The Center At Grande
THE CENTER AT GRANDE in TYLER, TX — inspection on November 16, 2025.
Found 1 citation. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
During an interview on 11/16/25 at 4:00 p.m. the DON said the one-week post admission labs for CBC, CMP, TSH, and Vit.D. were a mistake made by the staff when entering the order.
During an interview on 11/16/25 at 5:23 p.m. the DON said Resident #1's one week post admission CBC, CMP, TSH, Vit.D labs were not done.
The DON said she was not aware of what [Staff C] did until after [Resident #1] discharged .
The DON said Staff C and LVN D should have told her or the resident's doctor.
The DON said they did not have a system in place to verify labs were done because that was not an issue before, to her knowledge.
The DON said the facility used its own staff to draw blood because everything was in-house and not contracted.
She said Staff C was good, no complaints, and DON trained Staff C had been trained on how to draw laboratory specimens. On 11/21/25 at 12:55 p.m., attempted to interview LVN B, the staff who entered the orders, the telephone number provided by facility was not a working number and no interview was obtained. On a telephone interview was attempted with Staff C, regarding the unsuccessful lab attempts for Resident #1.
Staff C did not answer, and although a message with a call back telephone number was left, the interview was not obtained.
During a telephone interview on 11/21/25 at 12:57 p.m., Resident #1's physician who wrote the order for one-week post-admission laboratory tests said he had not been made aware that the labs ordered were not completed. He said he had not been notified of Staff C's unsuccessful attempts to collect the lab specimen. Resident #1's Physician stated he would have expected Staff C to inform her nurse manager or for the facility to contact him directly, so the matter could have been addressed. He further stated that not doing the lab would never be an option and expressed that he wished he had been notified.
Record review of revised facility laboratory services policy, dated 4/2/24, indicated, The facility stall: 1.
Provide or obtain laboratory services only when ordered by a physician; physician assistant; nurse practitioner or clinical nurse specialist in accordance with State law, including scope of practice laws. 2.Promptly notify the ordering physician, physician assistant, nurse practitioner, or clinical nurse specialist of laboratory results that fall outside of clinical reference ranges in accordance with facility policies and procedures for notification of a practitioner or per the ordering physician's orders.
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