Walnut Grove Care & Rehab Center

1001 South George Nigh Expressway, McAlester, OK 74501 (918) 423-7373
For profit - Limited Liability company 80 Beds MGM HEALTHCARE Data: November 2025 1 Immediate Jeopardy citation
Trust Grade
0/100
#281 of 282 in OK
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Last Inspection: February 2025

Within standard 12-15 month inspection cycle. Federal law requires annual inspections.

Overview

Walnut Grove Care & Rehab Center has received a Trust Grade of F, indicating significant concerns about the quality of care provided. Ranking #281 out of 282 facilities in Oklahoma places them in the bottom tier, and #6 out of 6 in Pittsburg County means there are no better local options available. The facility is experiencing a worsening trend, with issues increasing from 1 in 2024 to 7 in 2025. Staffing is a major weakness, with a low rating of 1 out of 5 stars and a high turnover rate of 72%, significantly above the state average. Additionally, the center has incurred $40,700 in fines, which is concerning as it is higher than 84% of facilities in Oklahoma. RN coverage is average, which may not be sufficient given the critical incidents observed, including a serious failure to protect a resident from verbal abuse and inadequate infection control measures for residents testing positive for COVID-19.

Trust Score
F
0/100
In Oklahoma
#281/282
Bottom 1%
Safety Record
High Risk
Review needed
Inspections
Getting Worse
1 → 7 violations
Staff Stability
⚠ Watch
72% turnover. Very high, 24 points above average. Constant new faces learning your loved one's needs.
Penalties
✓ Good
$40,700 in fines. Lower than most Oklahoma facilities. Relatively clean record.
Skilled Nurses
⚠ Watch
Each resident gets only 17 minutes of Registered Nurse (RN) attention daily — below average for Oklahoma. Fewer RN minutes means fewer trained eyes watching for problems.
Violations
⚠ Watch
22 deficiencies on record. Higher than average. Multiple issues found across inspections.
★☆☆☆☆
1.0
Overall Rating
★☆☆☆☆
1.0
Staff Levels
★★★★☆
4.0
Care Quality
★★☆☆☆
2.0
Inspection Score
↔
Stable
2024: 1 issues
2025: 7 issues

The Good

  • 4-Star Quality Measures · Strong clinical quality outcomes
  • Full Sprinkler Coverage · Fire safety systems throughout facility
  • No fines on record

Facility shows strength in quality measures, fire safety.

The Bad

1-Star Overall Rating

Below Oklahoma average (2.6)

Significant quality concerns identified by CMS

Staff Turnover: 72%

26pts above Oklahoma avg (46%)

Frequent staff changes - ask about care continuity

Federal Fines: $40,700

Above median ($33,413)

Moderate penalties - review what triggered them

Chain: MGM HEALTHCARE

Part of a multi-facility chain

Ask about local staffing decisions and management

Staff turnover is very high (72%)

24 points above Oklahoma average of 48%

The Ugly 22 deficiencies on record

1 life-threatening
Feb 2025 7 deficiencies 1 IJ
CRITICAL (J) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Immediate Jeopardy (IJ) - the most serious Medicare violation

Free from Abuse/Neglect (Tag F0600)

Someone could have died · This affected 1 resident

On 02/27/24, an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to protect Resident #45 from verbal and psychosocial abuse. On 02/27/25 at 2:06 p.m., Reside...

