Cherokee County Nursing Center

In the surveyor’s words

From the most serious findings on record at Cherokee County Nursing Center, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF554Feb 16, 2024

  Based on observation, record review, and interview, the facility failed to ensure residents were safe to self-administer medications for two (#34 and #66) of two sampled residents reviewed for self-administration of medications. The DON identified 99 residents resided in the facility. Findings: A Self-Administration of Medications policy, revised 11/22/16, read in parts, .A resident may be permitted to administer or retain medication in his/her room under the following conditions .Assessment .Order is obtained from the resident's physician . 1. Res #34 had diagnoses which included pain, type 2 diabetes mellitus, insomnia, HTN, CHF, depression, hyperlipidemia, and GERD. A quarterly resident assessment, dated 11/21/23, documented the resident's cognition was intact. […]

• No harm, potential for more than minimal, patternF759Feb 16, 2024

  Based on observation, record review, and interview, the facility failed to ensure the medication error rate was less than 5% for two (#27 and #75) of four sampled residents observed during medication pass. A total of 25 opportunities were observed with four errors. Total error rate was 16%. The DON identified 99 residents resided in the facility. Findings: A Medications, Errors procedure, dated 11/22/16, read in parts, .A medication error is a discrepancy between what the physician orders are and what is administered. Medication errors include .wrong dose .Any medication error must immediately be reported to the resident's attending physician, Charge Nurse, or DON . 1. […]

• No harm, potential for more than minimal, patternF578Feb 10, 2023

  Based on record review and interview, the facility failed to ensure advanced directives, including DNRs, were signed by an individual with the authority to do so for six (#36, 38, 48, 50, 57, and #71) of 33 residents whose records were reviewed for advanced directives. The Resident Census and Conditions of Residents form documented 66 residents in the facility had an advanced directives and/or DNR. Findings: 1. Resident #36 had diagnoses which included diabetes, dementia, and weakness. An admission assessment, dated [DATE], documented the resident was moderately impaired in cognition and required limited assistance with most ADLs. An Oklahoma DNR form was present in Res #36's EHR and documented a signature different from the resident. […]

• No harm, potential for more than minimal, patternF638Feb 10, 2023

  Based on record review and interview, the facility failed to ensure quarterly MDS assessments were completed no later than 14 days after the assessment reference date for seven, (#5, 31, 35, 36, 53, 70, and #92) of 24 residents whose MDS assessments were reviewed. The Resident Census and Condition of Residents form documented 99 residents resided in the facility. Findings: 1. A final validation report documented Res #5 had a quarterly MDS with an ARD of 01/10/23. The assessment was documented as being completed late with a signature date of 01/25/23. 2. A final validation report documented Res #31 had a quarterly MDS with an ARD of 01/11/23. The assessment was documented as being completed late with a signature date of 01/26/23. 3. […]

• No harm, potential for more than minimal, patternF641Feb 10, 2023

  Based on record review, observation, and interview, the facility failed to ensure resident assessments accurately reflected residents' current status for three (#12, 57, and #60) of 24 residents whose assessments were reviewed. The facility failed to accurately code for: a. dialysis for Res #60. b. hallucinations and delusions for Res #12. c. PASRR Level II for Res #57. d. prognosis for Res #57. The Resident Census and Conditions of Residents form documented 99 residents resided in the facility. Findings: 1. Res #60 had diagnoses which included diabetes, chronic kidney disease, and atherosclerosis of the renal artery. A care plan, initiated on 03/11/21, documented the resident received hemodialysis on Mondays, Wednesdays, and Fridays. […]