Health inspection·October 17, 2024

F 0658 Ensure services provided by the nursing facility meet professional standards of quality. Level of Harm - Minimal harm or potential for actual harm Based on observation, interview and record review, the facility failed to ensure completion of a physician ' s order of stat (immediate) lab draw for one of the residents (Resident 1) for eight hours. Residents Affected - Few This failure resulted in Resident 1 having a delay in the completion of a physician ' s order of stat blood draw which potentially impacted Resident 1 ' s treatment and well-being. Findings: During a record review of Resident 1 ' s face sheet, undated, Resident 1 was admitted in November 2022 with diagnoses of essential hypertension (high blood pressure without identifiable cause). During a record review of Progress Notes written on 11/16/22 at 1715 (5:15 p.m.), the note indicated a physician telephone order at 3:00 p.m. for stat blood draw for complete blood count (CBC-measures number and size of different cells in the blood), basic metabolic panel (BMP-measures glucose, calcium, sodium, potassium, carbon dioxide and chloride levels in the blood and kidney functioning), urinalysis (UA-detects urinary tract infections, kidney disease and diabetes) and culture & sensitivity (C&S-detects infection). During an interview on 8/21/23, at 1:10 p.m., with Laboratory Staff (LS) 1, LS 1 stated the facility called the lab for stat labs on 11/16/22 at 4:18 p.m. Per LS 1, dispatch notes at 11:45 p.m. indicated there was no lab tech available to go to the facility. LS 1 stated the facility contacted the lab and cancelled the lab order on 11/17/22 at 12:44 a.m. as Resident 1 was taken to the hospital. During an interview on 10/1/24, at 9:15 a.m., with the Director of Nursing (DON), the DON stated stat labs had to be done within four hours. Per DON, if in three hours still no lab, call the lab again to get lab draw expedited. During an interview on 10/17/24, at 8:55 a.m., with Licensed Vocational (LVN) 1, LVN 1 stated stat lab order is supposed to be completed within four to six hours. Per LVN 1, if there was still no lab tech, contact the lab ' s area manager to get a status and to get labs get done sooner. During a review of the facility ' s policy and procedure (P&P) titled, Diagnostic Services, dated 5/24/13, the P&P indicated, All requests for diagnostic services must be ordered by a physician and completed timely. Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 3 Event ID: 055534 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 055534 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/17/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE The Reutlinger Community 4000 Camino Tassajara Danville, CA 94506 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)