Diablo Valley Post Acute

During an interview on [DATE] at 11:47 a.m. with the Medical Director (Med Dir), Med Dir 1 stated when a resident experienced a significant change in condition, such as severe chest pain, particularly for a resident with a history of a recent heart attack, the expectation was to administer the prescribed nitroglycerin and immediately activate emergency medical services by calling 911.

Med Dir stated nitroglycerin administration may be held if the resident's bp was below 90/50 mmHg.

Med Dir further stated delayed interventions for a resident experiencing chest pain could result in cardiac arrest and prolonged, unrelieved pain.During a record review of the facility's undated policy and procedure (P&P), titled, Pain Assessment and Management, the P&P indicated, The purposes of this procedure are to help staff identify pain in resident, and to develop interventions that are consistent with the resident's goals an needs and that address the underlying causes of pain.2.

Monitor the resident for presence of pain and the need for further assessment when there is a change of condition.5.

During the pain assessment gather the following information as indicated from the resident (or legal representative) .c.

Characteristics of pain.(1) Location of pain. (2) Intensity of pain.(3) Characteristics of pain (e.g., aching, crushing, numbness, burning, etc.).(4) Pattern of pain (e.g., constant or intermittent).and (5) Frequency, timing, duration of pain.d.

Impact of pain on quality of life.i.

Current medical conditions and medications.Identifying causes of pain.3.

Review the resident's clinical record to identify conditions or situations that may predispose the resident to pain, including.d. circulatory/heart . (1) angina (chest pain) .During a record review of the facility's P&P, titled, Administering Medications, revised in [DATE], the P&P indicated Medications are administered in accordance with prescriber orders, including any required timeframe.During a record review of the facility's P&P, titled, Change in a Resident's Condition or Status, revised in February 2021, the P&P indicated, 2. A ‘significant change' in condition is a major decline or improvement in the resident's status that.a. will not normally resolve itself without intervention by staff or by implementing standard disease-related clinical interventions.9. If a significant change in resident's physical or mental condition occurs, a comprehensive assessment of resident's condition will be conducted.During a record review of the facility's record, titled, Job Description: Registered Nurse (RN), prepared by Human Resources in February 2024, the RN job description indicated, The primary responsibility of your job is to supervise day-to-day nursing activities of the facility.Such supervision must be accordance with current and federal, state, and local standards, guidelines and regulations that govern the facility.to ensure that highest degree of quality of care is maintained at all times.Must demonstrate the knowledge and skills necessary to provide care appropriate to the age-related needs of resident served.Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to nursing care facilities.Must possess a current, unencumbered, active license to practice as an RN in this state.Must remain in good standing State Board of Nursing at all times.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

12/23/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Diablo Valley Post Acute

3806 Clayton Road Concord, CA 94521

SUMMARY STATEMENT OF DEFICIENCIES