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On 02/27/24, an Immediate Jeopardy (IJ) situation was determined to exist related to the facility's failure to protect Resident #45 from verbal and psychosocial abuse. On 02/27/25 at 2:06 p.m., Resident #45 reported over the weekend staff blamed them for turning on the call light. Resident #45 stated CNA #1 came to their room to answer the call light and Resident #45 told CNA #1 they needed assistance with incontinent care. Resident #45 stated CNA #1 told them they were assisting another resident and would come back when they could. Resident #45 stated when CNA #1 returned they yelled at them and stated they would be there in a minute and to stay off the light. Resident #45 stated they had not activated the call light again, that CNA #1 had not turned the call light off from the first interaction. Resident #45 stated they were so upset they started crying. Resident #45 stated they called the nurses station and reported the occurrence to the charge nurse/ LPN #4. Resident #45 stated they were so upset they wanted to leave the facility. On 02/27/25 at 2:12 p.m., the administrator stated on Monday 02/24/25, CNA #2 tattle-tailed on about three things, one of which were concerns about CNA #1 regarding verbal abuse over the weekend. The administrator stated it was reported CNA #1 wasn't very nice to Resident #45. The administrator stated they did not interview the resident or conduct an investigation. On 02/27/25 at 2:19 p.m., charge nurse/LPN #4 stated Resident #45 reported the incident to them and the resident was so upset they started crying. The LPN stated they removed CNA #1 from the resident's hall and placed them on another hall. LPN #4 stated they had not heard anything more regarding the incident. LPN #4 stated they should have reported the incident to the administrator and did not. There was no documentation the incident occurred. There were no progress notes, no staff or resident interviews, and there was no incident report submitted to the Oklahoma Department of Health. On 02/27/25 at 7:41 p.m., the Oklahoma State Department of Health was notified and verified the existence of the IJ situation. On 02/27/25 at 8:01 p.m., the administrator, DON, and regional RN were notified of the presence of an immediate jeopardy situation related to Resident #45 not being free from verbal abuse. The IJ template was provided to the administrator. On 02/27/25 at 8:47 p.m., an acceptable plan of removal was approved by the Oklahoma State Department of Health. The plan of removal, read, Walnut Grove IJ Abatement 02/27/25. Resident #45 was interviewed by Social Services on 2/27/25 and was offered counseling to help [them] with this situation. The resident states [they] feel safe, and very secure, it was just the one incident that made [them] feel disrespected. On 2/27/25 the Administrator self-reported to the state of Oklahoma. On 2/27/25 Certified Nursing Assistant #1 was placed on suspension pending investigation. On 2/27/25 all residents in the facility were interviewed by Director of Nursing and Administrator for any concerns or reports of rude behavior by CNA #1 while [they] were taking care of them. With no concerns found. On 2/27/25 the Regional Nurse Consultant interviewed staff that worked with Certified Nursing Assistant #1, no concerns were noted apart from Certified Nursing Assistant #2. On 2/27/25 All staff educated by Regional Nurse Consultant and Director of Nursing on the Policy for abuse and neglect and importance of notifying supervisor immediately of any allegations. No staff member will work until they are educated. All new employees will be educated on Abuse and Neglect policy. On 2/27/25 Regional Nurse Consultant educated the Administrator on the policy of Abuse and Neglect and reporting any allegations to the State of Oklahoma per education of timelines and doing an immediate investigation. All completed on 02/27/25 [at 8:47] p.m. Signed by the administrator. On 02/27/25 at 8:47 p.m., the IJ was lifted when all components of the plan of removal were completed. The deficient practice remained at a level of no actual harm with a potential for more than minimal harm. Based on record review and interview, the facility failed to protect a resident's right to be free from verbal abuse for 1 (#45) of 16 sampled residents reviewed for abuse. The administrator identified 59 residents who resided in the facility. Findings: On 02/27/25 at 2:06 p.m., Resident #45 reported over the weekend, staff blamed them for turning on the call light. Resident #45 stated CNA #1 came to their room to answer the call light and Resident #45 told CNA #1 they needed assistance with incontinent care. Resident #45 stated CNA #1 told Resident #45 they were assisting another resident and would come back when they could. Resident #45 stated when CNA #1 returned they yelled at them and stated they would be there in a minute and to stay off the light. Resident #45 stated they had not activated the call light again, that CNA #1 had not turned the call light off from the first interaction. Resident #45 stated they were so upset that they started crying. Resident #45 stated they called the nurses station and reported the occurrence to the charge nurse/ LPN #4. Resident #45 stated they were so upset they wanted to leave the facility. Resident #45 had diagnoses which included cognitive communication deficit, need for assistance with personal care and generalized anxiety. An admission MDS assessment, dated 12/10/24, showed Resident #45 was cognitively intact with a BIMS of 15, but was dependent on staff for bathing, lower body dressing, transfers, and toileting hygiene. The assessment showed Resident #45 required max assist with bed mobility, moderate assistance with upper body dressing. The assessment showed walking did not occur. On 02/27/25 at 2:12 p.m., the administrator stated on Monday 02/24/25, CNA #2 tattle-tailed on about three things, one of which were concerns about CNA #1 regarding verbal abuse over the weekend. The administrator stated it was reported CNA #1 wasn't very nice to Resident #45. The administrator stated they did not interview the resident or investigate in any way. On 02/27/25 at 2:19 p.m., charge nurse/LPN #4 stated Resident #45 reported the incident to them and the resident was so upset they started crying. The LPN stated they removed CNA #1 from the resident's hall and placed them on another hall. LPN #4 stated they had not heard anything more regarding the incident. LPN #4 stated they should have reported the incident to the administrator and did not. On 02/27/25 at 3:54 p.m., CNA #1 stated they worked on B hall for about 30 minutes. They stated there were a lot of call lights and they told Resident #45 they would get to them as fast as they could. CNA #1 stated Resident #45 kept hitting the call light, they were busy and Resident #45 became upset. CNA #1 stated they walked out. CNA #1 stated the nurse moved them to E hall. On 02/27/25 at 3:57 p.m., CNA #2 stated they were not there at the time the incident actually occurred, but was informed by evening shift that CNA #1 made Resident #45 cry and also had an attitude with Resident #215. CNA #2 stated they went to talk to Resident #45 and they identified CNA #1 as the staff that made them cry. CNA #2 stated they told the administrator about the incident on Monday morning and the administrator stated they would handle it. On 02/27/25 at 6:58 p.m., Resident #215 whom resided on E hall, stated they received good care Monday through Friday, but the weekends were terrible. Resident #215 stated last weekend a staff member told them they were short on staff and to stay off the call light. Resident #215 was unable to remember the staff members name. Resident #215 stated the staff member then left and did not even help them. Resident #215 stated, When they sent the [other staff] in here they were good to me. Resident #215 stated they did not know who to tell so they did not report it. Resident #215 stated the staff member did not return to their room, but they did not want to use the call light when that staff member was there.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0567 (Tag F0567)

Could have caused harm · This affected 1 resident

Based on record review and interview, the facility failed to ensure a resident had access to their trust account money on nights and weekends for 1 (#1) of 1 sampled resident reviewed for access to th...

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Based on record review and interview, the facility failed to ensure a resident had access to their trust account money on nights and weekends for 1 (#1) of 1 sampled resident reviewed for access to their trust account money. The BOM identified 12 residents who had money in the trust account. Findings: An undated Policy and Procedure of Resident Trust Fund, read in part, The management of the trust shall be managed by the business office or it's designees and ensure that proper accounting principals are followed .but not to exclude State and Federal regulations. A review of the trust account ledgers for Resident #1 contained no entries of money being withdrawn at night or on the weekends. On 02/24/25 at 12:26 p.m., Resident #1 reported over the weekend they wanted a coke and was told they did not have any money. On 02/27/25 at 10:04 a.m., the BOM stated they worked at the facility Monday through Friday. They stated if residents wanted money they would need to request it from them on Friday and keep it on their person. They stated the facility did not keep petty cash. They stated, I guess they wouldnt when asked directly how residents would get their money if they wanted it at night or on the weekends. On 02/27/25 at 10:17 a.m. RN #1 stated they worked Tuesday through Saturday and they did not deal with the money. They stated if a resident asked for money on the weekend, they would have to contact the BOM. They stated if a resident requested money on a Friday, they would have to keep it on their person.
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

Report Alleged Abuse (Tag F0609)

Could have caused harm · This affected 1 resident

Based on record review, and interview, the facility failed to report an allegation of abuse to the state agency for 1 (#45) of 1 sampled resident reviewed for abuse. The administrator identified 59 re...

