Health inspection·June 27, 2024

F 0770 Provide timely, quality laboratory services/tests to meet the needs of residents. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview and record review, the facility failed to obtain laboratory services to meet the needs of its residents for 1 (Resident #1) of three residents reviewed for laboratory services. Residents Affected - Some The facility failed to collect a urine specimen for a UA (urine analysis) for Resident #1 as ordered by the physician on 06/18/24 until 06/26/24. The UA results reflected blood in his urine. This failure could place residents with indwelling urinary catheters at risk of infection, renal failure, urinary tract infections, and pain. Findings Included: Review of Resident #1's undated face sheet reflected a [AGE] year-old male who was admitted to the facility on [DATE] with diagnoses including quadriplegia (the dysfunction or loss of motor and/or sensory function in the cervical area of the spinal cord), urinary tract infection, and neuromuscular dysfunction of the bladder (muscles in the bladder wall not contracting or relaxing properly). Review of Resident #1's admission MDS assessment, dated 06/24/24, reflected a BIMS of 15, indicating no cognitive impairment. Section H (Bladder and Bowel) reflected he had an indwelling catheter. Review of Resident #1's admission care plan, dated 06/20/24, reflected he had urinary elimination altered due to Neuromuscular Dysfunction of the bladder requiring a foley catheter with an intervention of monitoring for signs and symptoms of a UTI. Review of Resident #1's hospital records, dated 06/05/24, reflected he had been admitted for a UTI with sepsis due to improper insertion with pain. Review of Resident #1's physician order, dated 06/18/24, reflected the type of lab ordered: UA c/s. During an observation and interview on 06/26/24 at 10:20 AM, Resident #1 stated he was concerned because he had a history of UTIs with sepsis and he discussed getting a UA done with the NP a few days ago and it still had not been done. He stated the output in his foley back was dark and it was usually that color when he had a UTI or sepsis. He stated he was extremely worried and hoped something got done soon. This Surveyor observed his foley bag which contained approximately 500 CCs of urine that was a dark amber color. There was sediment around the tubing. During a telephone interview on 06/26/24 at 10:45 AM, Resident #1's NP stated the facility had not gotten back to her with results from the UA that was supposed to have been done on 06/18/24. She (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: 675458 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 675458 B. Wing A. Building (X3) DATE SURVEY COMPLETED 06/27/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Parkview Nursing and Rehabilitation Center 1501 S Main St Lockhart, TX 78644 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)