Below average — CMS composite of the measures below.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Checotah Nursing Center during CMS and state inspections, most recent first.
Two residents sustained first- and second-degree burns after spilling excessively hot coffee or tea that had been served without lids and without adherence to the facility’s hot liquid safety policy. One resident with dementia, psychosis, and impaired vision, who could not complete a BIMS interview, was left drinking hot coffee alone without a lid despite a care plan intervention to ensure awareness of hot liquids and provide lids as needed. Another cognitively intact resident with convulsions, reduced mobility, muscle weakness, and tremors treated with propranolol also drank from an unlidded cup and later reported spilling hot tea, resulting in a second-degree burn. Surveyors measured coffee and hot water temperatures well above the policy threshold, and kitchen staff reported they did not temp hot beverages and were unaware of the hot liquid policy.
The facility did not provide quarterly written statements of financial transactions to residents with personal funds managed in a trust, as required by facility policy. Instead, residents were only shown their trust fund ledger when they inquired about their balance.
Surveyors found that the facility did not keep the kitchen clean and served unpasteurized shell eggs that were not fully cooked to residents. The dietary manager confirmed the use of unpasteurized eggs and acknowledged that kitchen floors had not been cleaned for about a week, with the cleaning schedule left incomplete. Meals prepared in these conditions were served to 39 residents.
The facility did not provide RN coverage for eight consecutive hours on multiple days, as shown by the October schedule and confirmed by the administrator. At the time, 43 residents were in the facility.
A resident's room was found to have a large crack in the window and significant dirt and grime buildup. Housekeeping staff indicated windows should be cleaned weekly and cracks reported to maintenance, but maintenance was unaware of the issue. This resulted in a failure to provide a clean, comfortable, and homelike environment.
A resident with severe cognitive impairment, fully dependent on staff for transfers, slipped out of a sit-to-stand mechanical lift when only one staff member assisted, contrary to facility policy requiring two staff for such transfers. Staff interviews confirmed knowledge of the policy, but the required assistance was not provided at the time of the incident.
A facility failed to update a care plan with interventions for a resident with a history of inappropriate sexual behaviors, despite the resident's severe cognitive impairment and previous incidents. The DON acknowledged the lack of a formal plan to prevent such behaviors, although staff knew how to respond.
The facility failed to implement its abuse policy after a CNA was reported for verbal abuse, using offensive language in front of a resident. Despite the substantiated allegation, the CNA was not terminated as per policy and continued working without documented training. This led to a deficiency due to improper handling and documentation of the incident.
The facility failed to document an investigation into abuse allegations, affecting all residents. A resident reported a CNA using offensive language, which was substantiated, resulting in termination. Another allegation of aggression by the same CNA was not substantiated, allowing the CNA to continue working. No witness statements or investigation documentation were available, and employees confirmed the lack of documentation despite claiming an investigation was conducted.
The facility failed to adhere to professional standards for respiratory care by not dating oxygen tubing for residents requiring oxygen therapy. Observations revealed that several residents with chronic respiratory conditions had undated oxygen tubing, despite physician orders for weekly changes. The DON confirmed that staff were expected to change and date the tubing as ordered.
The facility failed to employ sufficient staff in the food and nutrition service, leading to inadequate meal service. Observations showed a lack of staff during meal times, with residents eating from disposable trays due to staff shortages. The Dietary Manager noted that meal menus had to be adjusted due to insufficient staffing, affecting the preparation and service of meals for 28 residents and one resident on tube feeding.
The facility did not have a system in place for surveillance and monitoring to prevent Legionnaires' disease. Although a policy for Legionella surveillance existed, the DON was unaware of any documentation for monitoring efforts. This deficiency was identified despite the presence of 29 residents in the facility.
The facility failed to ensure correct and legal documentation of advance directives for two residents. One resident's care plan lacked documentation of an advance directive, and the DON could not locate the necessary documents. Another resident's POA form was not notarized, making it invalid, and their advance directive was not documented in the care plan.
The facility failed to store food safely as the refrigerator had been dripping for several days, with bowls placed to catch the liquid. The ice machine was also broken, requiring ice to be sourced externally. The refrigerator door gasket was sticking out, indicating a need for repair. The DM acknowledged these issues.
The facility failed to administer medications as ordered for two residents, leading to multiple missed doses. One resident with multiple diagnoses had several medications not documented as administered in February 2024, while another resident with atrial fibrillation, hypertension, and depression had missed doses in January 2024. The ADON confirmed the medications were not given as required.
The facility failed to complete a baseline care plan within 48 hours for a resident admitted with multiple diagnoses, including UTI, cerebral infarct, A-fib, dysarthria, heart failure, hemiplegia, and aphasia. The MDS Coordinator confirmed the care plan had not been created yet.