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Based on record review, and interview, the facility failed to report an allegation of abuse to the state agency for 1 (#45) of 1 sampled resident reviewed for abuse. The administrator identified 59 residents resided in the facility. Findings: An undated Abuse Prevention Program policy, undated, read in part, It is the policy of this facility to prevent resident abuse, neglect, mistreatment and misappropriation of resident property .Employees are required to report any incident, allegation or suspicion of potential abuse, neglect or mistreatment they observe, hear about or suspect to the Administrator .The Administrator is the Abuse Coordinator .IF YOU SUSPECT ABUSE .Notify a Supervisor/Nurse Immediately .Notify the Administrator and Director of Nursing .The Administrator or designee utilizing the state specific Incident Reporting System will immediately notify the Department of Health by the Incident Reporting System .Investigation .All incidents will be documented, whether or not abuse occurred, was alleged or suspected .Any incident or allegation involving abuse or mistreatment will result in an abuse investigation .All personnel must promptly report any incident or suspected incident of abuse, mistreatment or neglect, including injuries of unknown origin. Resident #45 had diagnoses which included cognitive communication deficit, need for assistance with personal care and generalized anxiety. An admission MDS assessment, dated 12/10/24, showed Resident #45 was cognitively intact with a BIMS of 15, but was dependent on staff for bathing, lower body dressing, transfers, and toileting hygiene. The assessment showed Resident #45 required max assist with bed mobility, moderate assistance with upper body dressing. The assessment showed walking did not occur. On 02/27/25 at 2:06 p.m., Resident #45 reported over the weekend, staff blamed them for turning on the call light. Resident #45 stated CNA #1 came to their room to answer the call light and Resident #45 told CNA #1 they needed assistance with incontinent care. Resident #45 stated CNA #1 told Resident #45 they were assisting another resident and would come back when they could. Resident #45 stated when CNA #1 returned they yelled at them and stated they would be there in a minute and to stay off the light. Resident #45 stated they had not activated the call light again, that CNA #1 had not turned the call light off from the first interaction. Resident #45 stated they were so upset that they started crying. Resident #45 stated they called the nurses station and reported the occurrence to the charge nurse/ LPN #4. Resident #45 stated they were so upset they wanted to leave the facility. On 02/27/25 at 2:12 p.m., the administrator stated on Monday 02/24/25, CNA #2 tattle-tailed on about three things, one of which were concerns about CNA #1 regarding verbal abuse over the weekend. The administrator stated it was reported CNA #1 wasn't very nice to Resident #45. The administrator stated they did not interview the resident or conduct an investigation. On 02/27/25 at 2:19 p.m., charge nurse/LPN #4 stated Resident #45 reported the incident to them and the resident was so upset they started crying. The LPN stated they removed CNA #1 from the resident's hall and placed them on another hall. LPN #4 stated they had not heard anything more regarding the incident. LPN #4 stated they should have reported the incident to the administrator and did not.
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

Investigate Abuse (Tag F0610)

Could have caused harm · This affected 1 resident

Based on record review, and interview, the facility failed to investigate an allegation of abuse for 1 (#45) of 1 sampled resident reviewed for abuse. The administrator identified 59 residents resided...

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Based on record review, and interview, the facility failed to investigate an allegation of abuse for 1 (#45) of 1 sampled resident reviewed for abuse. The administrator identified 59 residents resided in the facility. Findings: There was no documentation that this incident even occurred. There were no progress notes, no staff or resident interviews, no facility-initiated report provided to Oklahoma Department of Health. An undated Abuse Prevention Program policy, undated, read in part, It is the policy of this facility to prevent resident abuse, neglect, mistreatment and misappropriation of resident property .Employees are required to report any incident, allegation or suspicion of potential abuse, neglect or mistreatment they observe, hear about or suspect to the Administrator .Any incident or allegation involving abuse or mistreatment will result in an abuse investigation .All personnel must promptly report any incident or suspected incident of abuse, mistreatment or neglect, including injuries of unknown origin. Resident #45 had diagnoses which included cognitive communication deficit, need for assistance with personal care and generalized anxiety. An admission MDS assessment, dated 12/10/24, showed Resident #45 was cognitively intact with a BIMS of 15, but was dependent on staff for bathing, lower body dressing, transfers, and toileting hygiene. The assessment showed Resident #45 required max assist with bed mobility, moderate assistance with upper body dressing. The assessment showed walking did not occur. On 02/27/25 at 2:06 p.m., Resident #45 reported over the weekend, staff blamed them for turning on the call light. Resident #45 stated CNA #1 came to their room to answer the call light and Resident #45 told CNA #1 they needed assistance with incontinent care. Resident #45 stated CNA #1 told Resident #45 they were assisting another resident and would come back when they could. Resident #45 stated when CNA #1 returned they yelled at them and stated they would be there in a minute and to stay off the light. Resident #45 stated they had not activated the call light again, that CNA #1 had not turned the call light off from the first interaction. Resident #45 stated they were so upset that they started crying. Resident #45 stated they called the nurses station and reported the occurrence to the charge nurse/ LPN #4. Resident #45 stated they were so upset they wanted to leave the facility. On 02/27/25 at 2:12 p.m., the administrator stated on Monday 02/24/25, CNA #2 tattle-tailed on about three things, one of which were concerns about CNA #1 regarding verbal abuse over the weekend. The administrator stated it was reported CNA #1 wasn't very nice to Resident #45. The administrator stated they did not interview the resident or conduct an investigation. On 02/27/25 at 2:19 p.m., charge nurse/LPN #4 stated Resident #45 reported the incident to them and the resident was so upset they started crying. The LPN stated they removed CNA #1 from the resident's hall and placed them on another hall. LPN #4 stated they had not heard anything more regarding the incident. LPN #4 stated they should have reported the incident to the administrator and did not.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0761 (Tag F0761)

Could have caused harm · This affected 1 resident

Based on observation, record review and interview, the failed failed to ensure medication carts were secured when not in use for 2 of 7 medication carts observed. The administrator identified 59 resid...

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Based on observation, record review and interview, the failed failed to ensure medication carts were secured when not in use for 2 of 7 medication carts observed. The administrator identified 59 residents resided in the facility. Findings: On 02/27/25 at 8:33 p.m., medication carts for halls A/B and E/F and on the North side of the nursing station were observed unlocked and unattended with keys in the lock. On 02/27/25 at 8:34 p.m., nursing was staff observed sitting at the nurses station and medication carts A/B and E/F were observed unlocked and unattended. An undated Medication Storage in the Facility policy, read in part,Medication rooms, carts, and medication supplies are locked or attended by persons with authorized access. On 02/27/25 at 8:35 p.m., the licensed practical nurse #3 stated medication carts A/B and E/F were supposed to be locked and attended by staff who were assigned to the medication carts. On 02/28/25 at 11:06 a.m., the director of nursing stated it was policy for medication carts A/B and E/F to be attended to and locked at all times.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Infection Control (Tag F0880)

Could have caused harm · This affected 1 resident

Based on observation, record review, and interview, the facility failed to ensure infection control was maintained and EBP were followed during the administration of medications. The administrator id...

