Broken Bow Health: Cancer Patient Missed 77 Doses - OK
Resident #1 at Broken Bow Health and Rehab was supposed to start taking Anastrozole, a cancer medication, on March 24. The oncologist had written the prescription during the resident's first visit and sent it to the pharmacy.
But the medication sat unused while the resident's cancer appointment was canceled.
A nursing note from April 30 showed staff called the resident's power of attorney about an upcoming oncology appointment. The family member told them to cancel because "not receiving the medication oncologist was supposed to put Resident #1 on the first time they seen the doctor."
The nurse noted that the oncologist had sent the prescription to the pharmacy back then.
The facility received 30 tablets of Anastrozole on April 28. CMA #1 signed for the delivery and documented it on a medication order sheet. But nobody administered the drug to the resident.
Records show the medication wasn't given until May 26 — two months after the doctor ordered it.
Between March 24 and May 26, Resident #1 missed 77 doses of the cancer medication.
The assistant director of nursing told inspectors on August 21 that the physician's order was written March 24 for Resident #1. "They did not administer the medication for Resident #1 until 05/26/25," she said.
The director of nursing confirmed the timeline. "Resident #1's cancer medication was not administered in March 2025 and April 2025. Resident #1 went 2 months without the cancer medication."
The breakdown happened because of a gap in the facility's medication management system.
Social services personnel scanned the physician orders into their computer system on April 28 — the same day the medication arrived. But scanning the order wasn't enough.
CMA #1 explained the problem to inspectors: "Resident #1's medication was received on 04/28/25 on the medication order and reorder form. The nurses were supposed to put the orders in the system. They did not put the medication in the system until 05/26/25, so they did not know to administer the medication to Resident #1."
The facility had the drug. Staff had documentation of the doctor's order. But because nurses didn't enter the medication into their administration system, no one knew to give it to the resident.
A fax document dated May 20 showed the Anastrozole order: "1mg orally daily. To be done: 03/24/25." An LPN finally signed off on May 26.
The medication administration record for May shows Resident #1 received the cancer drug daily from May 26 through May 31 — exactly when it was supposed to be given.
But by then, the resident had already gone without the prescribed treatment for 63 days.
The director of nursing acknowledged the potential consequences to inspectors. "Without the administration of the medication the cancer could spread," she said.
Federal regulations require nursing homes to contract with licensed consultant pharmacists to help obtain and maintain timely pharmacy services that support residents' needs and meet current standards of practice.
The inspection found the facility failed to ensure proper medication management for a cancer patient whose treatment depended on consistent daily dosing of Anastrozole.
While the resident ultimately began receiving the medication, the two-month gap occurred during a critical period when the oncologist had determined treatment should begin immediately after the initial consultation.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Broken Bow Health and Rehab from 2025-08-26 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 20, 2026 · Our methodology
Broken Bow Health and Rehab in Broken Bow, OK was cited for violations during a health inspection on August 26, 2025.
Resident #1 at Broken Bow Health and Rehab was supposed to start taking Anastrozole, a cancer medication, on March 24.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.