Midwest City Post Acute & Rehab

In the surveyor’s words

From the most serious findings on record at Midwest City Post Acute & Rehab, in the surveyor’s own words.

• Immediate jeopardy, isolatedF760Feb 21, 2024

  On [DATE] an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to prevent significant medication errors for Resident #2. Resident #2 was ordered Morphine 20mg/ml give 0.5ml every four hours as needed. The Controlled Drug Receipt/Record/Disposition Form, dated [DATE], documented LPN #1 administered Morphine 0.5ml at 6:00 a.m., 10:15 a.m., and 2:30 p.m. The Controlled Drug Receipt/Record/Disposition Form, dated [DATE], documented LPN #1 administered an additional dose of Morphine 0.5ml at 10:15 a.m., 2:30 p.m., and 3:00 p.m. per family request. The MAR, dated [DATE], documented LPN #1 administered Morphine 0.5ml at 5:58 a.m., 11:15 a.m., and 2:23 p.m. […]

• Actual harm, isolatedF600Jun 23, 2021

  Based on observation, record review, and interviews, it was determined the facility failed to: ~ ensure a staff member accompanied one (#10) of one sampled resident who was reviewed for safety procedures during a scheduled, out of facility physician appointment and ~ ensure there was a sufficient supply of portable oxygen for two (#10 and #11) of three sampled residents who were reviewed for the use of oxygen per nasal cannula. Resident #10 was oxygen dependent related to end stage [CONDITION(S)] and [CONDITION(S)] with [CONDITION(S)]. On the morning of 10/15/20 the resident was transported to a physician appointment unaccompanied by a staff member. […]

• Actual harm, isolatedF689Jun 23, 2021

  Based on observation, record review and interview, it was determined the facility failed to: ~ ensure residents were free of falls involving bedrails for one (#8) of three sampled residents who were reviewed for falls, Resident #8 had a fall which required being sent to the emergency room after hitting the left side of her head. The resident had a small laceration which required sutures, and ~ implement fall precautions for two (#1 and #3) of three sampled residents who were reviewed for falls. The facility identified 11 residents with interventions for falls. Findings: A policy titled side rails and beds, dated 01/2018, documented side rail latches shall be secure and stable so that the side rail does not fall from the up position when shaken or bumped. 1. […]

• Actual harm, isolatedF695Jun 23, 2021

  Based on observation, record review, and interviews, it was determined the facility failed to ensure there was a sufficient supply of portable oxygen for two (#10 and #11) of three sampled residents who were reviewed for the use of oxygen per nasal cannula. The facility identified eleven residents who had orders to receive oxygen per nasal cannula. Resident #10 was oxygen dependent related to end stage [CONDITION(S)] and [CONDITION(S)] with [CONDITION(S)]. On the morning of 10/15/20 the resident was transported to a physician appointment unaccompanied by a staff member. Upon arrival to the physician's office the resident was in respiratory distress, had an oxygen saturation level of 57%, had an empty 02 tank, and could not answer any questions except to give a name. […]

• No harm, potential for more than minimal, patternF755Jun 25, 2026

  Based on record review and interview, the facility failed to ensure medications were administered according to physician orders for 2 (#5 and #6) of 3 sampled residents reviewed for timely administration of medications. The DON identified 99 residents received medications in the facility. Findings:An Administering Medications policy, revised 04/2019, read in part, Medications are administered in accordance with prescriber orders, including any required time fame. If a drug is withheld, refused, or given at a time other than the scheduled time, the individual administering the medication shall initial and circle the MAR space provided for that drug and dose. 1. […]