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Based on observation, record review, and interview, the facility failed to ensure infection control was maintained and EBP were followed during the administration of medications. The administrator identified seven residents required enhanced barrier precautions. Findings: On 02/25/25 at 8:41 a.m., LPN #3 was observed providing crushed medications through a PEG tube to a resident that required EBP. LPN #3 washed their hands and wore gloves, but did not wear a gown while providing care to the indwelling device. An Enhanced Barrier Precautions policy, copyright date 2025, read in part, Many residents in nursing homes are at increased risk of becoming colonized and developing infections with multi-drug resistant organisms .This facility utilizes Enhanced Barrier Precautions .as a strategy to decrease transmission of CDC [Centers for Disease Control and Prevention]-targeted and epidemiologically important MDROs when Contact Precautions do not apply .Enhanced Barrier Precautions: An infection control intervention designed to reduce transmissions of multidrug-resistant organisms that employs targeted gown and glove use during high contact resident care activities. EBP are used in conjunction with standard precautions and expand the use of PPE [personal protective equipment] to donning of gown and gloves during high contact care activities that provide opportunities for transfer of MDROs to staff hands and clothing .Indications .Wounds and/or indwelling medical devices even if the resident is not know to be infected or colonized with an MDRO .Indwelling devices include, but are not limited to, feeding tubes. On 02/25/25 at 8:46 a.m., LPN #3 stated EBP included a gown, gloves, and a mask. They stated they would have worn a gown if they would have thought about it. They stated they were not wearing a gown while providing medication through a percutaneous endoscopic gastrostomy tube. On 02/26/25 4:51 p.m., the DON stated they would have to look up the actual policy, but essentially a gown, gloves, and mask should be worn when the resident had something contagious.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Food Safety (Tag F0812)

Could have caused harm · This affected multiple residents

Based on observation, record review, and interview, the facility failed to ensure the low temperature warewasher had the appropriate amount of chemical to sanitize dishes for the facility. The adminis...

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Based on observation, record review, and interview, the facility failed to ensure the low temperature warewasher had the appropriate amount of chemical to sanitize dishes for the facility. The administrator identified 55 residents ate meals from the kitchen. Findings: On 02/24/25 at 11:26 a.m., the CDM was observed using test strips for sanitizer in the low temperature warewasher and the sanitizer was not pumping through to release the chemical into the warewasher. An undated chemical company instruction manual, read in part,Test paper must read at least 50 parts per million. A policy titled Warewasher revised date 12/18/24, read in part, The dish machine, if low temp, shall use a detergent, a rinse drying agent, and a sanitizer .The sanitizing temperature to activate the sanitizer per manufactuers' instructions .Low temperature dish machine log Sanitizer greater than 50 part per million. On 02/24/25 at 11:27 a.m., the CDM stated the sanitizer was reading 25 ppm and it should be at 50 ppm.
Jul 2024 1 deficiency
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

ADL Care (Tag F0677)

Could have caused harm · This affected 1 resident

Based on record review and interview, the facility failed to ensure baths were provided as care planned for one (#2) of four sampled residents reviewed for ADL (activities of daily living) assistance....

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Based on record review and interview, the facility failed to ensure baths were provided as care planned for one (#2) of four sampled residents reviewed for ADL (activities of daily living) assistance. A facility resident report, dated 07/24/24, documented 61 residents resided in the facility. Findings: A facility ADL Care Bathing policy, dated 07/21/22, read in part, Nursing staff will assist in bathing Residents to promote cleanliness and dignity. A care plan focus, dated 06/16/24, read in part, BATHING/SHOWERING: Offer Bathing/Showering twice weekly and as necessary. Resident #2's bathing records were reviewed. Documentation stated the resident was offered baths 2 of 14 dates between 06/30/24 and 07/13/24. Of the two days the resident was offered baths, documentation indicated they had a bath on 07/02/24 and refused a bath on 07/11/24. On 07/25/24 at 9:33 a.m., CNA #1 stated they were assigned to work with Resident #2 that day. They stated after a bath was offered, they inform the charge nurse if the resident was given a bath or if they refused. They stated they then put the information in the resident electronic medical record (EMR). On 07/25/24 at 9:39 a.m., CNA #2 stated they inform the charge nurse after offering baths and then chart in the EMR if the resident was bathed or if they refused. On 07/25/24 at 9:46 a.m. the assistant director of nursing (ADON) stated after offering a bath to a resident the aides fill out a bath sheet and document in the electronic medical record. The ADON reviewed Resident #2's EMR and stated the button the aides would click to open the area of the EMR to document was not in the chart. They stated the aides would not be able to chart bathing in the EMR without that button. They reviewed the resident's bathing records and stated the resident had not received the required number of baths in the first two weeks of July 2024. On 07/25/24 at 10:54 a.m. ADON stated the staff had not documented if the resident had or had not received all the baths that had been care planned. They stated the staff had not followed facility policy regarding bathing and documentation.
Oct 2023 9 deficiencies
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Assessment Accuracy (Tag F0641)

Could have caused harm · This affected 1 resident

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure a resident assessment was accurate for one (#34) of 25 sampl...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to ensure a resident assessment was accurate for one (#34) of 25 sampled residents whose assessments were reviewed for accuracy. The Resident Census and Conditions of Residents form documented 61 residents resided in the facility. Findings: Res #34 was admitted to the facility on [DATE] with diagnoses of frontotemporal neurocognitive disorder, major depressive disorder, post-traumatic stress disorder, sleep apnea, and hypertension. An MDS assessment, dated 09/13/23, documented the resident's cognition was moderately impaired. The MDS documented the resident had non-alzheimer's dementia. On 10/23/23 at 11:30 a.m., MDS #1 reported the assessment was inaccurate.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

PASARR Coordination (Tag F0644)

