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Complaint Investigation

Arbor Lake Nursing & Rehabilitation, Llc

April 15, 2025 · Fort Worth, TX · 901 Pennsylvania Ave
Citations 1
CMS Rating 2/5
Beds 123
Provider ID 675034
Healthcare Facility
Arbor Lake Nursing & Rehabilitation, Llc
Fort Worth, TX  ·  View full profile →
Inspection Summary

Arbor Lake Nursing & Rehabilitation, LLC in Fort Worth, TX — inspection on April 15, 2025.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF689
Immediate a burn mark and blister from the incident. Few All residents have the potential to be affected. affected

Findings included:

Record review of Resident #1's MDS dated [DATE] reflected the resident was a [AGE] year-old male admitted to the facility 04/09/25.

His diagnoses included stroke, hemiplegia (paralysis of one side of the body), anoxic brain damage (when the brain is deprived of oxygen, leading to damage brain cells) and bell's palsy (a condition that causes temporary weakness or paralysis of the muscles on one side of the face). Resident #1 had a BIMS of 0 indicating his cognition was severely impaired.

The MDS further reflected the resident required substantial/maximal assistance (helper does more than half of the effort) for all ADLs.

Record review of Resident #1's care plan revised on 05/19/25 reflected the resident had an ADLs self-care performance deficit related to confusion, limited mobility, and anoxic brain damage.

Interventions included the resident would require assistance with ADLs.

Record review of Resident #1's progress notes dated 05/28/25 at 6:23 AM documented by RN A reflected the following:

Summoned by the nurse aide that there's ants in the resident bed, arrived at the resident room noted ants on the bed and on resident's gown, resident denies being in pain at this time.

Moved the resident to his recliner, head to toe assessment noted, no ant bites noted at this time, denies being in pain, no sign of discomfort noted, bath given and transferred temporarily to [Room], Management and RP notified, closely monitoring for any changes.

Further progress notes reflected the following:

- 05/28/25 at 8:18 AM - Resident noted to have ant bites to left shoulder and upper back, [Doctor] notified with order received to hydrocortisone cream each shift.

- 05/29/25 - Redness remains on shoulder and upper back, denies any pain or itching, No signs or symptoms of infection noted .

- 05/30/25 - Resident's area of possible bites from ants are fading, redness less, denies any itching at this time.

675034

Form Approved OMB

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.

Building 675034 B.

Wing 04/15/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Arbor Lake Nursing & Rehabilitation LLC 901 Pennsylvania Ave Fort Worth, TX 76104

Frequently Asked Questions

What is an F-tag violation?
F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
Were these violations corrected?
Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
How often do nursing home inspections happen?
CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
What should families do about these violations?
Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Fort Worth, TX, (5) Report new concerns to state authorities.
Where can I see the full inspection report?
Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Arbor Lake Nursing & Rehabilitation, LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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