Rainbow Health Care Community and Rainbow Assisted

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure food was not served beyond their expiration date. The administrator identified 84 residents received nourishment from the kitchen.

Inspectors wroteBased on observation and interview, the facility failed to ensure the most recent survey results of the facility were posted in a place readily accessible to residents, family members and legal representatives of residents. The DON reported 75 residents resided at the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure a controlled medication was secured in a locked container that was permanently affixed to the building for 1 (#14) of 1 sampled resident reviewed for medication storage. The DON reported 75 residents at the facility were administered medications at the facility.

Inspectors wroteOn 11/07/24, an IJ situation was determined to exist related to the facilities failure to ensure staff were aware of proper transportation after a resident slid out of a wheelchair during a transport. On 10/29/24, Resident #3 came out of their wheelchair during a transport from the hospital to the facility when the facility driver had to slam on the brakes. CNA #1 and transport driver #1 where unable to lift Resident #3 back into the wheelchair. This resulted in Resident #3 riding approximately 30 miles on the floor of the transport van. On 11/07/24 at 1:20 p.m., the Oklahoma State Department of Health was notified and verified the existence of the IJ situation. On 11/07/24 at 1:30 p.m., the administrator was notified of the IJ situation and the IJ template was provided. On 11/08/24 at 10:29 a.m., an acceptable plan of removal was provided. The plan of removal documented: [...]

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure proper handwashing was conducted during incontinent care, between residents, and/or a roll gauze that was dropped on the floor was not used to perform a treatment for seven (#1, 2, 5, 6, 7, 8, and #9) of seven sampled residents observed for infection control. The charge nurse identified 70 residents resided in the facility.

Inspectors wroteBased on observation and interview, the facility failed to ensure a sanitary environment in the shower rooms. The DON identified 76 residents who reside at the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure ongoing assessment including pre/post assessments were completed for two (#129 and #25) of two residents who were reviewed for dialysis. The DON identified four residents who received dialysis services.

Inspectors wroteBased on observation, interview, and record review, the facility failed to offer the residents an HS snack and ensure snacks were served to the residents in accordance with the facility policy, for three (#11, 16, and #25) of three sampled residents reviewed for food and nutrition services. The DON identified 76 residents resided in the facility.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure the ice machine was clean. The DON identified # residents ate from the kitchen.

Inspectors wroteBased on observation and interview, the facility failed to ensure staff followed infection control protocols while delivering meals to residents in the dining room. The administrator identified 76 residents who resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure residents were offered the opportunity to formulate an advance directive for one (#31) of three sampled residents who were reviewed for advance directives. The DON identified 76 residents who resided in the facility.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure care plans were reviewed and revised for two (#16 and #43) of nine residents who were reviewed for care plans. The DON identified 76 residents who reside at the facility.

Inspectors wroteBased on observation, record review and interview, the facility failed to ensure fall mats were properly placed for two (#43 and #10) of two resident who were reviewed for accident hazards. The DON identified # residents who were at risk for falls.

Inspectors wroteBased on record review and interview the facility failed to ensure nutritional supplements were provided as ordered for one (#73) of seven residents who were reviewed for nutrition. The DON identified 19 residents who were ordered nutritional supplements.

Inspectors wroteBased on record review, observation, and interview, the facility failed to assess the resident for risk of entrapment from bed rails prior to installation, review the risks and benefits of bed rails with the resident or resident representative, and obtain an informed consent prior to installation for two (#11 and #16) of two sampled resident reviewed for side rails. The ADON identified four residents had grab bars/u-rails attached to their beds.

Inspectors wroteBased on record review and interview, the facility failed to ensure side effect monitoring was implemented for anticoagulant medications for two (#3 and #129) of six sampled residents whose medications were reviewed. The DON identified 12 residents who were ordered anticoagulant medications.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure the medication error rate was below five percent. A total of 28 opportunities were observed with two medication errors. Total medication error rate was 7.14%. The DON identified 76 residents resided in the facility.

Inspectors wroteBased on record review and interview, the facility failed to ensure arbitration agreements provided for the selection of a neutral arbitrator and a neutral venue agreed upon by both parties for one (#129) of two sampled residents who were reviewed for arbitration agreements. The administrator identified 76 residents who resided in the facility.

Inspectors wroteBased on observation, record review, and interview, the facility failed to ensure residents were free from physical restraints which were not required to treat the resident's medical symptoms for one (#1) of two residents reviewed for restraints. The administrator identified 78 residents resided in the facility.

Inspectors wroteBased on record review, observation, and interview, the facility failed to ensure a medication administration error rate was less than five percent for two (#13 and #70) of five sampled residents observed during the medication pass. There were four medication errors out of 27 opportunities, which made the error percentage rate 14.81 percent. The Resident Census and Conditions of Residents form documented 76 residents resided in the facility.

Inspectors wroteBased on observation and interview, the facility failed to ensure: a. the kitchen was maintained clean and in good repair, and; b. staff did not handle foods with their bare hands. The dietary manager identified 75 residents received services from the kitchen. One resident received nutrition and hydration solely through a feeding tube.

Inspectors wroteBased on observation and interview, the facility failed to post nurse staffing information daily, which included all of the required components. The Resident Census and Conditions of Residents form documented 76 residents resided in the facility.

Inspectors wroteBased on record review and interview, it was determined the facility failed to ensure residents were free of duplicate medication dosage for one (#16) of five residents reviewed for unnecessary medication. The Resident Census and Conditions of Residents, dated 01/23/23, documented 76 residents resided in the facility.