Could have caused harm · This affected 1 resident

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to refer a resident with a new mental health diagnosis to OHCA for a P...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to refer a resident with a new mental health diagnosis to OHCA for a PASRR level II evaluation for one (#48) of four sampled residents reviewed for PASRR. The Resident Census and Conditions of Residents form documented 61 residents resided in the facility. Findings: Res #48 was admitted to the facility on [DATE] with a diagnosis of impulse disorder. The resident's EHR documented the resident was diagnosed with delusion disorders on 05/11/22. The EHR did not contain documentation that OHCA had been contacted regarding a new mental health diagnosis On 10/24/23 at 12:00 p.m., the MDS coordinator reported she didn't know that the state needed to be contacted regarding new mental health diagnosis.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0657 (Tag F0657)

Could have caused harm · This affected 1 resident

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to develop a comprehensive care plan for one (#54) of five sampled res...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to develop a comprehensive care plan for one (#54) of five sampled residents whose care plans were reviewed. The Resident Census and Conditions of Residents, dated 10/17/23, documented a census of 61 residents. Findings: A Comprehensive Interdisciplinary Plan of Care policy, dated July 2018, read in part, .Comprehensive Interdisciplinary Plan of Care will be developed and implemented no later than 21 days following the admission . Res #54 was admitted on [DATE] with diagnoses which included dementia, gastrostomy, neuromuscular dysfunction of the bladder and frontotemporal neurocognitive disorder. An admission resident assessment for Res #54 was completed on 09/15/23 which documented the resident received nutrition through a PEG tube, had an indwelling urinary catheter, and required extensive assistance with ADL's. A comprehensive care plan for Res #54 was not developed. On 10/23/23 at 11:45 a.m., the MDS Coordinator reported there was no comprehensive care plan for Res #54. The MDS Coordinator reported the comprehensive care plan was late and should have been done.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0661 (Tag F0661)

Could have caused harm · This affected 1 resident

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to complete a discharge summary for two (#58 and #59) of two closed re...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on record review and interview, the facility failed to complete a discharge summary for two (#58 and #59) of two closed records reviewed. The Resident Census and Conditions of Residents form documented 61 residents resided in the facility. Findings: 1. Res #58 was admitted to the facility on [DATE] and had diagnoses which included right femur fracture, heart failure, and hypothyroidism. An admission assessment, dated [DATE], documented the resident was moderately cognitively impaired and required extensive assistance with most ADLs. A progress note, dated [DATE] at 11:42 a.m., documented the resident was found unresponsive in wheelchair and CPR was immediately initiated. The note documented the resident was transported via EMS to the hospital. A progress noted, dated [DATE] at 1:17 p.m., documented the resident was deceased at the hospital. There was no documentation of a discharge summary found in the medical record. 2. Res#59 was admitted to the facility on [DATE] with diagnoses of Alzheimer's disease, schizophrenia, dementia, and depressive disorders. A nurse's note, dated [DATE] at 11:30 p.m., documented the resident was yelling in pain, pointing to the left hip. The note documented the resident stated they was hurting real bad and had been medicated recently. The note documented the resident was sent to the hospital. The resident was admitted to the hospital. The clinical record contained no discharge summary. On [DATE] at 10:20 a.m., the DON stated a discharge summary for Res #58 and Res #59 was not completed but should have been.
CONCERN (D) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

ADL Care (Tag F0677)

Could have caused harm · This affected 1 resident

Based on observation, record review, and interview, the facility failed to provide nail care for a resident who was unable to carry out activities of daily living for one (#35) of 25 sampled residents...

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Based on observation, record review, and interview, the facility failed to provide nail care for a resident who was unable to carry out activities of daily living for one (#35) of 25 sampled residents. The Resident Census and Conditions of Residents form documented 61 residents resided in the facility. Findings: Res #35 was admitted to the facility with diagnoses of anorexia, cerebrovascular disease, dysphagia, and cerebral infarction. An annual assessment, dated 07/17/23, documented the resident required extensive assist with all ADL's. On 10/18/23 at 10:07 a.m., Rest #35 was observed resting in bed with eyes open. The resident's fingernails were observed to be long and starting to curve back under, nail polish was observed to missing from most of the nails. On 10/24/23 at 9:50 am the resident's fingernails were observed to be long and starting to curve back under, fingernail polish was observed to be missing from most of the nails. On 10/24/23 at 9:54 a.m., CNA #1 was asked who was responsible for the resident's nail care. CNA #1 reported another CNA was. On 10/24/23 at 9:57 a.m., LPN #1 reported the CNA's are responsible for nail care as long as the resident was not a diabetic. On 10/24/23 at 10:02 a.m., the DON reported the CNA's are responsible for the resident's nail care as long as they were not diabetic.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Drug Regimen Review (Tag F0756)

Could have caused harm · This affected 1 resident

Based on record review and interview, the facility failed to implement a physician agreed upon pharmacist MRR recommendation for one (#31) of five sampled residents reviewed for unnecessary medication...

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Based on record review and interview, the facility failed to implement a physician agreed upon pharmacist MRR recommendation for one (#31) of five sampled residents reviewed for unnecessary medications. The Resident Census and Conditions of Residents form documented 61 residents resided in the facility. Findings: A policy with regard to timeliness of pharmacist recommendation and response, dated 07/01/19, documented the physician and/or director of nursing are requested to acknowledge and act upon recommendation within 30 calendar days of the consultant pharmacist's drug regimen review/recommendation. Res #31 had diagnoses which included heart failure, acquired absence of leg below the knee, and atherosclerotic heart disease. An admission assessment, dated 04/01/23, documented Res #31 was cognitively intact and required extensive assistance with most ADLs. A pharmacist MRR, dated 08/01/23, read in part, .Based on current CDC recommendations and new CMS recommendations for opioid use disorder, opioid doses greater than 50 MME/day, or an ordered combination of benzodiazepines and an opioid: Please consider adding the following order/protocol to this patient's medical record. Narcan nasal liquid 4 mg/0.1 ml for overdose .Administer one spray in one nostril one time. May repeat in alternating nostrils every 2-3 minutes until responsive or EMS arrives . The MRR documented the physician's agreement to the recommendation. The physician's response was undated. There was no documentation of physician ordered Narcan in Res #31's medical record. On 10/23/23 at 2:00 p.m., the DON stated the physician agreed MRR dated 08/01/23 for adding Narcan to the resident's medication regimen was never implemented but should have been per policy.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Incontinence Care (Tag F0690)

