Bartlesville Health and Rehabilitation Community

In the surveyor’s words

From the most serious findings on record at Bartlesville Health and Rehabilitation Community, in the surveyor’s own words.

• Immediate jeopardy, isolatedF678Jan 12, 2026

  On [DATE], an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to ensure CPR was administered in accordance with the AHA standards of practice, which states the primary goal is to ensure a firm, hard surface to maximize compression depth and the facility policy for resident #6. CPR was administered in Resident #6's bed without a back board and was ineffective. On [DATE] at 5:15 p.m., the OSDH was notified and verified the existence of the IJ related to the facility's failure to implement their CPR policy and provide effective CPR to Resident #6.On [DATE] at 6:00 p.m., the administrator, DON, and ADON were notified of the IJ situation and the IJ template was provided. On [DATE] at 2:38 p.m., an acceptable plan of removal was approved by the OSDH. […]

• Actual harm, patternF689Aug 28, 2023

  Based on observation, record review, and interview, the facility failed to: a. implement interventions to prevent the reoccurrence of falls; b. complete incident reports and neurological checks according to policy and procedure; and c. revise the care plan with new interventions to prevent falls for one (#23) of two sampled residents reviewed for accident hazards. Resident #23 experienced 15 falls between 08/18/22 and 07/27/23. On 09/06/22, Res #23 fell and sustained a traumatic subdural hemorrhage, laceration on the left side of their face, and left sided fifth and seventh rib fractures, resulting in the resident being admitted to the hospital ICU. On 06/12/23, the resident fell and sustained a left fractured shoulder. […]

• No harm, potential for more than minimal, widespreadF812Aug 28, 2023

  Based on observation and interview, the facility failed to ensure the kitchen was maintained to promote food safety and sanitation. The Resident Census and Conditions of Residents report, dated 08/22/23, documented 60 residents resided in the facility. The CDM identified all residents received services from the kitchen. Findings: On 08/22/23 at 10:18 a.m., a tour of the kitchen and dining area were conducted. The following observations were made: a. Multiple precooked pieces of chopped chicken in a plastic bag was stored in the two compartment sink. There was no water running over the bag. The meat was still partially frozen, b. Multiple pieces of raw of chicken breasts in a plastic bag were stored on the preparation surface of the Continental three door cold preparation cooler. […]

• No harm, potential for more than minimal, patternF698Dec 4, 2024

  Based on record review and interview, the facility failed to ensure pre and post dialysis patient assessments were filled out completely and routinely by staff for one (#45) of one sampled resident reviewed for dialysis care. The DON identified one resident at the facility received dialysis services. Findings: The facility was unable to provide a policy for the care of residents that received dialysis services. An admission record for Resident #45 documented they had been readmitted to the facility on [DATE]. […]

• No harm, potential for more than minimal, patternF812Dec 4, 2024

  Based on observation and interview, the facility failed to ensure dietary staff wore hair nets and beard guards while preparing food for the residents. The administrator identified 74 residents routinely ate meals provided by the facility kitchen. Findings: On 12/02/24 at 8:05 a.m., cook #1 was observed preparing food without wearing a hair net or beard guard. On 12/02/24 at 8:10 a.m., cook #1 stated they should be wearing a hair net and beard guard and that the facility was out of beard guards until the truck came in. On 12/02/24 at 8:30 a.m., the dietary manager stated the dietary staff should be wearing hair nets and beard guards. On 12/03/24 at 3:08 p.m., the administrator stated dietary staff should be wearing hair nets and beard guards.