Choctaw Residential Center
CHOCTAW RESIDENTIAL CENTER in CHOCTAW, MS — inspection on March 6, 2025.
Found 13 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
F-F0500 . F.
How important is it to you to do your favorite activities? Very important was marked.
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Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 255339 B.
Wing 03/06/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
Review of the admission Record revealed the facility admitted Resident #76 on 7/30/21 with a medical diagnosis that included type 2 diabetes mellitus with unspecified complications.
Review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 1/28/25 revealed, under section C, a Brief Interview for Mental Status (BIMS) summary score of 15, which indicated Resident #76 was cognitively intact.
Review of the admission Record revealed the facility admitted Resident #100 on 10/14/24 with a medical diagnosis that included chronic kidney disease, stage 3.
Review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 12/31/24 revealed, under section C, a Brief Interview for Mental Status (BIMS) summary score of 13, which indicated Resident #100 was cognitively intact.
Review of the admission Record revealed the facility admitted Resident #309 on 2/18/25 with a medical diagnosis that included type 2 diabetes mellitus with foot ulcer.
Review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 2/25/25 revealed, under section C, a Brief Interview for Mental Status (BIMS) summary score of 15, which indicated Resident # 309 was cognitively intact.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
During an observation and interview on 3/05/25 at 9:45 AM, the Administrator confirmed the privacy
didn't even notice it. Resident #11 revealed It's been dirty like this for a long time.
A record review of Resident #11's admission Record revealed the facility admitted the resident on 02/24/2012 with diagnoses that included Major Depressive Disorder, Unspecified Kidney Failure, and Anxiety Disorder.
A record review of Resident #11's MDS Section C with an ARD of 1/23/2025 revealed a BIMS score of 15, indicating that the resident is cognitively intact.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
revealed, under section C, a Brief Interview for Mental Status (BIMS) summary score of 15, which
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
81 mg chewable tablet signed off as administered.
but later realized it was not the correct medication.
She confirmed after reviewing the medication
the six rights of medication administration and stated that if she had done so, she likely would not have made the error.
Record review of the admission Record revealed Resident #90 was admitted on [DATE], with a diagnosis of End-Stage Renal Disease.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
Review of the facility policy titled Activities of Daily Living Policy with a revision date of 7/2014, revealed under, Policy Statement: Based on previous evaluations and current date, the nursing staff, in conjunction with Attending Physician, Consultant Pharmacist, therapy staff, and others, will seek to identify the level of care a resident requires for ADLs.
An observation of Resident #74, on 3/03/25 at 12:00 PM, revealed he was lying in bed with fingernails that were approximately 1 inch (in.) in length on the left hand with a brown substance on each nail and one nail that was broken off and hanging inside his palm.
The residents' upper and lower teeth and lower gum line were covered in a thick white substance.
An observation with interview on 3/05/25 at 7:50 AM with Resident #74 revealed no change in the resident's appearance and he stated that he had asked the staff in the past to brush his teeth.
An observation and interview with Registered Nurse (RN) #1 on 3/05/25 at 8:00 AM confirmed Resident #74 had long nails on the left fingers that could cause skin breakdown due to his contracted fingers, which were turned inward toward the palm.
She revealed the nurses, or the aides, could trim his nails. RN #1 described the residents' teeth as, They need brushing.
She confirmed that staff failing to do this could cause gingivitis and tooth decay.
She revealed the aides were responsible for brushing his teeth daily.
An interview with the Administrator (ADM) on 3/05/25 at 2:00 PM revealed her expectations were for staff to perform the care tasks listed and document accordingly.
Record review of the March 2025 Documentation Survey Report for Resident #74 revealed the resident requires total dependence for personal hygiene with the assist of 1- two (2) staff.
Record review of the admission Record revealed the facility admitted Resident #74 on 2/02/22 with medical diagnoses that included Cerebral Infarction and Hemiplegia Unspecified Affecting the Left Nondominant Side.
Record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 2/11/25 revealed, under section C, a Brief Interview for Mental Status (BIMS) summary score of 15, which indicated that Resident #74 was cognitively intact.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
all she could do to meet the interest of Resident #41.
dated 11/8/21.
Record review of the admission Record revealed the facility admitted Resident #41 on 9/6/24 with a medical diagnosis that included Hemiplegia and Hemiparesis following Cerebral Infarction Affecting the Right Dominant Side.
Record review of the MDS with an ARD of 9/16/24 revealed under, Section C, a BIMS summary score of 13, which indicated Resident #41 was cognitively intact.
Also revealed, under section F-F0500 . F.
How important is it to you to do your favorite activities? Very important was marked.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
medical diagnoses that included Cerebral Infarction and Hemiplegia Unspecified Affecting the Left
Record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 2/11/25
indicated that Resident #74 was cognitively intact.
