Grace Skilled and Nursing Therapy Norman

In the surveyor’s words

From the most serious findings on record at Grace Skilled and Nursing Therapy Norman, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF755Apr 6, 2023

  Based on record review, observation, and interview, the facility failed to ensure medications were administered in accordance with physician orders for one (#83) of five residents reviewed for unnecessary medications. The Resident Census and Conditions of Residents report, dated 04/03/23, documented 115 residents resided in the facility. Findings: Res #83 had diagnoses which included secondary hypertension. A physician order, dated 07/22/22, documented to administer losartan potassium 25 mg one time per day for secondary hypertension. The order documented to hold the medication if blood pressure was below 120/80. A MAR for July 22 2022 through July 31 2022, documented the resident received the losartan when blood pressure was below parameters four out of 10 opportunities. […]

• No harm, potential for more than minimal, patternF812Apr 6, 2023

  Based on observation and interview, the facility failed to ensure the kitchen was kept clean and maintained in good repair. The Resident Census and Conditions of Residents report, dated 04/03/23, documented 115 residents. Two residents received nutrition and hydration solely through a feeding tube. Findings: On 04/03/23 08:50 a.m., a tour of the kitchen was conducted. The following observations were made: a. there was an accumulation of black and brown residue on the floor and the walls in the dish wash area, b. there was a large hole in the wall in the dish wash area, c. there was an accumulation of white, brown, and black residue inside of the ice machine, d. there was an accumulation of grease and food on the floor in the cook area, e. […]

• No harm, potential for more than minimal, patternF727Nov 10, 2021

  Based on interviews the facility had routinely been working the DON as charge nurse. The ''Census and Conditions of Residents'' report documented 95 residents resided in the facility. Findings: On 11/03/21 at 6:47 a.m., during entrance conference with the administrator and DON, they were asked about the full time DON coverage. The DON stated she worked at least 40 hours a week. She stated one day a week or every other week she worked the floor as a charge nurse. On 11/10/21 at 9:03 a.m., the staffing coordinator was asked how often the DON worked as charge nurse. She stated the DON worked one to three times a week as charge nurse. She stated the facility was trying to hire nurses to fill the needed positions. […]

• No harm, potential for more than minimal, patternF801Nov 10, 2021

  Based on record review and interview, the facility failed to guarantee the person designated to serve as the DM was certified no later than one year after hire. The DON identified 91 residents received services from the kitchen. Findings: An employee handbook signature page documented the DM started employment at the facility on 08/05/19. There was no documentation the DM was certified as a dietary manager. On 11/03/21 at 5:50 a.m., the DM was asked how long he had been in his current position. He stated about two years. He was asked if he was certified as a DM. He stated he was not. He stated he had taken all of the courses for the class, but needed to test again.

• No harm, potential for more than minimal, patternF812Nov 10, 2021

  Based on observation and interview, the facility failed to follow proper food service sanitation. The DON identified 91 residents who received services from the kitchen. Findings: On 11/03/21 at 5:40 a.m., a tour of the main dining room was conducted. The following observations were made: a. Brown residue and/or trash in the cabinets and/or the floor below the drink station, b. An uncovered bowl of brown sugar on a shelf in the serving area, and c. two boxes of foam to go containers stored on the floor in the serving area. At 5:50 a.m., a tour of the kitchen was conducted. The following observations were made: a. An accumulation of lint on the ceiling vents and/or ceiling area around the vents, b. […]