Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Thunder Care And Rehabilitation during CMS and state inspections, most recent first.
Two residents were not protected from neglect and verbal abuse. One, fully dependent and cognitively impaired, was left unattended outside for over an hour due to poor staff communication. Another, also fully dependent, was subjected to yelling and foul language by a CNA during personal care, with the incident confirmed by witnesses.
The facility did not maintain an effective pest control program, as evidenced by repeated findings of cockroaches and a report of bed bugs in resident rooms and common areas. Multiple residents and a CNA confirmed the presence of pests, and inspection reports documented ongoing pest activity despite interventions. The administrator noted that resident hoarding contributed to the problem and that pest control services were called as needed, but pest issues persisted.
A resident with a history of stroke and significant physical impairments was not assessed or documented after a fall from bed. The incident was not reported or recorded by staff present, and the required post-fall evaluation and notifications were not completed, resulting in a lack of timely medical assessment.
A resident with hypothyroidism did not receive two scheduled doses of levothyroxine as ordered by the physician, with no documented reason for the missed administrations. The quality coordinator confirmed the medication should have been given according to the order.
The facility did not ensure that residents were protected from all forms of abuse and neglect, resulting in a deficiency related to resident safety and well-being.
Two residents with significant medical needs did not receive any of their scheduled showers over a six-day period, as confirmed by both their reports and missing bath documentation. Both residents stated they were supposed to receive showers three times weekly but had not received any, and the ADON could not locate the required bath records for the month.
The facility did not follow its abuse policy by failing to report an allegation of abuse within the required two-hour window. A resident with bipolar disorder and anxiety was involved in inappropriate behavior toward another resident and a staff member. Although the incident was recognized and the resident was redirected, the required incident form and notification to the state health department were not completed within the mandated timeframe.
A resident with a history of bipolar disorder and anxiety was involved in inappropriate physical contact with another resident and a staff member. The incident was not reported to the OSDH within the required two-hour window, as mandated by facility policy, and the DON confirmed that proper reporting procedures were not followed.
A resident with bipolar disorder and anxiety was reported to have inappropriately grabbed another resident's hand and later attempted to grab a staff member. Despite the facility's policy requiring investigation of all abuse allegations, the DON confirmed that no investigation was conducted into these incidents.
A resident with bipolar disorder and anxiety engaged in inappropriate physical contact with another resident and a staff member. Although the incident was documented and the care plan was revised to include the event, no new interventions were added to address the behavior, as confirmed by record review and interviews.
A resident with an indwelling urinary catheter did not have a physician order or care plan documentation for the catheter, and there was no record of catheter care or infection prevention interventions. Staff were unsure why the catheter remained in place and could not confirm if regular care was provided, resulting in a failure to ensure appropriate catheter management.
A resident with severe cognitive impairment was provided bed rails without a required safety assessment. Facility policy mandates a thorough evaluation before bed rail use, but staff confirmed that this was not completed prior to installation.
The facility did not include the required resident census and actual hours worked on the posted daily nurse staffing schedules for two consecutive days. The administrator was unaware of the requirement to post this information, and the deficiency was identified while 127 residents were present in the facility.
A resident did not receive prescribed morning medications within the facility's scheduled administration window, as all medications were given after the designated time. Facility policy required timely administration, and the DON confirmed the medications were administered late.
A nurse failed to wear a gown while providing wound care to a resident with a stage four pressure ulcer, contrary to the facility's Enhanced Barrier Precautions policy, which requires both gown and glove use for residents with wounds. No EBP signage was present near the resident's room, and both the nurse and DON acknowledged the lapse.
A resident with severe cognitive impairment was not protected from sexual abuse by another resident who was cognitively intact. The impaired resident frequently wandered into other residents' rooms, including the abuser's room, where inappropriate sexual behavior was observed by staff. Despite these observations, the facility failed to identify the incidents as sexual abuse and did not adequately implement its abuse policy, leading to a deficiency in protecting the resident.
A facility failed to implement its abuse policy when a cognitively impaired resident was found in a compromising situation with another resident. Despite multiple observations of inappropriate behavior, the incidents were not recognized or investigated as potential abuse. The facility's administrator and DON were not fully informed, and the abuse protocol was not followed, leading to a deficiency.