Could have caused harm · This affected multiple residents

**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to assess residents for the continued need for indwellin...

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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, record review, and interview, the facility failed to assess residents for the continued need for indwelling urinary catheters for one (#2 ) of two sampled residents reviewed for an indwelling urinary catheter. The Resident Census and Conditions of Residents, dated 10/17/23, documented four residents who had an indwelling urinary catheter. Findings: Res #2's medical record documented diagnoses which included neuromuscular dysfunction of the bladder. Res #2 was re-admitted to the facility from the hospital on [DATE], the re-admission nursing note, dated 09/10/23, documented Res #2 had an indwelling urinary catheter in place upon re-admission. A significant change resident assessment, dated 09/17/23, documented Res #2 had an indwelling urinary catheter in place. On 10/17/23 at 10:45 a.m. and throughout the survey, Res #2 was observed to have an indwelling urinary catheter in place. There was no documentation Res #2 had been assessed for the continued need for their indwelling urinary catheter. On 10/18/23 at 3:30 p.m., the corporate Nurse reported they were not aware the residents needed to be assessed for the continued use of an indwelling urinary catheter if they had a diagnosis to justify why a urinary catheter was needed. The corporate nurse reported Res #2 had not been assessed for the continued use of their indwelling urinary catheters.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Food Safety (Tag F0812)

Could have caused harm · This affected multiple residents

Based on observation and interview, the facility failed to ensure food was labeled and stored in a sanitary manner. The Resident Census and Conditions of Residents, dated 10/17/23, documented 57 resid...

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Based on observation and interview, the facility failed to ensure food was labeled and stored in a sanitary manner. The Resident Census and Conditions of Residents, dated 10/17/23, documented 57 residents receive their meals from the kitchen. Findings: A Refrigerator Storage policy, dated February 2010, read in part, .label all leftovers with recipe name and date (month, day, year) of storage. Discard refrigerated leftovers after 48 hours . On 10/17/23 at 9:30 a.m., an intial tour of the kitchen was conducted. The following was found in the refrigerator: a. Bologna in a ziplock bag dated 09/23. b. An unlabeled zip lock bag of hot dogs. c. Chopped eggs in a ziplock bag dated 9/4. d. [NAME] in a ziplock bag date 9/4. e. An unlabeled zip lock bag of a green herb. f. Cheese in a zip lock bag dated 10/7. g. An unlabeled bag of deli meat that was open and leaking juices onto a tray containing other food items. On 10/17/23 at 10:02 a.m., the dietary manager reported the refrigerator was a mess. The dietary manager reported refrigerator food storage was their responsibility and they hadn't had time to get to it due to staffing changes in the kitchen.
CONCERN (F) 📢 Someone Reported This

A family member, employee, or ombudsman was alarmed enough to file a formal complaint

Potential for Harm - no one hurt, but risky conditions existed

Infection Control (Tag F0880)

Could have caused harm · This affected most or all residents

Based on observation and interview, the facility failed to properly inform visitors and staff of residents who were in isolation on transmission based precautions for three (#13, 19, and #48) of three...

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Based on observation and interview, the facility failed to properly inform visitors and staff of residents who were in isolation on transmission based precautions for three (#13, 19, and #48) of three sampled residents who tested positive for COVID. The IP identified 22 residents who tested positive for COVID. Findings: The Infection Control Manual, dated 5/11/23, read in part, .An isolation notice will be placed in plain view outside the entrance to the isolation/quarantine room . On 10/17/23 at 9:30 a.m., a white cross or plus sign was observed on the doors to Res #13, 19 and #48's rooms. On 10/18/23 at 8:00 a.m., a large letter Q was observed on the doors to Res #13, 19 and #48's rooms. The resident roster documented Res #13, 19 and #48 tested positive for COVID on 10/10/23. On 10/18/23 at 2:00 p.m., the corporate nurse reported the white cross was a plus sign meaning the residents were COVID positive and the letter Q was for quarantine, but acknowledged there would be no way for a visitor to know what the white plus sign or letter Q meant.
May 2022 5 deficiencies
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0563 (Tag F0563)

Could have caused harm · This affected 1 resident

Based on record review and interview, the facility failed to ensure one (#20) of 61 residents had the right to receive visitors of the resident's choosing. The Resident Census and Conditions of Resid...

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Based on record review and interview, the facility failed to ensure one (#20) of 61 residents had the right to receive visitors of the resident's choosing. The Resident Census and Conditions of Residents, dated 05/03/22, documented 61 residents resided in the facility. Findings: On 05/02/22 at 11:46 a.m., Res #20 reported FM #1 had been banned from visiting by the administrator since 04/22/22. A Resident/Patient Concern Report, dated 04/22/22, signed by the administrator, read in parts, .was yelling down the hall, someone better get down here and help my mother.continued to be beligerent, refused to come and talk about the situation . Stated Res #20 had the call light on for an hour. Staff was afraid to enter the room due to (FM #1's) behavior. LPN charge nurse called police due to FM#1's threatening behavior. Police came and FM #1 was banned from facility .called FM #2 to inform them what had happened. FM #2 said FM #1 tends to be a hot head. Encouraged FM #2 to come to me if they have any more concerns. On 05/03/22 at 10:44 a.m., during a phone interview, FM #2 reported they felt it would be safe for family FM #1 to visit Res #20. FM #2 reported FM #1 being banned from visiting Res #20 was detrimental to the resident. FM #1 reported they had not been contacted by the facility regarding the incident since 04/22/22. On 05/03/22 at 2:40 p.m., the administrator reported on 04/22/22 she was in her office and heard FM #1 yelling and cursing at the staff. She reported she left her office to try to assist in the situation. The administrator reported the LPN on duty phoned the police because the staff was afraid of FM #1. The administrator reported the police asked if she wanted FM #1 banned from the facility and she agreed. The administrator reported FM #1 had not visited Res #20 since 04/22/22. The administrator reported she had not followed up with Res #20 or the family since the incident. On 05/03/22 at 4:00 p.m., the administrator reported the facility did not have a policy for visitor restriction.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

Report Alleged Abuse (Tag F0609)

Could have caused harm · This affected 1 resident

Based on record review, and interview, the facility failed to complete incident reports in a timely manner to the Oklahoma State Department of Health for two (#40 and #55) of two residents reviewed fo...

