Leisure Village Health Care Center
Inspection Findings
F-Tag F0580
F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record review and interview, the facility failed to ensure resident representatives were notified of a change
in condition for 2 (#4 and #9) of 4 sampled residents reviewed for change in condition.The DON reported
the census in the facility was 80. Findings: A facility policy titled Notification of Change in Condition, revised 02/06/25, read in part, The attending physician/physician extender (nurse practitioner, physician assistant, or clinical nurse specialist) and the resident representative will be notified of a change in resident's condition, per standards of practice and federal and/or state regulations.1. An admission record, dated 10/23/20, showed Res #4 had diagnoses which included congestive heart failure and obstructive sleep apnea.A nurse note, dated 12/05/24, showed Res #4 had complained of nausea and the physician had been notified and ordered Zofran 4mg (a medication used to prevent nausea) every four hours as needed.
The note did not show the resident's representative had been notified of the new medication.A nurse note, dated 01/21/25, showed Res #4 had an elevated A1C level (a test that measures average blood sugar levels). The note showed the physician was notified and the physician ordered metformin 500mg (an antihyperglycemic medication) twice a day by mouth for a new diagnosis of type II diabetes mellitus. The note did not show the resident's representative had been notified of the abnormal laboratory value, the new medication, or the new diagnosis.An annual assessment, dated 06/18/25, showed Res #4 had a brief
interview for mental status score of 15 which was indicative of intact cognition.On 09/09/25 at 11:30 a.m., Res #4's representative stated they had been contacted by the facility once since admission on [DATE REDACTED].2.
An admission record dated 02/28/25, showed Res #9 had diagnoses which included diabetes mellitus and muscle weakness.A nurse note, dated 05/02/25, showed Res #9 fell from the bed onto a fall mat. The note showed the physician, the DON and Res #9's family member were notified.On 09/09/25 at 10:55 a.m., Res #9's family member stated the facility did not notify them of the fall that occurred on 05/02/25.On 09/09/25 at 11:40 a.m., LPN #1 stated that resident representatives should be notified of any significant change to a resident's condition. LPN #1 stated if the resident was cognitively intact, they did not always have to notify family. On 09/09/25 at 11:45 a.m., LPN #2 stated representatives should be notified whenever a resident was sent to the hospital, had a medication change, or any other significant event.On 09/09/25 at 11:55 a.m., the DON stated representatives should be notified of significant changes, but it was not always necessary to notify the representatives of cognitively intact residents unless the representative requested to be notified.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Leisure Village Health Care Center in Tulsa, OK inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Tulsa, OK, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Leisure Village Health Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.