Failure to Control Hot Liquid Temperatures Resulting in Resident Burns
Penalty
Summary
The facility failed to ensure hot liquids were served at a safe temperature and that residents at risk for burns were adequately protected, resulting in burns to two residents. One resident with vascular dementia, behavioral disturbance, unspecified psychosis, and mildly impaired vision, and who was unable to complete a BIMS interview (score 99), was observed sitting alone at a table drinking from a brown coffee cup without a lid. This resident later sustained scalding burns to both thighs and a blister on the left thigh after spilling a hot fluid, with the physician describing the injury as 99% first-degree and 1% second-degree burns. The resident’s care plan included an intervention to ensure awareness of hot liquids and to provide lids as needed, but no lid was observed in use. A state incident report documented the hot fluid spill and resulting burns. A subsequent surveyor temperature check of coffee measured 160.9°F, and food temperature records showed coffee holding temperatures of 180°F on two dates, despite a facility policy stating that hot liquids above 140°F should be held in dietary until they reached an appropriate temperature. A second resident, who was cognitively intact (BIMS 13) but had diagnoses including unspecified convulsions, reduced mobility, impaired cognitive functions and awareness, and muscle weakness, and who was receiving propranolol for tremors, was also observed drinking from a brown coffee cup without a lid. This resident had previously reported spilling hot tea on their lap before breakfast, resulting in a wound measuring 6.0 x 2.5 inches with a blistered area of 4.0 x 1.5 inches; a physician later classified this as a second-degree burn, with updated wound measurements of 6 cm x 2 cm x 0.1 cm. A surveyor-measured hot water temperature was 166.9°F. The assistant director of nursing identified four residents at risk for burns from hot liquids. The cook stated they did not take temperatures of coffee or tea before serving and simply provided drinks to CNAs, and the dietary manager reported not knowing the policy for serving hot liquids, indicating that the facility’s written hot liquid safety policy was not being followed in practice.
Failure to Provide Quarterly Trust Fund Statements
Penalty
Summary
The facility failed to provide quarterly written itemized statements of financial transactions to all 16 residents whose personal funds were managed in a trust by the facility. According to facility documents and policies, residents or their representatives were to receive these statements at least quarterly. However, interviews with the Business Office Manager (BOM) and the administrator revealed that they were unaware of the policy requirements and had not been issuing the required quarterly statements. Instead, residents were only shown their trust fund ledger upon request, rather than receiving regular written statements as stipulated by facility policy.
Failure to Maintain Kitchen Cleanliness and Use Pasteurized Eggs
Penalty
Summary
Surveyors observed that the facility failed to maintain kitchen cleanliness and did not ensure the use of pasteurized eggs for residents' meals. Unpasteurized shell eggs were found stored in the kitchen refrigerator and were used to prepare soft or over-medium eggs for residents, as confirmed by the dietary manager (DM), who was unaware if the eggs were pasteurized. A receipt confirmed the purchase of unpasteurized eggs, and there was no evidence that pasteurized eggs had been ordered. Additionally, the kitchen floor was found to be unclean, with a brown substance present against the walls, around table legs, and under the dish machine. The DM acknowledged that the kitchen floors had not been swept or mopped for about a week, and the cleaning schedule for the month had not been completed. A total of 39 residents were identified as having received meals prepared by the kitchen during this period. No information was provided regarding the medical history or condition of the residents at the time of the deficiency.
Failure to Ensure Required RN Coverage
Penalty
Summary
The facility failed to provide registered nurse (RN) coverage for eight consecutive hours each day, seven days per week, as required. Review of the facility's schedule for October 2025 revealed that no RN was scheduled to work on six specific days during the month. The administrator confirmed that there was no RN present in the facility on those days. At the time, the facility had 43 residents residing there. This deficiency was identified through record review and administrator interview, with direct evidence that the required RN coverage was not maintained on the specified dates.
Failure to Maintain Clean and Safe Resident Environment
Penalty
Summary
A deficiency was identified when a resident's room was observed to have a 10 to 12 inch crack in the window glass along with a build-up of dirt and grime. The housekeeping supervisor stated that resident windows were supposed to be cleaned weekly and that any cracks should be reported to maintenance for repair. However, the maintenance supervisor reported being unaware of the crack in the window and acknowledged that it should be repaired. These findings indicate that the facility failed to maintain a clean and comfortable environment for the resident as required.
Failure to Provide Adequate Assistance During Mechanical Lift Transfer
Penalty
Summary
The facility failed to provide adequate assistance to prevent a resident from sliding out of a mechanical lift. According to the facility's policy, two staff members are required for any transfer involving a sit-to-stand mechanical lift. A resident with severe cognitive impairment, who was totally dependent on staff for transfers, slipped out of the sit-to-stand mechanical lift and was assisted to the ground. The incident report indicated that staff were to be educated on the requirement for two-person assistance during such transfers. Interviews revealed that at the time of the incident, only one staff member was present during the transfer, despite knowing the policy required two. The staff member reported being unable to find another person to assist. Other staff, including a CNA, an LPN, and the assistant director of nursing, confirmed that the facility policy mandates two staff members for transfers using the mechanical lift. This failure to follow established policy resulted in the resident sliding out of the lift.