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Based on record review, and interview, the facility failed to complete incident reports in a timely manner to the Oklahoma State Department of Health for two (#40 and #55) of two residents reviewed for falls. The administrator reported a census of 61. Findings: 1. Res #40 was admitted to the facility with diagnoses which included repeated falls. An incident report, dated 12/10/21 at 4:03 p.m., documented Res #40 had fallen and was sent to the emergency room. A progress note, dated 12/10/21 at 7:45 p.m., documented in part . remains at the emergency room at this time for left hip fracture. A Communication Result Report, dated 12/13/21, verified the incident report was sent by facsimile to the Oklahoma State Department of Health on 12/13/21 at 11:58 a.m. On 05/04/22 at 11:45 a.m., the administrator reported they had faxed an initial and combined incident report to the Oklahoma State Department of Health on 12/13/21. The Administrator reported since the Res #40 had a fall with major injury, the incident report should have been faxed within 24 hours of the incident. 2. Res #55 was admitted to the facility with diagnoses which included osteoporosis. A progress note, dated 01/10/22, at 3:11 p.m., documented Res #55 had fallen, complained of pelvis pain, and was transferred to the emergency room. A progress note, dated 01/10/22, 4:19 p.m., documented Res #55 was admitted to the hospital with a right femur fracture. A Communication Result Report, dated 01/12/22, verified the incident report was sent by facsimile to the Oklahoma State Department of Health on 01/12/22 at 1:23 p m. On 05/04/22 at 10:08 a.m., the DON stated the facility was aware of Res #55's fracture on 01/10/22 and the incident report should have been faxed within 24 hours of the incident. On 05/04/22 at 10:09 a.m., RN #1 reported the incident report was not completed in a timely manner. On 05/04/22 at 10:15 a.m., the administrator reported the incident report had not been faxed in a timely manner.
CONCERN (D)

Potential for Harm - no one hurt, but risky conditions existed

ADL Care (Tag F0677)

Could have caused harm · This affected 1 resident

Based on observation, interview, and record review, the facility failed to provide bathing for one (#6) of two residents reviewed for bathing. The administrator reported 54 residents required assista...

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Based on observation, interview, and record review, the facility failed to provide bathing for one (#6) of two residents reviewed for bathing. The administrator reported 54 residents required assistance with bathing. Findings: An annual assessment, dated 02/01/22, documented Res #6 was incontinent of bladder and required assistance with bathing. A flow sheet, dated 03/01/22 to 03/31/22, documented Res #6 was scheduled for 14 baths and had received six baths. A flow sheet, dated 04/01/22 to 04/30/22, documented Res #6 was scheduled for 14 baths and had received five baths. On 05/02/22 at 10:15 a.m., Res #6 was observed sitting in a chair, upon entry to the resident's room, the surveyor detected an odor of urine. Res #6 reported they had not received a bath in over a week. The resident reported the staff did not offer a bath if the facility was short on staff. On 05/03/22 at 2:34 p.m., CNA #1 reported Res #6 was scheduled for a bath three days a week. CNA #1 reviewed Res #6's flow sheets and reported Res #6 had not received baths as scheduled. On 05/03/22 3:07 p.m., the DON reported Res #6 was scheduled for a bath three days a week and had not received baths as scheduled.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Deficiency F0725 (Tag F0725)

Could have caused harm · This affected multiple residents

Based on interview, and record review, the facility failed to provide sufficient staff for 11 of 183 shifts reviewed. The administrator reported a census of 61 residents. Findings: A staffing schedul...

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Based on interview, and record review, the facility failed to provide sufficient staff for 11 of 183 shifts reviewed. The administrator reported a census of 61 residents. Findings: A staffing schedule, dated February 2022, documented on 02/12/22 and 02/26/22, 10 of 11 required staff members were on duty, and on 02/27/22 eight of 11 required staff members were on duty. A staffing schedule, dated March 2022, documented on 03/03/22, 03/04, 03/06, 03/08, 03/16, 03/20, 03/27, 03/30/22, three of four required staff members were on duty. On 05/05/22 at 9:14 a.m., CNA #2 reported they had worked short handed. On 05/05/22 at 10:07 a.m., LPN #1 reported they had worked short staffed. On 05/05/22 at 10:44 a.m., the administrator reported in March 2022 there were eight night shifts with three staff members on duty, and in February 2022 day shift was short staffed on three shifts. The administrator reported in February 2022, there were two days with 10 staff and one day with eight staff. The administrator reported the shifts should have been fully staffed.
CONCERN (E)

Potential for Harm - no one hurt, but risky conditions existed

Food Safety (Tag F0812)

Could have caused harm · This affected multiple residents

Based on observation and interview, the facility failed to ensure pureed diets were prepared in a sanitary manner for seven (#55, 41, 31, 59, 210, 35, and #44) of seven residents reviewed for a pureed...

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Based on observation and interview, the facility failed to ensure pureed diets were prepared in a sanitary manner for seven (#55, 41, 31, 59, 210, 35, and #44) of seven residents reviewed for a pureed diet. The Resident Census and Condition, dated 05/03/22, documented seven residents received a pureed diet. Findings: a. On 05/03/22, from 10:15 a.m. to 10:28 a.m, [NAME] #1, stirred pureed carrots with spatula and placed spatula onto unsanitized surface three consecutive times. b. On 05/03/22 at 10:28 a.m., [NAME] #1 touched their face mask, eye glasses, and shirt, then plated pureed food without performing hand hygiene. On 05/03/22 at 10:33 a.m., [NAME] #1 reported the spatula was placed on an unsanitized surface and hand hygiene wasn't performed prior to plating pureed food. On 05/03/22 at 10:35 a.m., the dietary manager and registered dietician reported the pureed food had been prepared in an unsanitary manner.
Understanding Severity Codes (click to expand)
Life-Threatening (Immediate Jeopardy)
J - Isolated K - Pattern L - Widespread
Actual Harm
G - Isolated H - Pattern I - Widespread
Potential for Harm
D - Isolated E - Pattern F - Widespread
No Harm (Minor)
A - Isolated B - Pattern C - Widespread

Questions to Ask on Your Visit

  • "What changes have you made since the serious inspection findings?"
  • "What safeguards are in place to prevent abuse and neglect?"
  • "Why is there high staff turnover? How do you retain staff?"
  • "Can I speak with families of current residents?"
  • "What's your RN coverage like on weekends and overnight?"

