Rainbow Terrace Care Center

In the surveyor’s words

From the most serious findings on record at Rainbow Terrace Care Center, in the surveyor’s own words.

• Immediate jeopardy, patternF607Sep 12, 2023

  On 08/17/23 at 5:45 p.m., an Immediate Jeopardy situation was determined to be in existence related to the facility failing to ensure background screenings were completed for four of 29 employees hired between 2022 and 2023. The facility failed to ensure residents were not at risk for abuse related to staff background screening and finger printing not being completed. On 08/17/23 at 5:50 p.m., the charge nurse on duty was informed of an Immediate Jeopardy situation and the IJ template was emailed to the DON at that time. The administrator, assistant administrator, and DON were not in the facility at that time. On 08/21/23 at 4:38 p.m., an acceptable plan of removal was submitted to the Oklahoma State Department of Health by the assistant administrator. […]

• Immediate jeopardy, isolatedF678May 17, 2022

  An Immediate Jeopardy (IJ) situation was determined to exist effective [DATE] based upon the facility's failure to immediately contact EMS when CPR was initiated for Res #26 with a full code status who was found not breathing and without a detectable heart beat. On [DATE] at 11:21 a.m., the Oklahoma State Department of Health was notified and verified the existence of the IJ situation. On [DATE] at 11:26 a.m., the administrator was notified of the IJ situation. On [DATE] at 1:38 p.m., an acceptable plan of removal was provided. The plan of removal documented: ''Rainbow Terrace Care Center Immediate Jeopardy Plan for Removal [DATE]. On [DATE], a resident was found to not have viable vital signs, resulting in CPR being initiated. […]

• Actual harm, isolatedF686Sep 12, 2023

  Based on observation, record review, and interview, the facility failed to: a. complete pressure ulcer assessments which included measurements and description for one (#128); b. notify the physician of a wound area and unstageable pressure ulcer timely for one (#128); and c. have a care plan in place and/or updated to prevent pressure ulcers for residents at risk for ulcers for two (#128 and #115) of two residents reviewed for pressure ulcers. Res #128's medical records documented a scabbed area to the resident's coccyx that continued through June and July 2023 without assessment or physician notification. On 07/28/23 the unstageable ulcer was assessed and measured at 3.0 x 5.0 x 1.0 cm. The physician was notified on 07/31/23 and an order for treatment was obtained. […]

• No harm, potential for more than minimal, widespreadF835Jun 13, 2023

  Based on observation, record review, and interview, the facility failed to be administered effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident. The administration failed to ensure: a. resident call lights were within reach of residents. b. a safe, clean, comfortable, homelike environment was provided. c. comprehensive assessments were completed within 14 days of admission and annually. d. quarterly assessments were completed every three months. e. resident assessments were transmitted to CMS within seven days of completion. f. comprehensive care plans were developed. g. resident care plans were reviewed and updated. h. extension cords were used in a safe manner. i. […]

• No harm, potential for more than minimal, patternF727Jan 8, 2025

  Based on record review and interview, the facility failed to ensure RN coverage for eight consecutive hours seven days per week. The administrator identified 29 residents resided in the facility. Findings: The work schedule for July 2024 through August 2024 documented no RN coverage for 7/12, 8/6, 8/16, 8/17, 8/18, 8/23, 8/24, 8/25, 8/29, and 8/30. On 01/08/25 at 12:46 p.m., the DON stated in July and August they were short staffed on RNs and did not have RN coverage every day.