Elmbrook of Hugo

In the surveyor’s words

From the most serious findings on record at Elmbrook of Hugo, in the surveyor’s own words.

• Immediate jeopardy, patternF689Apr 21, 2023

  An IJ situation was determined to be in existence related to the facility failing to ensure foot pedals were used during a wheelchair transfer which resulted in Resident #1 sustaining a fracture on 04/09/23. An x-ray, dated 04/09/23, documented Resident #1 sustained a displaced fracture of the medial malleolus of the left ankle. Resident #1 had been transported to an orthopedic appointment on 04/11/23 and wheel chair foot pedals were not in use during that transfer. On 04/21/23 at 1:01 p.m., the Oklahoma State Department of Health was notified and verified the existence of the IJ situation. On 04/21/242 at 1:08 p.m., the Administrator and DON were notified of the IJ situation. On 04/21/23 at 3:03 p.m., an acceptable plan of removal was submitted to the Oklahoma State Department of Health. […]

• Immediate jeopardy, isolatedF600May 6, 2025

  On 04/17/25, a past noncompliance Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to ensure Res #35 was not verbally abused. On 04/17/25 at 1:30 p.m. the OSDH was notified and verified the existence of the past noncompliance IJ related to the facility's failure to ensure residents were not verbally abused. On 05/06/25 at 12:48 p.m. the administrator was notified of the immediate jeopardy situation. The administrator was provided the IJ template. Documentation showed the facility completed staff in-service regarding abuse on 03/03/25. Employee #1 was suspended, then terminated on 03/04/25. A quality assurance meeting was held on 03/05/25 regarding abuse. […]

• Immediate jeopardy, isolatedF678Jun 21, 2024

  A past noncompliance Immediate Jeopardy (IJ) situation was determined to exist effective [DATE] related to the facility's failure to ensure cardio-pulmonary resuscitation was provided according to standards of care for Res #1 who was a full code status and implement all components of the facility's CPR policy On [DATE] at 4:20 p.m., the Oklahoma State Department of Health was notified and verified the existence of the past noncompliance IJ related to the facility's failure to implement their CPR policy and provide CPR to Res #1 who was a full code. The past noncompliance IJ was removed effective [DATE] after the facility put measure in place to prevent recurrence. […]

• Actual harm, isolatedF580Jun 21, 2024

  Based on record review and interview, the facility failed to notify the physician of a resident's change in condition for one (#1) of four sampled residents who were reviewed for neglect. The administrator identified 55 residents who resided in the facility. Findings: The Guidelines for Notifying Physicians of Clinical Problems, revised [DATE], read in part, The charge nurse or supervisor should contact the attending physician if a clinical situation appears to require immediate discussion and management . […]

• No harm, potential for more than minimal, widespreadF812Dec 7, 2023

  Based on observation and interview the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. The DON identified 59 resident residing in the facility who receive meals from the kitchen. Findings: 1. On 12/04/23 at 9:33 a.m., an initial tour of the kitchen was conducted. The following observations were made. On 12/04/23 at 9:38 a.m., the walk in refrigerator contained two open large cans of pudding one chocolate and the other one was banana pudding. The tops of the puddings were covered with plastic wrap but did not have a date on the cans, a scoop was in the banana pudding. A cut tomato wrapped in plastic wrap was not labeled or dated. A resalable bag of corn bread with a used by date of 11/30/23. […]