Choctaw Nursing and Rehabilitation Center

Inspectors wroteBased on observations, interviews, and facility policy review, the facility failed to maintain the kitchen in a sanitary condition in order to serve and prepare food for one (1) of two (2) kitchen tours. Findings Include: Review of the facility policy titled Sanitary Conditions of the Food Service Department with an originated date of 9/04, revealed the following policy statement, Facilities and equipment used in the preparation and serving of food provided to residents are safe and sanitary. During the initial kitchen tour on 6/28/2026 at 2:20 PM with Dietary #1, Dietary #2, and Dietary #3, observations were made regarding the cleanliness of the kitchen environment. The pantry door frame facing the kitchen contained accumulated dirt and dried food residue. [...]

Inspectors wroteBased on interview and record review, the facility failed to accurately complete Section P of the Minimum Data Set (MDS) assessment related to alarms for one (1) of 19 residents reviewed for MDS accuracy. Resident #9Findings Include:The facility provided a statement on letterhead that read, We do not have a policy concerning accuracy of MDS. We do however follow the guidance of the MDS RAI (Resident Assessment Instrument) manual. Record review of Resident #9's Physician Order revealed an order dated 7/18/25, Ensure chair alarm is turned on and functioning properly. Record review of Resident #9's MDS with an Assessment Reference Date (ARD) of 5/19/26 revealed Item P0200 did not identify the resident's use of a wheelchair alarm during the assessment reference period. [...]

Inspectors wroteBased on observations, resident and staff interviews, record review, and facility policy review, the facility failed to develop and implement comprehensive, person-centered care plans for two (2) of nineteen (19) residents reviewed for care planning. The facility failed to develop a comprehensive care plan addressing urinary catheter care for one (1) resident (Resident #1) and failed to implement the established care plan related to diabetic nail care for one (1) resident (Resident #15).

Inspectors wroteBased on observations, resident and staff interviews, record reviews, and facility policy review, the facility failed to provide activities of daily living (ADL) care necessary to maintain personal hygiene for one (1) of 56 residents observed. (Resident #15)

Inspectors wroteBased on observation, resident and staff interview, record review, and facility policy review, the facility failed to periodically reassess a resident's wheelchair alarm to determine whether it remained necessary and appropriate based on the resident's current assessed needs for one (1) of three (3) residents reviewed for falls. Resident #9Findings Include:Review of the facility policy titled Accidents and Supervision revealed under, Policy: The resident environment will remain as free of accident hazards as is possible. Each resident will receive adequate supervision and assistive devices to prevent accidents. This includes: 3. Implementing interventions to reduce hazard(s) and risk(s). 4. Monitoring for effectiveness and modifying interventions when necessary .Review of the facility policy titled Resident Alarms revealed under, Policy: [...]

Inspectors wroteBased on observation, staff interviews, record review, and facility policy review, the facility failed to ensure staff used proper technique with catheter care to prevent a Urinary Tract Infection (UTI) for one (1) of two (2) residents with catheters. (Resident #1)

Inspectors wroteBased on observation, interview, record review, and facility policy review the facility failed to ensure a self-administered medication was securely stored resulting in the medication being accessible to unauthorized individuals for 1 (one) of 56 residents reviewed. Resident #49 Findings Include: Review of the facility policy Medication Storage revealed, It is the policy of this facility to ensure all medications housed on our premises will be stored in the pharmacy and/or medication rooms according to the manufacturer's recommendations and sufficient to ensure proper sanitation, light, ventilation, moisture control, segregation, and security . An observation on 06/28/26 at 3:03 PM revealed Resident #49 sitting on his bed with oxygen in use and there was an Albuterol Inhaler on top of his bedside table. [...]

Inspectors wroteBased on observation, staff interviews, record review, and facility policy review, the facility failed to ensure staff performed appropriate hand hygiene and changed gloves between a contaminated task and a clean resident care task to help prevent the spread of infection during one (1) of four (4) resident care observations (Resident #1).

Inspectors wroteBased on record review, staff interview, and facility policy review, the facility failed to ensure pneumococcal immunizations were administered in accordance with physician oversight, facility policy, and current CDC recommendations for one (1) of five (5) residents reviewed for immunizations (Resident #42). Specifically, after the resident representative consented to pneumococcal vaccination, the facility failed to notify the physician when the electronic medical record generated a contraindication alert related to long-term steroid therapy. Instead, the vaccine was incorrectly documented as refused without physician evaluation to determine whether administration was appropriate. [...]

Inspectors wroteBased on interviews, record reviews, policy and procedure reviews, the facility failed to follow the Activity of Daily Living (ADL) care plan for Resident #1's bed mobility, which resulted in a fall with multiple fractures for Resident #1. Resident #1 was one (1) of three (3) Residents reviewed for care plans. The facility policy and procedure dated 2/18/22 and revised date of 1/5/25 titled Comprehensive Care Plans stated: It is the policy of this facility to develop and implement a comprehensive person-centered care plan for each resident, consistent with residents rights, that includes measurable objectives and timeframes to meet a resident's medical, nursing, and mental and psychosocial needs and ALL services that are identified in the resident's comprehensive assessment and meet professional standards of quality. [...]

