Memory Care Center at Emerald

Inspectors wroteBased on record review and interview, the facility failed to protect the resident's right to be free from physical abuse by a resident for 1 (#64) for 3 sampled residents reviewed for abuse. The administrator identified 58 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure they had a full-time DON for 8 of 30 dates reviewed for the employment of a DON.The administrator identified 58 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure the OSDH and a local law enforcement agency were notified of allegations of abuse within two hours of the allegations becoming known to the facility for 2 (#3 and #64) of 3 sampled residents reviewed for abuse. The administrator identified 58 residents resided in the facility.

Inspectors wroteBased on observation and interview, the facility failed to ensure drugs and biologicals were kept at proper temperatures in 1 of 1 medication refrigerator. The administrator identified 58 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure influenza and pneumococcal vaccinations were provided for 2 (#8 and #10) of 5 sampled residents reviewed for immunizations. The ADON identified 24 residents were admitted to the facility from 10/31/25 through 03/31/26.

Inspectors wroteBased on record review and interview, the facility failed to ensure the COVID-19 vaccine was provided for 2 (#8 and #10) of 5 sampled residents reviewed for immunizations. The ADON identified 24 residents were admitted to the facility from 10/31/25 through 03/31/26.

Inspectors wroteBased on record review and interview, the facility failed to ensure an antipsychotic medication was not prescribed for the diagnosis of dementia and ensure an as needed anxiety medication order had a 14-day limit for 1 (#5) of 5 sampled residents reviewed for unnecessary medications. The ADON identified 24 residents were prescribed antipsychotic medications.

Inspectors wroteBased on record review and interview, the facility failed to ensure a care plan was revised after multiple incidents of aggression toward others for 1 (#24) of 3 sampled residents reviewed for abuse. The administrator identified 58 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to complete an annual performance review for 1 (CNA #3) of 2 sampled CNAs reviewed for performance reviews. The current staff roster identified 13 CNAs were employed.

Inspectors wroteBased on record review and interview, the facility failed to ensure a monthly pharmacy review was conducted for 1 (#5) of 5 sampled residents reviewed for unnecessary medications. The ADON identified 55 residents received medications in the facility.

Inspectors wroteBased on record review and interview, the facility failed to report allegations of abuse to the Oklahoma State Department of Health for 1 (#1) of 3 sampled residents reviewed for abuse. The administrator reported 56 residents resided at the facility.

Inspectors wroteBased on record review and interview, the facility failed to: a. thoroughly investigate allegations of sexual abuse; b. investigate an allegation of misappropriation; and c. initiate precautions to protect residents from the alleged perpetrators for 1 (#1) of 3 sampled residents reviewed for abuse The administrator stated the facility had 56 residents resided at the facility.

Inspectors wroteBased on record review and interview, the facility failed to protect the resident's right to be free from neglect for one (# 1) of four residents reviewed for neglect. The Administrator reported the facility census was 53.

Inspectors wroteBased on observation and interview, the facility failed to ensure proper food service sanitation, cleaning and storage requirements were followed. The ADON identified all 56 residents who resided at the facility received food from the kitchen.

Inspectors wroteBased on record review and interview, the facility failed to ensure the resident's representative completed the resident's code status correctly and were offered the choice to formulate an advanced directive for two (#6 and #48) of three sampled residents reviewed for advanced directives. The administrator identified 56 residents who resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure wheelchairs were clean and maintained in good repair for two ( #1 and #25) of three sampled residents who were reviewed for wheelchair maintenance. The Administrator identified 56 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to implement their abuse policy related to: a. reporting allegations of abuse and/or neglect to the OSDH and investigating allegations of abuse and/or neglect for three (#6, #9, and #41) of five sampled residents who were reviewed for abuse allegations; and b. abuse training upon hire for seven (#1, 2, 3, 4, 5, 6, and #7) of 25 sampled employee files reviewed for abuse training. The administrator identified 56 residents who resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to develop a care plan for oxygen therapy for one (#6) of one sampled resident who received oxygen therapy and limited range of motion with contracture for one (#20) of two sampled residents who had limited range of motion. The ADON identified six residents who utilized oxygen, ten residents who had limited range of motion, and three residents who had contractures. Findings. The facility's Special Needs policy, revised 01/2024, read in part, Comprehensive care plans will be developed based on resident assessments, goals and preferences. 1. Resident #6 had diagnoses which included acute respiratory failure with hypoxia. Resident #6's Monthly Physician's Orders, included oxygen 2 liters via nasal cannula continuously. [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure sufficient staff a. was available to provide incontinent care for one (#9) of one sampled resident who required incontinent care; b. was available to provide supervision during meals for one (#46) of two sampled residents who required supervision with meals; and c. was available to provide a licensed staff member on a 24 hour basis. The ADON identified 40 residents who required assistance with incontinent care, 10 residents who required assistance with meals, and 56 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure licensed nurse, and certified nurse aides received competency/skills checks for four (LPN #1, CNA # 2, CNA #3, and CNA #4) of five employee files reviewed for competency/skills checks. The administrator identified 56 residents resided in the facility.

