BRISTOW, OK- RAINBOW HEALTH CARE COMMUNITY AND RAINBOW ASSISTED

The Department of Health & Human Services conducted an inspection of the facility. The following  highlighted decencies listed below were found in a public survey.

Honor the resident’s right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

Based on record review and interview, the facility failed to ensure residents were offered the opportunity t formulate an advance directive for one (#31) of three sampled residents who were reviewed for advance directives.

The DON identified 76 residents who resided in the facility.

Honor the resident’s right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

Based on observation and interview, the facility failed to ensure a sanitary environment in the shower rooms. The DON identified 76 residents who reside at the facility.

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Based on observation, record review and interview, the facility failed to ensure care plans were reviewed and revised for two (#16 and #43) of nine residents who were reviewed for care plans. The DON identified 76 residents who reside at the facility.

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Based on observation, record review and interview, the facility failed to ensure fall mats were properly placed for two (#43 and #10) of two resident who were reviewed for accident hazards. The DON identified # residents who were at risk for falls.

Provide enough food/fluids to maintain a resident’s health.

Based on record review and interview the facility failed to ensure nutritional supplements were provided as ordered for one (#73) of seven residents who were reviewed for nutrition. The DON identified 19 residents who were ordered nutritional supplements.

Provide safe, appropriate dialysis care/services for a resident who requires such services.

Based on record review and interview, the facility failed to ensure ongoing assessment including pre/post assessments were completed for two (#129 and #25) of two residents who were reviewed for dialysis. 

Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.

Based on record review, observation, and interview, the facility failed to assess the resident for risk of entrapment from bed rails prior to installation, review the risks and benefits of bed rails with the resident or resident representative, and obtain an informed consent prior to installation for two (#11 and #16) of two sampled resident reviewed for side rails. The ADON identified four residents had grab bars/u-rails attached to their beds.

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Based on record review and interview, the facility failed to ensure side effect monitoring was implemented for anticoagulant medications for two (#3 and #129) of six sampled residents whose medications were reviewed.

Ensure medication error rates are not 5 percent or greater.

Based on observation, record review, and interview, the facility failed to ensure the medication error rate was below five percent. A total of 28 opportunities were observed with two medication errors. Total medication error rate was 7.14%.

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Based on observation, interview, and record review, the facility failed to offer the residents an HS snack and ensure snacks were served to the residents in accordance with the facility policy, for three (#11, 16, and #25) of three sampled residents reviewed for food and nutrition services.

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Based on observation, record review and interview, the facility failed to ensure the ice machine was clean.

Provide a neutral and fair arbitration process and agree to arbitrator and venue.

Based on record review and interview, the facility failed to ensure arbitration agreements provided for the selection of a neutral arbitrator and a neutral venue agreed upon by both parties for one (#129) of two sampled residents who were reviewed for arbitration agreements.

Provide and implement an infection prevention and control program.

Based on observation and interview, the facility failed to ensure staff followed infection control protocols while delivering meals to residents in the dining room.