VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Generations Crossing
3765 Taylor Spring Lane
Rockingham, VA 22801
(540) 434-4901

Current Inspector: Jessica Gale (540) 571-0358

Inspection Date: Sept. 23, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-60 ADMINISTRATION 22VAC40-60 PERSONNEL. 22VAC40-60 SUPERVISION. 22VAC40-60 BUILDINGS AND GROUNDS. 22VAC40-60 ADMISSION, RETENTION AND DISCHARGE. 22VAC40-60 PROGRAMS AND SERVICES. 22VAC40-60 EMERGENCY PREPAREDNESS. 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2(19.2) Criminal Procedures. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Technical Assistance:

The hot water temperature registered 122 degrees Fahrenheit (F), please continue to monitor and ensure it remains between 105 to 120 degrees F.

Comments:

An unannounced renewal inspection was conducted on 9/23/19 from approximately 8:20 am to 2:50 pm. A tour was immediately conducted of the interior and exterior of the facility. All of the required postings were in place and the center was clean, well maintained and free from any foul odors. Upon arrival, there were six participants in care and two staff and one student on duty. Upon departure, there were 13 participants in care and four staff on duty. Interviews were conducted with family members, participants and staff. Medication administration observations were completed with two participants and their physicians' orders and medication administration records were reviewed. The posted menu and activities calendar accurately reflected this inspector's observations. Six participant, one discharge, one student and three staff records were reviewed. Selected sections of four additional staff records were also reviewed. The area of noncompliance was plans of care. Staff answered all questions and obtained all information requested. Thank you for your assistance and cooperation during this inspection.

Violations:

Standard #:	22VAC40-60-570-B-1
Description:	Based upon documentation and an interview, the center failed to ensure all assessed needs were included on five of the seven plans of care reviewed. Evidence: 1) The plans of care did not include the following assessed needs: confusion and forgetfulness for participant B; mechanical assistance and supervision with transferring, disorientation to place and time for participant C; mechanical and physical assistance with bathing and mobility, supervision with bathing and eating, physical assistance with toileting and transferring and disorientation to time for participant D; mechanical assistance with bathing, mechanical and physical assistance with dressing and toileting and disorientation to place and time for participant E; supervision with mobility for participant G. 2) On 9/23/19, the licensing inspector (LI) interviewed the nurse on duty who reviewed the plans of care and confirmed these needs were not included.
Plan of Correction:	The nurse coordinator will communicate our plan of correction stated below with each registered nurse (RN). The RNs will be responsible to review and update all charts as needed over the next two weeks. In addition, the nurse coordinator will meet with each RN individually to emphasize the importance of every plan of care reflecting the information that is documented on the clinical assessments. Moving forward, the nurse coordinator will review random charts each month to ensure compliance.