• CMS rates this facility 1/5 stars (below average)
• Has 112 certified beds with an average of 55.1 residents per day (49% occupancy)
• Last health inspection found 13 deficiencies (inspected Sep 27, 2024)
• Has been fined a total of $62,078 across 3 fine(s)
• Total nursing staff: 3.43 hours per resident per day
• Part of the Diakonos Group chain (7 facilities)
Windsor Hills Nursing Center is a 1-star Medicare and Medicaid certified nursing home in Oklahoma City, Oklahoma with 112 certified beds. It has been operating since 2001. The facility scored below average compared to Oklahoma facilities.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Provide and implement an infection prevention and control program.
Ensure each resident receives an accurate assessment.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Provide enough food/fluids to maintain a resident's health.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Assess the resident when there is a significant change in condition
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Ensure medication error rates are not 5 percent or greater.
Ensure that residents are free from significant medication errors.
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Provide and implement an infection prevention and control program.
Staffing hours per resident per day. The black line shows the national average.
Quality measures as percentages of residents. Lower is better for all measures.
| Name | Role | Type | Ownership % | Since |
|---|---|---|---|---|
| LEP HOLDINGS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | N/A | Feb 1, 2019 |
| PILGRIM, LEE | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Individual | N/A | Feb 1, 2019 |
| PILGRIM, SCOTT | OPERATIONAL/MANAGERIAL CONTROL | Individual | N/A | Feb 1, 2019 |
| SMITH, ANTOINE | OPERATIONAL/MANAGERIAL CONTROL | Individual | N/A | Feb 1, 2019 |
| SMITH, ANTOINE | W-2 MANAGING EMPLOYEE | Individual | N/A | Feb 1, 2019 |
This chain operates 7 facilities. View all →