specified the use of a self-releasing alarming seatbelt for this resident due to unawareness of physical limitations and a diagnosis of schizoaffective disorder. However, the current plan of care only addressed the seatbelt as a fall intervention and did not address its use as a restraint. The Director of Nursing Services confirmed that there was no supporting documentation available regarding reassessment for restraints for this resident.
Misappropriation of Resident Trust Funds
Penalty
Summary
The facility failed to protect residents from the misappropriation of their property, specifically their trust fund accounts. The investigation revealed discrepancies in the trust fund accounts of 32 residents, with unauthorized withdrawals and suspected forged signatures. The facility's policy required that all disbursements from the trust fund be authorized by the resident or their designated representative, and that transactions be documented with signatures. However, the review of records showed multiple instances where these procedures were not followed, leading to significant financial discrepancies. Several residents, including those with cognitive impairments, were affected by these unauthorized transactions. For example, one resident discovered a $490 shortfall in their account, while another resident's account was missing $972. Interviews with residents and the Regional Financial Consultant confirmed that many of the signatures on the trust fund receipts were forged, and in some cases, the amounts on the receipts were altered. This indicates a systemic issue within the facility's management of resident trust funds, as the discrepancies were widespread and involved significant sums of money. The facility's failure to adhere to its own policies and procedures regarding the management of resident trust funds resulted in financial losses for the residents. The discrepancies were identified through a review of the trust fund receipt books, which showed irregularities such as forged signatures, unauthorized withdrawals, and altered receipt amounts. These findings highlight a lack of oversight and control in the facility's financial management practices, leading to the misappropriation of resident funds.
Failure to Timely Report Misappropriation of Resident Funds
Penalty
Summary
The facility failed to develop and implement policies and procedures for reporting a reasonable suspicion of a crime in accordance with section 1150B of the Act. This deficiency was identified during a review of a case involving a resident who reported a discrepancy in his trust fund account. The resident, who was cognitively intact, discovered that his account was $490 short and suspected that someone had taken his money. He reported this to the administrator the following day. However, the facility did not report the allegations to a law enforcement entity within the required 24-hour timeframe. The facility's abuse prevention policy, last revised in August 2017, required reporting the results of all investigations to the administrator and other officials within five working days, but did not ensure compliance with the 24-hour reporting requirement to law enforcement. The administrator was informed of the alleged misappropriation on 05/31/2024 but only notified the Attorney General's office and the local sheriff's department on 06/13/2024 and 06/14/2024, respectively, after completing an internal investigation. This delay in reporting to law enforcement entities constituted a failure to adhere to the mandated reporting requirements.
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Illustrative
What surveyors actually found near you
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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 Ruston
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Princeton Place-ruston | 4.2 mi | ★★★★★ | 6 | 0 |
| Alpine Skilled Nursing And Rehabilitation | 14.9 mi | ★★★★★ | 6 | 0 |
| Arbor Lake Skilled Nursing & Rehabilitation | 19.2 mi | ★★★★★ | 9 | 0 |
| Bernice Nursing And Rehabilitation Center, Llc | 19.6 mi | ★★★★★ | 3 | 0 |
| Farmerville Nursing And Rehabilitation Center, Llc | 19.7 mi | ★★★★★ | 0 | 0 |
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