Thunder Care and Rehabilitation: Missed Doses - OK
The inspection, completed October 16, 2025, was triggered by a complaint. Inspectors reviewed medication records for three residents and found a problem with one of them, identified in the report as Resident 2.
The resident had been prescribed levothyroxine sodium, 150 micrograms daily, to treat hypothyroidism. The order started July 24, 2025. Two days later, on July 26, and again on July 27, the medication wasn't given. The July medication administration record showed blank spaces for both dates. Nobody had documented a reason. Nobody had flagged it.
Levothyroxine is a synthetic thyroid hormone that patients with hypothyroidism typically take every day. When the thyroid doesn't produce enough hormone on its own, the medication fills the gap. Missing doses can allow hypothyroid symptoms to reassert, though the severity depends on the individual and the duration of the gap.
The facility's own policy, revised in April 2019, stated that medications are administered in accordance with prescriber orders, including any required time frame. The physician had ordered the medication to start July 24. The medication was not given July 26 or July 27.
At 3:18 in the afternoon on the day of the inspection, the quality coordinator told inspectors they could not find a reason why the doses were missed, but acknowledged they should have been given.
That was the extent of the explanation. No documentation of a shortage. No note about a refusal. No record of a nurse making a clinical judgment call. The spaces on the medication administration record were simply blank, and more than two months later, when inspectors arrived, the facility still couldn't account for them.
The resident was discharged October 8, 2025, eight days before the inspection. The levothyroxine order was marked discontinued at that point. Whatever happened in those two days in late July, the resident was no longer at the facility when anyone came to ask about it.
Inspectors cited the facility under F0755, which covers pharmaceutical services, at a harm level described as minimal harm or potential for actual harm. The facility housed 115 residents at the time of the inspection.
The citation is narrow. One resident, two missed doses, one medication. The inspection report does not describe any documented harm to Resident 2 as a result of the missed doses, and the deficiency was not rated at a higher level of severity. But the circumstances that produced it are not particularly reassuring: a prescribed medication, a clear start date, a straightforward daily administration schedule, and two consecutive days where nothing happened and nobody noticed, or if they noticed, nobody wrote it down.
The quality coordinator's answer to inspectors was honest, at least. They couldn't find a reason. It should have been given. That is the full accounting Thunder Care and Rehabilitation was able to offer for what happened to Resident 2 on July 26 and July 27, 2025.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Thunder Care and Rehabilitation from 2025-10-16 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: September 8, 2026 · Our methodology
Thunder Care and Rehabilitation in Moore, OK was cited for violations during a health inspection on October 16, 2025.
The inspection, completed October 16, 2025, was triggered by a complaint.
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.