MCALESTER, OK- MITCHELL MANOR

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 and the facility must promote and facilitate resident self-determination through support of resident choice.

Based on record review and interview, the facility failed to provide assistance with transportation to a
scheduled physician appointment for one (#24) of one sampled resident reviewed for transportation.

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, it was determined the facility failed to ensure the code status was identified and correct for one (#12) of one resident whose code status was reviewed.

PASARR screening for Mental disorders or Intellectual Disabilities

Based on record review and interview, the facility failed to complete correctly a PASARR level l evaluation for one (#11) of three residents reviewed for PASARR.

Ensure services provided by the nursing facility meet professional standards of quality.

Based on record review and interview, it was determined the facility failed to ensure professional accepted standards of quality were met related to a mental health diagnoses given to one (#34) of five sampled residents reviewed for unnecessary medication and diagnoses.

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

Based on observation, record review, and interview, the facility failed to ensure the physician was notified and interventions in place for weight loss for one (#54) of one sampled resident reviewed for nutrition.

Res #54 was admitted on [DATE] and had diagnoses which included displaced avulsion fracture/chip fracture of right talus, osteoarthritis, depression, and malignant neoplasm of tongue.

A admission assessment, dated 08/03/23, documented the resident was cognitively intact and required minimal assistance with ADLs. The assessment also documented the resident’s weight was 181 pounds.

The vital sign record, dated 10/18/23, documented a weight of 153.6 pounds.

A dietary note, dated 10/23/23, documented a recommendation of health shakes twice a day between meals related to weight loss.

A quarterly assessment, dated 11/03/23, documented the resident had a weight of 152 pounds and a weight loss of 5% or more in the last month or 10% or more in the last six months.

The vital sign record, dated 11/16/23, documented a weight of 150.6 pounds. This was a 16% weight loss in three months.

There was no documentation the physician was notified of the significant weight loss.

The care plan did not document the weight loss.

On 11/27/23 at 12:52 p.m., an observation was made of snacks and crackers in the resident’s room.

On 11/30/23 at 1:07 p.m., an interview with the DON was conducted and they stated recommendation for the health shakes got missed until now and the weight loss was missed completely.