Heritage Hills Living & Rehabilitation Center

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

could not risk the possibility that the abuse occurred. The DON stated they suspended LPN #1 as soon as

the administration was notified and later terminated LPN #1. The DON stated LPN #1 did not work in the facility after they were informed of the allegation. On 10/22/25 at 6:00 p.m., the administrator stated right

after the incident, they in-serviced all staff on abuse: what was abuse, what to do if you suspect abuse, what were the regulations regarding abuse, and what to do if you're too stressed with a resident to provide immediate care. The administrator stated they routinely in-serviced their staff on abuse but incidents like

this still happened. On 10/22/25 at 6:20 p.m., CNA #2 stated they were in the hall with another CNA when LPN #1 approached and said Resident #1 was on the ground in the inner courtyard and needed help getting up. CNA #2 stated they retrieved the lift and sling to raise the resident from the ground. CNA #2 stated when they entered the courtyard, they saw Resident #1 laying in a large puddle of liquid and thought

they may have urinated on themselves but quickly realized there was too much liquid and the resident was wet in places where urine would not have flowed. CNA #2 stated Resident #1 said LPN #1 had poured a pitcher of water over them. CNA #2 stated LPN #1 corrected the resident and said they poured water on the resident's feet to clean them of feces. CNA #2 stated the amount of liquid they saw and where Resident #1 was wet did not match with the statement LPN #1 said about washing the resident's feet. CNA #2 stated

they assisted the resident to the shower and helped them shower. CNA #2 stated the resident had scrapes

on their elbow, hip, and knee. CNA #2 stated Resident #1 was upset and told them that LPN #1 pushed them from the chair, poured a cup of water on their feet, left and returned to the courtyard with a pitcher of ice water, poured the ice water onto Resident #1, and then used profanity to tell them that was what they deserved for defecating on themselves. CNA #2 stated the allegation sounded like abuse, but they were not sure how to proceed since they were to report any allegation of abuse to their charge nurse which was LPN #1. They stated they asked other staff for help and was able to contact the facility administration and inform them of events. CNA #2 stated LPN #1 left the facility and everyone wrote statements as to what they saw and heard.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Hills Living & Rehabilitation Center

411 North West Street McAlester, OK 74502

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

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 secure chemicals which had the potential to harm residents if the chemicals were touched, inhaled, or ingested. The DON identified 50 residents resided in the facility. Findings: On 10/22/25 at 11: 00 a.m., there were no wandering residents observed on the East hall. At the end of the East hall was an unsecured resident room which was used for storage. There was no way to lock the storage room door and located behind the door was six 1-gallon sized bottles of unsecured chemicals. The chemicals included three 1-gallon bottles of ZEP Wet Look Floor Polish, two 1-gallon bottles of Floor Front Floor Finish, and a gallon bottle of Betco Advanced Alcohol Gel Sanitizer. Each of the 6 bottles of chemicals had a warning label which read to keep out of reach of children.On 10/22/25 at 11:07 a.m., the DON observed the unsecured chemicals in the storage room. An undated and unnamed facility policy showed all chemicals must be secured with locks and accessible to only housekeeping and maintenance.The MSDS for Floor Front Floor Finish, dated 05/15/19, showed the chemical may be harmful if swallowed, may cause skin irritation, may cause eye irritation, and inhalation of vapors or mist may cause respiratory irritation. The MSDS for Zep Wet Look Floor Polish, dated 05/24/19 showed the vapors may cause irritation to the eyes respiratory system and the skin. The MSDS showed to avoid contact with skin and eyes; smoking, eating and drinking should be prohibited in the application area; and to dispose of rinse water according to local and national regulations. The MSDS for Advanced Alcohol Gel Sanitizer, dated 06/08/22, showed the chemical was dangerous; was a highly flammable liquid and vapor; and caused serious eye irritation. On 10/22/25 at 11:07 a.m., the DON stated all chemicals were to be locked up and only accessible to housekeeping and maintenance. The DON stated the staff knew better than to store chemicals in an unsecured room.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/24/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Heritage Hills Living & Rehabilitation Center

411 North West Street McAlester, OK 74502

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

FORM CMS-2567 (02/99) Previous Versions Obsolete

Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Based on observation and interview, the facility failed to securely store protected health information. The DON identified 50 residents resided in the facility. Findings:On 10/22/25 at 11: 00 a.m., at the end of the East hall was an unsecured resident room with three 4-drawer tall file cabinets and one 5-drawer tall file cabinet. On top of one file cabinet were loose papers and files with residents' protected health information, including name, birthdate, social security numbers, insurance information, labs, and physician's progress notes. None of the file cabinet drawers were locked and two of the 4-drawer file cabinets held more resident clinical records. On 10/22/25 at 11:07 a.m., the DON observed the unsecured storage room and resident records. An undated and unnamed facility policy showed all resident records were to be behind locked doors at all times with keys kept in the administrator's office.On 10/22/25 at 11:07 a.m., the DON stated all resident records should be secured with a lock and with limited staff access.

Event ID:

Facility ID:

If continuation sheet