Inspectors wroteBased on record review and interview the facility failed to ensure: a. the services of an RN was available in the facility eight hours daily seven days a week, and b. there was a RN designated as full time DON. The administrator identified 56 residents resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure menus were followed for one of one meal preparation and service observed. The ADON identified all 56 residents received their meals from the kitchen.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure oxygen tubing was stored in a manner to prevent cross contamination for one (#6) of one sampled resident who was observed for oxygen therapy. The ADON identified six residents who received oxygen therapy.

Inspectors wroteBased on observation and interview, the facility failed to ensure emergency call cords were long enough to be reached by the residents if they were lying on the floor in the shower for two (#44 and #56) of two residents who were able to independently shower. The ADON identified 12 residents who would have the cognitive ability to utilize the call light.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure a resident was treated with dignity during dining for one (#20) of four sampled residents observed during two meals. The ADON identified 10 residents who required assistance with meals.

Inspectors wroteBased on record review and interview, the facility failed to ensure an investigation was initiated for one (#13) of six resident sampled for abuse. The Administrator identified 56 residents resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure MDS assessments were accurate for one (#20) of two sampled residents reviewed for accuracy of documentation for limited range of motion on the MDS assessment. The ADON identified 10 residents who had limited range of motion and three residents who had contractures.

Inspectors wroteBased on record review and interview, the facility failed to include a care plan regarding isolation for one (#13) of 19 sampled resident reviewed for care planning. The Administrator identified 56 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure neurological checks were completed after a fall with head injury for one (#41) of four sampled residents reviewed for accident hazards. The Administrator identified 56 residents resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure oxygen tubing was labeled, dated, and changed per facility policy for one (#6) of one sampled resident who was observed for oxygen therapy. The ADON identified six residents who received oxygen therapy.

Inspectors wroteBased on record review and interview, the facility failed to ensure antipsychotic medications were ordered with an appropriate diagnoses for one (#5) of five sampled residents reviewed for unnecessary medications. The ADON identified 23 residents were prescribed psychotropic medications.

Inspectors wroteBased on record review and interview, the facility failed to explain the arbitration agreement in a manner the resident representative could understand for one (#21) of three sampled residents who entered into a binding arbitration agreement. The administrator identified 25 residents who had entered into a binding arbitration agreement.

Inspectors wroteBased on record review and interview, the facility failed to convey remaining funds to the legal representatives of deceased residents within 30 days for two (#1 and #3) of three sampled residents reviewed for finances. An Action Summary report, dated [DATE], documented 12 residents had died while residing at the facility in the five months prior to the survey.

Inspectors wroteBased on record review and interview, the facility failed to notify a resident representative of a new skin issue after its discovery for one (#2) of three sampled residents reviewed for notification of change. A Detailed Census Report form, dated 10/16/23, documented 57 residents resided in the facility.

Inspectors wrote3. Res #57 was admitted to the facility on [DATE] and had diagnoses which included right femur fracture, Parkinson's disease, dementia with mild agitation, and neuropathy. A fall scene investigation report, dated 02/28/23, documented Res #57 was found on the floor by his chair, with no injuries. Interventions documented would be to monitor resident, re-orient, and continue with therapy. A care plan, initiated on 03/01/23, documented the resident was at risk for falls. The care plan documented the following interventions. a. Anticipate and meet the resident's needs. b. Be sure the resident's call light is within reach and encourage the resident to use it for assistance as needed. c. Educate the resident/family/caregivers about safety reminders and what to do if a fall occurs. d. [...]

Inspectors wroteBased on record review and interview, the facility failed to ensure a code status was documented and the person with legal authority signed the DNR form for two (#2 and #26) of 24 residents reviewed for advance directives. The facility failed to ensure: a. a code status was documented for Res #26, and b. the person with legal authority signed the DNR form for Res #2. The facility census and condition report documented 56 residents lived in the facility.

Inspectors wroteBased on observation and interview, the facility failed to ensure housekeeping and maintenance services were provided to maintain a sanitary, orderly, and comfortable interior for seven (#9, 15, 20, 34, 35, 39, and #51) of eight residents observed for a clean, comfortable, homelike environment. The Resident Census and Conditions of Residents form documented 56 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure residents were permitted to return to the facility after they were hospitalized for one (#111) of three residents reviewed for discharges. The MDS coordinator identified 21 residents who had been discharged from the facility in the last six months.

Inspectors wroteBased on record review and interview, the facility failed to conduct a significant change assessment within 14 days after a change in condition for two (#2 and #31) of 24 sampled residents whose assessments were reviewed. The Resident Census and Conditions of Residents form documented 56 residents who resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to ensure assessments accurately reflected residents' status for five (#25, 30, 36, 52 and #57) of 24 sampled residents whose assessments were reviewed. The facility failed to accurately assess: a. wandering for Res #30 and #52. b. falls for Res #25 and #57. c. skin conditions for Res #25 and #36. The Resident Census and Conditions of Residents report documented 56 residents who resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to develop comprehensive person-centered care plans related to nutrition/weight loss for two (#2 an #50) of two residents reviewed for nutrition. The Resident Census and Conditions of Residents report documented 56 residents who resided in the facility.