A facility failed to notify a resident's representative of a medication change, which involved the application of permethrin cream. The resident, diagnosed with cerebral palsy and other conditions, had no documentation in their record indicating that their representative was informed of the new order. An LPN could not recall if they had notified the representative.
A resident with cognitive impairment and obesity did not receive a proper bed bath due to CNAs reusing washcloths and failing to clean the peri area correctly. The CNAs reused washcloths due to a shortage and did not follow proper hygiene practices, particularly during the resident's menstrual cycle.
A facility failed to treat a resident with dignity and respect when a staff member grabbed the resident and took her back to her room after she attempted to hit the staff member. The resident had severe cognitive impairment and a care plan noting potential for physical and verbal behaviors.
Failure to Prevent Resident Neglect and Verbal Abuse
Penalty
Summary
The facility failed to protect two residents from neglect and abuse. One resident with spina bifida and quadriplegia, who was totally dependent on staff for care and had moderate cognitive impairment, was left unattended in the courtyard for over an hour. The resident had requested to go outside near shift change, and although staff came outside for smoke breaks, they did not check on the resident. The resident was only discovered and brought back inside during a routine two-hour check. Communication between CNAs was inadequate, as the CNA who took the resident outside claimed to have informed the next shift, but the receiving CNA stated they were not told the resident was outside and only found them during scheduled rounds. Another resident, who was totally dependent on staff for activities of daily living and was cognitively intact, experienced verbal abuse from a CNA. The resident requested assistance with personal hygiene, and the CNA responded by yelling and using foul language. The altercation escalated with both parties exchanging threats and inappropriate language. Witnesses confirmed the CNA's behavior, and the incident was substantiated as verbal abuse. The facility's policy required an abuse-free environment, but staff actions did not prevent or address the abuse and neglect in these cases.
Failure to Maintain Effective Pest Control Program
Penalty
Summary
The facility failed to maintain an effective pest control program, as evidenced by multiple documented instances of cockroach activity and a report of bed bugs within resident rooms and common areas. Service Inspection Reports over a three-month period detailed repeated findings of cockroaches in various resident rooms, a broom closet, and the kitchen, with physical removal of pests occurring on each occasion. The reports also noted that some rooms required repeated treatments, and that cockroach activity was found behind appliances and underneath baseboards. Additionally, a resident reported that their room had been sprayed after finding a bed bug in their bed, and another resident stated they had seen cockroaches in their room about a week prior. A CNA confirmed the presence of cockroaches in the facility. During interviews, the administrator acknowledged that some residents hoarded items or kept belongings in cardboard boxes, which complicated pest control efforts. The administrator stated that pest control services were called whenever pests were found, but that the issue was ongoing and not always confined to the same areas. Despite the facility's pest control policy and ongoing interventions, the repeated findings of pests and resident and staff reports indicate that the pest control program was not effective in keeping the building free of insects and rodents as required.
Failure to Assess and Document Resident After Fall
Penalty
Summary
The facility failed to assess a resident after a fall, as required by policy. A resident with a history of stroke, cognitive intactness, and significant physical impairments was dependent on staff for all activities of daily living. The resident self-reported rolling out of bed and hitting their left ribs, later experiencing left-sided pain and coffee brown emesis, which led to transport to the emergency room. There was no documentation of the fall in the medical record, and the required assessment for injuries, including vital signs and documentation, was not completed at the time of the incident. Interviews revealed that two CNAs and an LPN were present when the resident was moved back to bed after the fall, but no incident report was filed, and the fall was not communicated to nursing staff until the resident reported it. The administrator confirmed that the staff involved did not follow facility procedures for post-fall assessment and documentation, resulting in a lack of timely evaluation and notification to the physician and family as required by policy.