Also revealed under section GG, functional limitation in range of motion (shoulder, elbow, wrist, hand), impairment on both sides was marked.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
Review of the facility policy titled, Use of Psychotropic Medications, last revised in March 2025, revealed the following under Policy Explanation and Compliance Guidelines: Section 16: Psychotropic medications used on a PRN basis must be limited to no more than 14 days unless the provider determines it is appropriate to extend the order.
The medical record must indicate a specific duration. Resident #43 Record review of the Order Summary Report for Resident #43 revealed an order dated 12/06/24 for Ativan (Lorazepam) 1 mg (milligram), to be administered one tablet by mouth every 12 hours as needed for anxiety with no stop date provided.
Record review of the admission Record revealed Resident #43 was admitted to the facility on [DATE], with a diagnosis of Anxiety.
Record review of Resident #43's Quarterly Minimum Data Set (MDS), Section C, dated 1/28/25, revealed a Brief Interview for Mental Status (BIMS) score of 15, indicating the resident was cognitively intact.
During an interview with the Director of Nursing (DON) on 3/04/25 at 12:24 PM, he confirmed that Resident #43 had a PRN order for Ativan without a stop date. Resident #259 Record review of the Order Summary Report for Resident #259 revealed an order dated 2/20/25 for Clorazepate Dipotassium 3.75 mg, to be administered one tablet by mouth every 12 hours as needed for anxiety with no stop date provided.
Review of the admission Record revealed Resident #259 was admitted to the facility on [DATE], with a diagnosis of Anxiety.
Record review of Resident #259's admission MDS, Section C, dated 2/20/25, revealed a BIMS score of 15, indicating the resident was cognitively intact.
During an interview with the DON on 3/04/25 at 12:28 PM, he confirmed that Resident #259 had a PRN order for Clorazepate Dipotassium without a stop date.
The DON further stated that all PRN psychotropic medications should have a stop date to ensure residents are reevaluated for continued need. He acknowledged that failure to include a stop date could result in residents continuing to receive medications they no longer need.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
81 mg chewable tablet signed off as administered.
that she gave the incorrect form of aspirin when she administered Aspirin EC 81 mg, but later realized
medication administration and stated that if she had done so, she likely would not have made the error.
Record review of Resident #90's admission Record revealed the facility admitted the resident on 1/04/25, with diagnoses that included End-Stage Renal Disease.
255339 03/06/2025
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
Based on observation, staff interview, and facility policy review, the facility failed to ensure a
Findings Include: Review of the facility policy titled Medication Storage unrevised, revealed, Policy Explanation and Compliance Guidelines . c.
During a medication pass, medications must be under the direct observation of the person administering medications or locked in the medication storage area/cart.
An observation on 3/03/25 at 12:45 PM revealed the medication cart located on C hall was unlocked and unattended without a nurse in view.
An observation and interview with Licensed Practical Nurse (LPN) #1 on 3/03/25 at 12:49 PM confirmed she walked away from the medication cart and left it unlocked.
She explained that she got called away and forgot to lock it. LPN #1 revealed leaving the medication cart unlocked gave the residents access to the cart and stated, Any of the residents can get in it and take something.
An interview with the Administrator (ADM) on 3/04/25 at 10:11 AM confirmed the nurses should never leave the medication cart unlocked when out of view.
She revealed that any resident could walk by and take some medication and have an allergic reaction.
During a medication pass, medications must be under the direct observation of the person administering medications or locked in the medication storage area/cart.
An observation on 3/03/25 at 12:45 PM revealed the medication cart located on C hall was unlocked and unattended without a nurse in view.
An observation and interview with Licensed Practical Nurse (LPN) #1 on 3/03/25 at 12:49 PM confirmed she walked away from the medication cart and left it unlocked.
She explained that she got called away and forgot to lock it. LPN #1 revealed leaving the medication cart unlocked gave the residents access to the cart and stated, Any of the residents can get in it and take something.
An interview with the Administrator (ADM) on 3/04/25 at 10:11 AM confirmed the nurses should never leave the medication cart unlocked when out of view.
She revealed that any resident could walk by and take some medication and have an allergic reaction.
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During an interview on 3/5/25 at 1:10 PM, LPN #1 confirmed that she administered Glipizide 10 mg, which had been discontinued on 3/3/25.
She also confirmed that she administered Albuterol Sulfate HFA inhaler at an incorrect time, as it had already been given at 6:00 AM. LPN #1 lastly confirmed that she documented administration of Mometasone Furoate inhaler at 8:00 AM, despite not administering it.
She acknowledged that failure to verify the six rights of medication administration could lead to adverse resident outcomes.
Record revew of the Admission Record of Resident #39 revealed was admitted on [DATE], with diagnoses including Type 2 Diabetes Mellitus and Chronic Systolic Congestive Heart Failure.
Resident #90
255339
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 255339 B.
Wing 03/06/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Choctaw Residential Center 135 Residential Center Rd Choctaw, MS 39350
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.