Inspectors wroteBased on observation, interview, and record review, the facility failed to revise care plans for five (#14, 25, 36, 52, and #57) of 18 sampled residents whose care plans were reviewed. The facility failed to revise or update care plans related to: a. falls for Res #14, 25, and #57, b. wounds for Res #25 and #36, and c. psychoactive medication for Res #52. The Resident Census and Conditions of Residents form documented 56 residents resided at the facility.

Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure a resident received interventions to maintain nutritional status within acceptable parameters for two (#2 and #50) of two residents sampled for nutritional status. The Resident Census and Conditions of Residents report documented 56 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure medications were administered as ordered by the physician for two (#48 and #160) of five sampled residents whose medications were reviewed. The facility failed to ensure: a. the heart rate was monitored before administering heart medication for Res #48. b. medication was available and administered as ordered for Res #160. The Resident Census and Conditions of Residents documented 56 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure the physician responded to a pharmacist medication regimen review for two (#48 and #52) of five residents sampled for medication regimen reviews. The Resident Census and Conditions of Residents report documented 56 residents who resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to ensure food was palatable and at appetizing temperatures for one of one meal service observed. The Resident Census and Conditions of Residents documented 56 residents resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to store, prepare, and serve food in a sanitary manner. The Resident Census and Conditions of Residents documented 56 residents resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to have an effective administration to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. The administration failed to ensure: a. residents' code status were documented and the person with legal authority signed the DNR form. b. housekeeping and maintenance services were provided to maintain a sanitary, orderly, and comfortable interior. c. discharge notices contained the required components. d. residents were allowed to return to the facility after hospitalization if bed is available. e. comprehensive assessments were completed at least every 12 months. f. the facility failed to conduct a significant change assessment within 14 days after a change in condition. g. [...]

Inspectors wroteBased on interview and record review, the facility failed to ensure: a. the arbitration agreement contained clear language related to the residents or their representatives were not required to sign the agreement as a condition of admission; and b. the arbitration agreement granted the resident or his or her representative the right to rescind the agreement within 30 calendar days of signing it for three (#9, 20, and #57) of three residents reviewed for arbitration agreements. c. there was evidence a resident representative had the legal authority to sign the binding arbitration agreement for one (#9) of three residents reviewed for arbitration agreements. The SSD identified 25 residents which resided in the facility and had entered into arbitration agreements on or after 09/16/19.

Inspectors wroteBased on interview and record review, the facility failed to ensure the arbitration agreement provided for the selection of a neutral arbitrator agreed upon by both parties for three (#9, #20, and #57) of three residents reviewed for arbitration agreements. The SSD identified 25 residents which resided in the facility and had entered into arbitration agreements on or after 09/16/19.

Inspectors wroteBased on record review and interview, the facility failed to consistently monitor antibiotic use for one (#52) of five sampled residents whose medications were reviewed. The facility failed to evaluate the need for antibiotics prior to ordering and administering antibiotics. The MDS coordinator identified two residents currently on antibiotics.

Inspectors wroteBased on record review and interview, the facility failed to ensure: a. a copy of the discharge notice was sent to the representative of the Office of the State Long-Term Care Ombudsman; b. the discharge notice was provided by the facility at least 30 days before the resident was discharged ; c. the mailing and email address and telephone number of the agency responsible for the protection and advocacy of individuals with a mental disorder established under the Protection and Advocacy for Mentally Ill Individuals Act was provided; and d. the discharge notice included the specific location to which the resident is to be transferred or discharged for one (#111) of three residents reviewed for discharges. The MDS coordinator identified 21 residents who had been discharged from the facility in the last six months.

Inspectors wroteBased on record review and interview, it was determined the facility failed to ensure comprehensive assessments were completed at least every 12 months for one (#9) of 24 sampled residents whose assessments were reviewed. The facility census and condition report documented 56 residents lived in the facility.

Inspectors wroteBased on record review and interview, the facility failed to notify the OHCA of a resident with a new serious mental illness for one (#4) of one sampled residents reviewed for PASRR evaluations. The Resident Census and Conditions of Residents report documented 39 residents who received psychoactive medication.

Inspectors wroteBased on record review, observation, and interview, the facility failed to obtain diagnosis, assess, and monitor skin lesion for one (#25) of two residents reviewed for skin issues. The Resident Census and Conditions of Residents documented 56 residents resided in the facility.

Inspectors wroteBased on record review and interview the facility failed to provide pain management medications for one (#160) of five residents sampled for medication review. The Resident Census and Conditions of Residents documented 56 residents resided in the facility.