Failure to Administer Physician-Ordered Medication
Penalty
Summary
The facility failed to administer medication as ordered by the physician for one of three sampled residents reviewed for medication administration. Specifically, a resident with hypothyroidism had an active order for levothyroxine sodium oral tablet 150 mcg, which was to be started and continued until discharge. However, the July medication administration record showed that the medication was not administered on two consecutive days, with blank areas noted for those dates. The quality coordinator confirmed that there was no documented reason for the missed doses, and acknowledged that the medication should have been given according to the physician's order.
Failure to Protect Residents from Abuse and Neglect
Penalty
Summary
The facility failed to protect each resident from all types of abuse, including physical, mental, sexual abuse, physical punishment, and neglect by anybody. This deficiency indicates that residents were not adequately safeguarded from potential or actual harm caused by others, as required by regulations. The report identifies a lapse in ensuring residents' safety and well-being from abuse and neglect, but does not provide specific details about the individuals involved or the circumstances of the incident.
Failure to Provide Scheduled Bathing for Dependent Residents
Penalty
Summary
The facility failed to ensure that residents who required assistance with activities of daily living received scheduled bathing. Record review and interviews revealed that two residents missed all scheduled showers over a six-day period, despite both being cognitively intact and having medical conditions such as epilepsy, morbid obesity, hemiplegia, and hemiparesis following a cerebral infarction. Both residents reported not receiving their scheduled showers, which were supposed to occur three times per week. Additionally, the Assistant Director of Nursing was unable to locate the bath sheets for the relevant month, further indicating a lack of documentation and follow-through on scheduled care.
Failure to Timely Report Allegation of Abuse
Penalty
Summary
The facility failed to implement its abuse policy by not reporting an allegation of abuse within the required two-hour timeframe. According to the facility's abuse policy, all incidents and allegations involving abuse or resulting in serious bodily injury must be reported within two hours. A behavior note documented that one resident reported another resident had grabbed their hand and placed it in the other resident's pants in the dining room. The resident who initiated the behavior was redirected and later attempted to grab a staff member while being fed, stating they wanted to play. This resident had diagnoses including bipolar disorder and anxiety. The Director of Nursing (DON) was notified of the incident, and the administrator instructed staff to return the resident to their room and continue monitoring behaviors. However, the DON acknowledged that an incident form should have been completed and the state health department notified within two hours, which did not occur.
Failure to Timely Report Alleged Abuse to State Authorities
Penalty
Summary
The facility failed to report an allegation of abuse to the Oklahoma State Department of Health (OSDH) within the required two-hour timeframe, as specified in their abuse policy. Record review showed that a resident with diagnoses including bipolar disorder and anxiety was involved in an incident where they inappropriately grabbed another resident's hand and placed it in their pants in the dining room. The same resident also reached for a staff member of the opposite sex during feeding, expressing a desire to play. Although the Director of Nursing (DON) acknowledged that an incident report should have been completed and OSDH notified within two hours, this was not done in accordance with facility policy.
Failure to Investigate Alleged Abuse Incident
Penalty
Summary
The facility failed to conduct a thorough investigation following an allegation of abuse involving one of three sampled residents. According to the abuse policy, all allegations of abuse are to be investigated by the Administrator and the DON. Documentation showed that a resident was reported to have grabbed another resident's hand and placed it in their pants in the dining room, and later attempted to grab a staff member while voicing a desire to play. The resident involved had diagnoses including bipolar disorder and anxiety. Despite these incidents being reported, the DON confirmed that no investigation was conducted into the alleged abuse.
Failure to Revise Care Plan After Behavioral Incident
Penalty
Summary
The facility failed to ensure that a care plan was appropriately revised following a behavioral incident involving a resident. On 06/05/25, a behavior note documented that a resident with diagnoses of bipolar disorder and anxiety engaged in inappropriate physical contact with another resident in the dining room and later attempted similar behavior with a staff member. The resident was redirected and returned to their room. Although the care plan was revised the following day to note the incident, no new interventions were put in place to address the behavior. Review of records and interviews confirmed that the care plan should have been updated with specific interventions in response to the incident, but this was not done.