Inspectors wroteBased on policy and procedure reviews, interviews, observations, and record reviews, the facility failed to ensure safety and to prevent an accident of a fall during bed mobility, resulting in multiple fractures to Resident #1. Resident #1 was one (1) of three (3) residents reviewed for accidents and safety. Findings Include: The facility policy and procedure titled Safe Resident Handling/Transfers dated 1/1/22 revised 1/5/25 and signed by the facility Director of Nursing (DON) read: It is the policy of this facility to ensure that residents are handled and transferred safely to prevent or minimize risks for injury and provide and promote a safe, secure and comfortable experience for the resident while keeping the employees safe in accordance with current standards and guidelines. [...]

Inspectors wroteBased on resident and staff interviews, record reviews, and facility policy review, the facility failed to follow up on grievances from Resident council meetings related to missing silverware and condiments for four (4) of six (6) residents in the Resident Council Meeting. Resident #4, Resident #10, Resident #11, and Resident #35.

Inspectors wroteBased on observation, staff interviews, record review, and facility policy review, the facility failed to notify the physician when a resident receiving enteral nutrition by a percutaneous endoscopic gastrostomy (PEG) tube developed drainage around insertion site for one (1) of two (2) residents observed with tube feedings.

Inspectors wroteBased on staff interviews, record review, and facility policy review, the facility failed to implement comprehensive care plans for two (2) of the nineteen resident care plans reviewed.

Inspectors wroteBased on observation, resident and staff interviews, record review, and facility policy review the facility failed to provide Activities of Daily Living (ADL) care for two (2) of 56 residents observed during the initial tour related to nail care. Resident #18 and Resident #36.

Inspectors wroteBased on observation, staff interview, record review, and facility policy review, the facility failed to ensure a resident with a catheter had a catheter securing device for one (1) of six (6) catheters in the facility. Resident #28. Findings Include: Review of the facility policy titled Appropriate Use of Indwelling Catheters undated, revealed .Policy Explanation and Compliance Guidelines: . 7. Indwelling urinary catheters (urethral and suprapubic) will be utilized in accordance with current standards of practice, with interventions to prevent complications to the extent possible An observation during catheter care on 4/17/2024 at 10:15 AM, revealed Resident #28 did not have a catheter securement device, and the catheter was pulled tight with tension from the bedside drainage bag that was attached to the lower bed. [...]

Inspectors wroteBased on observation, resident and staff interviews, record review, and facility policy review, the facility failed to ensure a resident receiving enteral feedings via percutaneous endoscopic gastrostomy (PEG) tube received appropriate care and services to prevent possible complications for one (1) of two (2) residents observed with tube feedings.

Inspectors wroteBased on staff interviews, record review and facility policy review, the facility failed to submit accurate information into the Payroll Based Journal system as required by the Centers for Medicare and Medicaid Services (CMS) which was discovered through a CMS audit of period between January 1, 2023 through March 31, 2023. Due to the audit findings, the facility was lowered to a one star on the five-star staffing rating system for the quarter of October 1, 2023 through December 31, 2023 for one (1) of four (4) quarters reviewed. Based on the facility's implementation of corrective actions completed on 06/14/23, the State Agency (SA) determined this citation to be Past Non Compliance (PNC) prior to the SA's entrance on 4/15/24.

Inspectors wroteBased on observation, staff interview, and facility policy review, the facility failed to discard soiled linen in a safe and sanitary manner to prevent the possibility of the spread of infection for one (1) of three (3) care observations. Resident #28 Findings Include: Record review of the facility policy titled Handling Soiled Linen undated, revealed Policy: It is the policy of this facility to handle, store, process, and transport linen in a safe and sanitary method to prevent the spread of infection . Policy Explanation and Compliance Guidelines: 1. Linen can become contaminated with pathogens from contact with intact skin, body substances, or from environmental contaminants . 3. Linen should not be allowed to touch the . floor and should be handled as little as possible . 4. [...]

Inspectors wroteBased on observations, resident and staff interviews, record review, and facility policy review, the facility failed to provide treatment and services to prevent and heal pressure ulcers for two (2) of four (4) facility acquired pressure ulcers.

Inspectors wroteBased on staff and resident representative interviews, record review, and facility policy review, the facility failed to thoroughly investigate and report the results of an allegation of abuse for one (1) of six (6) grievances reviewed. Resident #1.

Inspectors wroteBased on staff interview, record review, and facility policy review, the facility failed to follow the comprehensive care plan for two (2) of 16 care plans reviewed.