Health inspection·October 24, 2024

F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interview and record review, the facility failed to follow its own policy and procedure (P&P) titled Change of Condition Reporting dated March 2024, by not reporting to the physician that the nursing staff did not obtain urine for a urinalysis (UA- test that checks your urine for signs of health issues like infections, kidney problems, and liver disease) ordered on 9/21/2024 for one of three sampled residents (Resident 1). Residents Affected - Few This deficient had the potential for Resident 1 not being provided treatment based on the results of the UA, which could lead to a worsening infection, decreased quality of life and possibly death. Findings: During a review of Resident 1's admission Record dated indicated Resident 1 was admitted to the facility on [DATE] with diagnoses that included type 2 diabetes mellitus (DM- a disorder characterized by difficulty in blood sugar control and poor wound healing), sepsis (a life-threatening condition that occurs when the body's response to an infection injures its own tissues and organs), Parkinson's disease (a progressive disease of the nervous system marked by tremor [a neurological condition that includes shaking or trembling movements in one or more parts of your body], muscular rigidity, and slow, imprecise movements), major depressive disorder (a mood disorder that causes a persistent feeling of sadness and loss of interest), and need for assistance with personal care. A review of Resident 1's history and physical dated 9/13/2024 indicated, Resident 1 can make needs known but can not make medical decisions. A review of Resident 1's Minimum Data Set (MDS - a federally mandated resident assessment tool) dated 9/14/2024 indicated, Resident 1's cognition (the mental action or process of acquiring knowledge and understanding through thought, experience, and the sense) was severely impaired. Resident 1 required supervision with eating, moderate assistance with oral hygiene and personal hygiene and maximum assistance with toileting hygiene, dressing and bathing. A review of Resident 1's Physician Order dated 9/21/2024 indicated, a physician order for a UA one time be done stat (immediately). A review of Resident 1's Nursing Progress Note dated 9/25/2024, completed by Licensed Vocational Nurse (LVN) 1, indicated, station 1 charge nurse (Licensed Vocational Nurse 2 [LVN 2]) notified that a UA was not collected for lab (laboratory) on 9/21/2024. Per charge nurse (LVN 2) will attempt to collect UA if unsuccessful will endorse to oncoming nurse (a nurse who takes over resident care from another nurse at the end of their shift). (continued on next page) 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 2 Event ID: 056337 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 056337 B. Wing A. Building (X3) DATE SURVEY COMPLETED 10/24/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Panorama Gardens Nursing and Rehabilitation Center 9541 Van Nuys Blvd. Panorama City, CA 91402 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)