Failure to Implement Interventions for Resident Safety
Penalty
Summary
The facility failed to implement necessary interventions to protect residents from abuse, specifically in the case of a resident with a history of inappropriate sexual behaviors. This resident, who was severely cognitively impaired and had diagnoses including sexual disorders, depressive disorders, and anxiety, was documented to have inappropriately touched another resident. Despite being admitted to a geri-psych facility for treatment, upon return, the resident's care plan was not updated with interventions to prevent further inappropriate behaviors. The Director of Nursing acknowledged that while staff were aware of how to respond to such behaviors, there was no formal plan in place to prevent them.
Failure to Implement Abuse Policy and Document Disciplinary Actions
Penalty
Summary
The facility failed to implement its abuse policy regarding an allegation of verbal abuse by a certified nursing assistant (CNA) which had the potential to affect all residents. The incident involved a resident who reported that the CNA used offensive language, including profanity, which was particularly upsetting during a gospel singing event. The director of nursing (DON) substantiated the allegation of verbal abuse, and the facility's policy stated that the employee should be terminated if the allegations were true. However, there was no documentation of the termination in the CNA's personnel file, and the employee roster did not reflect the termination. Despite the substantiated abuse, the CNA was allowed to return to work in the dietary department without undergoing any training on proper language use, contrary to what was documented. The CNA was later observed working in the nursing department and was reported by several anonymous employees to have not been terminated as initially decided by the administrator. This failure to adhere to the facility's abuse policy and the lack of proper documentation and follow-through on disciplinary actions led to the deficiency.
Failure to Document Investigation of Abuse Allegations
Penalty
Summary
The facility failed to conduct a thorough investigation regarding an allegation of abuse, which has the potential to affect all residents. The Reporting Resident Abuse policy requires the completion of an incident report form and, when possible, statements from any witnesses. An incident report dated June 2, 2024, documented that a resident reported a CNA using offensive language, which was substantiated, leading to the CNA's termination. Another incident report dated June 27, 2024, accused the same CNA of being aggressive with residents, but the investigation was not substantiated, and the CNA continued to work. There were no documented witness statements, interviews, or investigation records available for review. Interviews with several anonymous employees confirmed that no documentation of their interviews or the investigation was made, despite their claim of conducting an investigation.
Failure to Adhere to Oxygen Tubing Change Protocols
Penalty
Summary
The facility failed to provide respiratory care in accordance with professional standards for four residents who required oxygen therapy. Resident #9, diagnosed with congestive heart failure, chronic respiratory failure, and cerebral infarction, had physician orders to receive oxygen via nasal cannula and to have the oxygen tubing and humidifier changed weekly. However, observations on two separate occasions revealed that the oxygen tubing was not dated, indicating non-compliance with the physician's orders. Similarly, Resident #19, with chronic obstructive pulmonary disease and heart failure, was observed with undated oxygen tubing on two occasions, despite orders to change the tubing weekly. Resident #23, who had pneumonia, chronic obstructive pulmonary disease, and congestive heart failure, also had undated oxygen tubing during two observations, contrary to the physician's orders for weekly changes. Resident #24, diagnosed with chronic obstructive pulmonary disease, was found with oxygen tubing and a humidifier dated several weeks prior, indicating that the equipment had not been changed as required. The Director of Nursing acknowledged that the staff was expected to change and date the oxygen tubing as per the orders, and the lack of dating could lead to uncertainty about whether the tubing was changed as scheduled.
Staff Shortage in Food and Nutrition Service
Penalty
Summary
The facility failed to employ enough staff to effectively carry out the functions of the food and nutrition service. Observations, record reviews, and interviews revealed that the dietary schedule for August 2024 included only one cook and one dietary aide for the morning shift, one cook and one aide for a split shift, and one cook with no dietary aide for the evening shift. On a specific morning, a cart with eight disposable trays was observed unattended in the resident hall, and three residents were seen eating from disposable trays in the dining room. The Dietary Manager (DM) explained that breakfast was served on disposable trays due to staff shortages, with only one staff member available to serve breakfast that morning. Additionally, the DM provided menus for the week and stated that the lunch and supper menus had been switched because more time and staff were required to prepare the lunch menu. The DM acknowledged the need for more staff in the kitchen to adequately meet the dietary needs of the residents, which included 28 residents receiving meals prepared by the kitchen and one resident receiving nutrition via tube feeding.