Failure to Document and Provide Appropriate Catheter Care
Penalty
Summary
A resident with a history of benign prostatic hyperplasia and moderate cognitive impairment was observed with an indwelling urinary catheter in place after returning from the hospital. The resident's care plan only referenced the use of disposable briefs for urinary incontinence and did not mention the presence of a catheter. There was no physician order for the indwelling catheter in the medical record, nor was there documentation of catheter care or infection prevention interventions. The resident was unaware of the reason for the catheter and could not confirm if regular catheter care was provided. Staff interviews revealed uncertainty regarding the necessity of the catheter and a lack of documentation for catheter care and maintenance. The LPN stated that catheter care is generally performed every shift but acknowledged that there was no way to verify if this was done due to missing documentation. The DON confirmed that a physician order specifying the medical diagnosis, catheter size, and care interventions should have been present, and that the resident had not been assessed for catheter removal. These omissions resulted in a failure to provide appropriate care and services for a resident with an indwelling urinary catheter.
Failure to Assess Resident Prior to Bed Rail Installation
Penalty
Summary
Surveyors found that the facility failed to assess a resident for the use of bed rails prior to their installation. Observations on two separate occasions showed that bed rails were up on both sides of the resident's bed. The facility's policy requires a comprehensive assessment of various risk factors before bed rails are used, including medical diagnosis, cognitive status, mobility, and risk of entrapment. Record review revealed that the resident had a severely impaired cognitive status, as indicated by a BIMS score of three. The administrator confirmed that no assessment was completed before the bed rails were put in place, despite the policy and the resident's condition.
Incomplete Daily Nurse Staffing Information Posted
Penalty
Summary
The facility failed to post all required components of the daily nurse staffing information for two consecutive days. During observations, the daily staffing schedules displayed in a glass case on the North hall were found to be missing both the resident census and the actual hours worked, despite being dated for the respective days. The administrator confirmed that they were unaware that the census and actual hours worked were required to be included on the posted schedule. At the time of the survey, the facility had 127 residents.
Failure to Administer Medications According to Physician Orders
Penalty
Summary
The facility failed to ensure that medications were administered according to physician orders for one resident among those sampled for timely medication administration. Facility records indicated that the scheduled morning medication pass was from 7:00 a.m. to 11:00 a.m., and facility policy required medications to be administered in a safe and timely manner as prescribed. Physician orders for the resident included multiple medications to be given in the morning or twice daily. However, a medication administration audit showed that on a specific date, all of the resident's morning medications were administered after the scheduled window, between 12:28 p.m. and 12:32 p.m. The Director of Nursing confirmed that these medications were given late and should have been administered by 11:00 a.m.
Failure to Follow Enhanced Barrier Precautions During Wound Care
Penalty
Summary
A deficiency was identified when a registered nurse provided wound care to a resident with a stage four pressure ulcer without utilizing a gown, as required by the facility's Enhanced Barrier Precautions (EBP) policy. During the observation, the nurse wore gloves but did not don a gown, and there was no EBP signage near the resident's room. The facility's policy specifies that both gown and glove use are required during high-contact care activities for residents with wounds. The resident in question was severely cognitively impaired, as indicated by a BIMS score of three. Both the nurse and the Director of Nursing confirmed that a gown should have been worn during the wound care procedure.
Failure to Protect Resident from Sexual Abuse
Penalty
Summary
The deficiency involved a failure to protect a resident from sexual abuse within the facility. Resident #1, who was severely cognitively impaired and had not been evaluated for the capacity to consent to a sexual relationship, was found in a compromising situation with Resident #2, who was cognitively intact. On multiple occasions, Resident #1 was observed entering Resident #2's room, and on one occasion, staff observed Resident #2 engaging in inappropriate sexual behavior with Resident #1. Despite these observations, the facility did not initially identify the incidents as sexual abuse. The facility's records showed that Resident #1 had a history of wandering and entering other residents' rooms, which was documented in progress notes and assessments. Despite this behavior, the facility's response was limited to redirecting Resident #1 and implementing 15-minute checks after the incident on December 11, 2024. The facility's abuse policy was not effectively implemented, as the incidents were not reported or investigated as abuse, and the staff did not receive adequate guidance on handling such situations. Interviews with staff revealed inconsistencies in the reporting and handling of the incidents. CNA #1 and CNA #2 provided detailed accounts of the inappropriate behavior they witnessed, but these details were not fully communicated to the administrator or documented in the facility's records. The administrator and DON were not fully aware of the extent of the incidents, and the facility's investigation was based on incomplete information. This lack of communication and failure to follow the abuse policy contributed to the deficiency in protecting Resident #1 from sexual abuse.
