Heartsworth Center For Nursing & Rehabilitation

In the surveyor’s words

From the most serious findings on record at Heartsworth Center For Nursing & Rehabilitation, in the surveyor’s own words.

• Immediate jeopardy, isolatedF678Sep 18, 2025

  On [DATE], an IJ was determined to exist related to the facility's failure to ensure a resident who had chosen to have a full code status was provided CPR after a life threating medical emergency was discovered. On [DATE] CNA #1 found Res #3 in their room and unresponsive. CNA #1 reported the situation to LPN #1 who checked the blood pressure of the resident then told CNA #1 the resident was dead and to clean them up. CNA #1 stated no code had been called for Res #3 and no CPR had been attempted.On [DATE] at 12:02 p.m., the Oklahoma State Department of Health was notified and verified the existence of an IJ situation.On [DATE] at 12:20 p.m., the DON was notified of the IJ situation and provided the IJ template.On [DATE] at 4:09 p.m., an acceptable plan of removal was submitted to the… […]

• No harm, potential for more than minimal, widespreadF812Sep 18, 2025

  Based on observation, record review, and interview, the facility failed to ensure equipment in the kitchen was sanitized. The ADON reported 70 residents received meals from the kitchen. Findings:On 09/15/25 at 11:50 a.m., cook #1 was observed recording temperatures of food being held on the steam table. [NAME] #1 was observed to place the thermometer into a container of Brussel sprouts, remove the thermometer from the Brussel sprouts, grab a towel off the counter and wipe off the thermometer. [NAME] #1 then placed the thermometer into the sweet potatoes, removed the thermometer from the container of sweet potatoes and wiped the thermometer off with the same towel. […]

• No harm, potential for more than minimal, patternF606Jul 9, 2026

  Based on record review and interview, the facility failed to ensure a volunteer with adverse actions was not allowed to volunteer at the facility for 1 (Volunteer #1) of 1 sampled volunteer reviewed for adverse actions.The ADON identified seven volunteers performed services in the facility.Findings:An undated facility policy titled Abuse, Neglect and Exploitation, read in part, Background, reference, and credentials' checks will be conducted on potential employees, contracted temporary staff, students affiliated with academic institutions, volunteers, and consultants. The facility will maintain documentation of proof that the screening occurred.An activity calendar, dated 07/2026, showed karaoke was to be held in the facility on 07/09/26, 07/16/26, 07/23/26, and 07/30/26 from 1:00 p.m. […]

• No harm, potential for more than minimal, patternF657May 2, 2024

  Based on record review and interview, the facility failed to include a focus of wandering in a comprehensive care plan for one (#4) of two residents reviewed for wandering. The ADON identified two residents in the facility that wandered. Findings: A facility Elopements and Wandering Resident policy, dated 01/01/20, read in part, The facility ensures residents who exhibit wandering behavior and/or are at risk for elopement receive adequate supervision to prevent accidents, and receive care in accordance with with their person-centered plan of care addressing the unique factors contributing to wandering or elopement. Resident #34 had diagnoses which included recurrent depressive disorder. […]

• No harm, potential for more than minimal, patternF804May 2, 2024

  Based on observation, record review, and interview, the facility failed to serve foods at a palatable temperature from one of two kitchen service areas. The DON identified 40 residents who ate meals served from the satellite kitchen. Findings: The facility policy titled Food and Nutrition Services, read it part, Food and nutrition services staff will inspect food trays to ensure that the correct meal is provided to each resident, the food appears palatable and attractive, and it is served at a safe and appetizing temperature. On 05/01/24 at 11:15 a.m., the satellite kitchen was observed. The mid-morning meal, including breakfast and lunch style options were observed on the steam table. The steam table was not producing steam. […]