Our Honest Assessment

Strengths
  • • Licensed and certified facility. Meets minimum state requirements.
Concerns
  • • Multiple safety concerns identified: Federal abuse finding, 1 life-threatening violation(s), $40,700 in fines. Review inspection reports carefully.
  • • 22 deficiencies on record, including 1 critical (life-threatening) violation. These warrant careful review before choosing this facility.
  • • $40,700 in fines. Higher than 94% of Oklahoma facilities, suggesting repeated compliance issues.
  • • Grade F (0/100). Below average facility with significant concerns.
Bottom line: This facility has a substantiated abuse finding. Extreme caution advised. Explore alternatives.

About This Facility

What is Walnut Grove Care & Rehab Center's CMS Rating?

CMS assigns Walnut Grove Care & Rehab Center an overall rating of 1 out of 5 stars, which is considered much below average nationally. Within Oklahoma, this rating places the facility higher than 0% of the state's 100 nursing homes. A rating at this level reflects concerns identified through health inspections, staffing assessments, or quality measures that families should carefully consider.

How is Walnut Grove Care & Rehab Center Staffed?

CMS rates Walnut Grove Care & Rehab Center's staffing level at 1 out of 5 stars, which is much below average compared to other nursing homes. Staff turnover is 72%, which is 26 percentage points above the Oklahoma average of 46%. High turnover can affect care consistency as new staff learn residents' individual needs. RN turnover specifically is 100%, which is notably high. RNs provide skilled clinical oversight, so turnover in this role can affect medical care quality.

What Have Inspectors Found at Walnut Grove Care & Rehab Center?

State health inspectors documented 22 deficiencies at Walnut Grove Care & Rehab Center during 2022 to 2025. These included: 1 Immediate Jeopardy (the most serious level, indicating potential for serious harm or death) and 21 with potential for harm. Immediate Jeopardy findings are rare and represent the most serious regulatory concerns. They require immediate corrective action.

Who Owns and Operates Walnut Grove Care & Rehab Center?

Walnut Grove Care & Rehab Center is owned by a for-profit company. For-profit facilities operate as businesses with obligations to shareholders or private owners. The facility is operated by MGM HEALTHCARE, a chain that manages multiple nursing homes. With 80 certified beds and approximately 57 residents (about 71% occupancy), it is a smaller facility located in McAlester, Oklahoma.

How Does Walnut Grove Care & Rehab Center Compare to Other Oklahoma Nursing Homes?

Compared to the 100 nursing homes in Oklahoma, Walnut Grove Care & Rehab Center's overall rating (1 stars) is below the state average of 2.6, staff turnover (72%) is significantly higher than the state average of 46%, and health inspection rating (2 stars) is below the national benchmark.

What Should Families Ask When Visiting Walnut Grove Care & Rehab Center?

Based on this facility's data, families visiting should ask: "What changes have been made since the serious inspection findings, and how are you preventing similar issues?" "What safeguards and monitoring systems are in place to protect residents from abuse or neglect?" "How do you ensure continuity of care given staff turnover, and what is your staff retention strategy?" "Can you walk me through typical staffing levels on day, evening, and night shifts?" These questions are particularly relevant given the facility's Immediate Jeopardy citations, the substantiated abuse finding on record, the facility's high staff turnover rate, and the below-average staffing rating.

Is Walnut Grove Care & Rehab Center Safe?

Based on CMS inspection data, Walnut Grove Care & Rehab Center has documented safety concerns. The facility has 1 substantiated abuse finding (meaning confirmed case of resident harm by staff or other residents). Inspectors have issued 1 Immediate Jeopardy citation (the most serious violation level indicating risk of serious injury or death). The facility has a 1-star overall rating and ranks #100 of 100 nursing homes in Oklahoma. Families considering this facility should ask detailed questions about what corrective actions have been taken since these incidents.

Do Nurses at Walnut Grove Care & Rehab Center Stick Around?

Staff turnover at Walnut Grove Care & Rehab Center is high. At 72%, the facility is 26 percentage points above the Oklahoma average of 46%. Registered Nurse turnover is particularly concerning at 100%. RNs handle complex medical decisions and coordinate care — frequent RN changes can directly impact care quality. High turnover means new staff may not know residents' individual needs, medications, or preferences. It can also be disorienting for residents, especially those with dementia who rely on familiar faces. Families should ask: What is causing the turnover? What retention programs are in place? How do you ensure care continuity during staff transitions?

Was Walnut Grove Care & Rehab Center Ever Fined?

Walnut Grove Care & Rehab Center has been fined $40,700 across 1 penalty action. The Oklahoma average is $33,486. While any fine indicates a compliance issue, fines under $50,000 are relatively common and typically reflect isolated problems that were subsequently corrected. Families should ask what specific issues led to these fines and confirm they've been resolved.

Is Walnut Grove Care & Rehab Center on Any Federal Watch List?

Walnut Grove Care & Rehab Center is not on any federal watch list. The most significant is the Special Focus Facility (SFF) program, which identifies the bottom 1% of nursing homes nationally based on persistent, serious quality problems. Not being on this list means the facility has avoided the pattern of deficiencies that triggers enhanced federal oversight. This is a positive indicator, though families should still review the facility's inspection history directly.

Walnut Grove Care & Rehab Center

1001 South George Nigh Expressway, McAlester, OK 74501 | (918) 423-7373

F
Trust Grade (0/100)
1.0
CMS Rating
22
Deficiencies

Strengths

  • 4-star quality

Concerns

  • 1 Immediate Jeopardy citation
  • 1-star rating
  • Abuse finding

Ask about: Inspection Response, Abuse Safeguards, Staff Retention

nursinghomedata.org | Data: CMS November 2025