Failure to Implement Abuse Policy in Resident Interaction
Penalty
Summary
The facility failed to implement its abuse policy and procedure to identify and investigate an incident of sexual abuse involving two residents. Resident #1, who was severely cognitively impaired and had not been evaluated for the capacity to consent to a sexual relationship, was found in a compromising situation with Resident #2, who was cognitively intact. Despite multiple observations and reports of inappropriate behavior between the two residents, the facility did not recognize or investigate these incidents as potential sexual abuse. On several occasions, staff observed Resident #1 wandering into other residents' rooms, including Resident #2's room, where inappropriate contact was reported. On one occasion, a CNA observed Resident #2 on top of Resident #1, with Resident #2's hand down Resident #1's pants and engaging in inappropriate physical contact. Despite these observations, the facility categorized the incident as inappropriate behavior rather than abuse, and the abuse protocol was not implemented. The facility's administrator and DON were not fully informed of the details of the incidents, and the abuse policy was not followed. The administrator relied on reports from RN #1 and did not conduct a thorough investigation, including interviews with all involved staff and residents. The facility's failure to assess Resident #1's ability to consent and to recognize the incidents as potential abuse led to the deficiency.
Failure to Notify Resident's Representative of Medication Change
Penalty
Summary
The facility failed to notify a resident's representative of a medication change, which constitutes a deficiency in communication and notification protocols. The resident in question was admitted with diagnoses including cerebral palsy, autistic disorder, and spastic quadriplegic cerebral palsy. A physician's order was issued for the application of permethrin external cream 5% to the resident's entire body, to be left on for eight hours before washing off. However, the resident's record lacked documentation indicating that the resident's representative was informed of this new medication order. During an interview, a licensed practical nurse stated they did not remember notifying the resident's representative about the medication change.
Improper Bed Bath and Hygiene Practices
Penalty
Summary
The facility failed to ensure a proper bed bath was provided to a resident with a diagnosis of obesity and moderate cognitive impairment, who was dependent on staff for bathing. During the observation of the bed bath, it was noted that the CNAs reused washcloths by dipping them back into the soapy and clean water basins, which is against proper hygiene practices. The CNAs did not have enough washcloths to continue the bath, leading to the reuse of washcloths, which were considered dirty and should have been discarded after each use. Additionally, the CNAs did not properly clean the resident's peri area, particularly between the labia, during the bed bath. The resident was on their menstrual cycle, and the improper cleaning was confirmed by the presence of a blood stain and a string of blood clot on the washcloth used. The CNAs acknowledged that they did not follow the correct procedure for cleaning the resident's peri area, which should have been done from top to bottom, including proper cleaning of female residents' peri areas.
Failure to Treat Resident with Dignity and Respect
Penalty
Summary
The facility failed to ensure residents were treated with dignity and respect, as evidenced by an incident involving a resident with diagnoses of intellectual disability disorders, bipolar disorder, and anxiety. The resident, who was severely impaired with cognition, was grabbed by a staff member and taken back to her room after she attempted to hit the staff member. This incident was documented in a state incident report and occurred despite the resident's care plan noting her potential for physical and verbal behaviors.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 235 citations issued within 25 miles in the last 12 months — including the 11 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Moore
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Meadowlake Estates | 2.3 mi | ★★★★★ | 1 | 0 |
| Accel At Crystal Park | 2.4 mi | ★★★★★ | 10 | 1 |
| Brookwood Skilled Nursing And Therapy | 2.7 mi | ★★★★★ | 8 | 0 |
| Emerald Care Center Southwest Llc | 3.8 mi | ★★★★★ | 1 | 0 |
| Capitol Hill Skilled Nursing And Therapy | 5 mi | ★★★★★ | 0 | 0 |
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