Failure to Monitor and Prevent Legionnaires' Disease
Penalty
Summary
The facility failed to implement a system of surveillance and monitoring to identify and prevent Legionnaires' disease. The Director of Nursing (DON) identified that 29 residents resided in the facility. A policy titled 'Legionella Surveillance' was documented, indicating that Legionella surveillance is a component of the facility's water management plans for reducing the risk of Legionella. The policy stated that in the absence of Legionella infections for at least one year, the facility should implement primary prevention strategies, including diagnostic testing. However, during an interview on August 7, 2024, the DON provided a Legionella Policy but was unaware of any documentation for monitoring the prevention of Legionnaires' disease.
Deficiency in Advance Directive Documentation
Penalty
Summary
The facility failed to ensure that information regarding advance directives was correct and legal for two residents. Resident #9, who had diagnoses including congestive heart failure, chronic respiratory failure, type 2 diabetes mellitus, and cerebral infarction, was documented as having a full code status in their care plan dated 12/19/23. However, the care plan did not document an advance directive. An acknowledgment form dated 06/18/24 indicated that the resident had executed an advance directive and a Power of Attorney (POA), but the Director of Nursing (DON) could not locate these documents in the resident's clinical record. Resident #20, with diagnoses including congestive heart failure, type 2 diabetes mellitus, and hypertension, had a care plan dated 08/15/23 that documented a full code status but did not include an advance directive. A POA form dated 03/02/21 was found in the records but was not notarized, rendering it not a legal document. An acknowledgment form dated 08/07/23 indicated that the resident had executed an advance directive and a POA, but the DON confirmed that an advance directive was not available in the resident's records.
Food Storage Deficiency Due to Equipment Issues
Penalty
Summary
The facility failed to store food in accordance with professional standards for food service safety. During a kitchen tour, it was observed that the refrigerator had two plastic bowls on the top rack collecting liquid dripping from the ceiling. The Dietary Manager (DM) acknowledged that the refrigerator had been dripping for about four to five days. Additionally, the ice machine was broken, and ice was being sourced externally. During a meal service observation, the refrigerator still had the bowls in place to catch drips, and staff were seen moving the bowls to access other items. The refrigerator door also had a piece of the gasket sticking out, indicating a need for repair. The DM confirmed that both the refrigerator and the ice machine required maintenance.
Failure to Administer Medications as Ordered
Penalty
Summary
The facility failed to administer medications as ordered for two residents, leading to multiple instances of missed doses. Resident #4, who had diagnoses including anxiety, major depression, hyperlipidemia, disc degeneration lumbar region, dementia, and DMII, had several medications not documented as administered on specific dates in February 2024. These medications included baclofen, tramadol hydrochloride, acetaminophen, divalproex sodium extended release, mirtazapine, atorvastatin calcium, trazodone hydrochloride, and levemir. The Assistant Director of Nursing (ADON) confirmed that the lack of documentation indicated the medications were not given, and no records were found in the paper medication administration book either. Similarly, Resident #1, who had diagnoses including atrial fibrillation, hypertension, and depression, also experienced missed medication administrations. The January 2024 Medication Administration Record (MAR) showed no documentation of time given for several medications, including budesonide, ipratropium bromide, refresh celluvisc, senna-plus, eliquis, folic acid, diltiazem hydrochloride, hydralazine hydrochloride, famotidine, levothyroxine sodium, and levalbuterol hydrochloride. The ADON reviewed the MAR and confirmed that the medications were not administered on the specified dates and times. The facility's failure to administer medications as ordered and to properly document medication administration led to significant gaps in the residents' treatment regimens. This deficiency was identified through record reviews and interviews, highlighting a critical lapse in the facility's pharmaceutical services and adherence to physician orders.
Failure to Complete Baseline Care Plan Within 48 Hours
Penalty
Summary
The facility failed to ensure a baseline care plan was completed within 48 hours for one of seven sampled residents reviewed for baseline care plans. The facility's policy mandates that a baseline plan of care to meet the resident's immediate needs should be developed by the Interdisciplinary Team (IDT) within 48 hours of admission. Resident #7, who was admitted with diagnoses including UTI, cerebral infarct, A-fib, dysarthria, heart failure, hemiplegia on the right dominant side, and aphasia, did not have a care plan located in their clinical record. The MDS Coordinator confirmed that the care plan had not been put together yet.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Checotah
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Eufaula Manor Nursing And Rehabilitation Center | 12.8 mi | ★★★★★ | 0 | 0 |
| Lakeview Nursing & Rehab | 13.3 mi | ★★★★★ | 0 | 0 |
| Countryside Estates | 14.2 mi | ★★★★★ | 0 | 0 |
| The Springs Skilled Nursing And Therapy | 20.5 mi | ★★★★★ | 16 | 0 |
| Pleasant Valley Health Care Center | 20.7 mi | ★★★★★ | 0 | 0 |
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