VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Jeanne's Elderly Care
1682 Monterey Road
Roanoke, VA 24019
(540) 563-1262

Current Inspector: Angela Marie Swink (276) 623-6575

Inspection Date: Oct. 2, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 32.1 Reported by persons other than physicians 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 SANCTIONS.

Comments:

The LI for Jeanne's Elderly Care conducted an unannounced renewal study at the facility on 10/2/19 from 10:00am until 3:00pm and noted six residents to be in care. Resident and staff records as well as other forms of facility documentation were reviewed. A tour of the facility physical plant was conducted and the mid day meal was observed. If you have any questions please feel free to contact your LI at 540-309-2968.

Violations:

Standard #:	22VAC40-73-320-A
Description:	Based on a review of resident records, the facility failed to ensure that a physical examination was completed as required. EVIDENCE: 1. The record for resident 1, admitted to the facility on 2/2/19 has a physical exam with a completion date of 7/16/18, which is outside of the 30 days preceding the residents admission to the facility.l 2. The physical exam in the record for resident 2, dated 2/11/19 has documentation that the resident requires continuous licensed nursing care, which make is unable to determine if this resident is an appropriate placement for an AL facility.
Plan of Correction:	The Administrator or designee will contact the residents physician to review the physical. All new admissions will have all paperwork reviewed for accuracy prior to admission.
Standard #:	22VAC40-73-325-A
Description:	Based on a review of resident records, the facility failed to ensure that fall risk rating were completed annually of required residents. EVIDENCE: 1. The record for resident 3 has a fall risk rating that does not include a date of the completion of the form to ensure that a fall risk rating is being completed annually.
Plan of Correction:	The Administrator will ensure that all fall risk ratings are completed as required and properly dated.
Standard #:	22VAC40-73-390-A
Description:	Based on a review of resident records, the facility failed to provide a facility agreement with all required information to resident prior to admission. EVIDENCE: 1. The resident agreement in the records for resident 1 (admitted on 2/2/19) and resident 2 (admitted on 3/14/19) do not contain all information per this standards requirement.
Plan of Correction:	The administrator will update resident agreements with all required information.
Standard #:	22VAC40-73-440-A
Description:	Based on a review of resident records, the facility failed to update uniform assessment instruments (UAI) with changes in residents conditions. EVIDENCE: 1. The record for resident 1 has documentation that the resident requires the use of a wheelchair with staff assistance for wheeling and mobility. Interview with staff person 4 expressed that this information is correct. The UAI dated 3/1/19 in the record for resident 1 is in correct as is has documentation that the resident requires no help with wheeling or mobility.
Plan of Correction:	The administrator or designee will update the UAI to reflect current ADL needs.
Standard #:	22VAC40-73-450-F
Description:	Based on a review of resident records, the facility failed to ensure that individualized service plans (ISPs) were updated as changes in condition occurred. EVIDENCE: 1. The history on physical dated 2/11/19 in the record for resident 2 has a order for a puree nectar diet. The ISP dated 3/1/19 was not updated to reflect this need.
Plan of Correction:	The administrator or designee will update the ISP to reflect all identified needs.
Standard #:	22VAC40-73-690-B
Description:	Based on a review of resident records, the facility failed to ensure that medication reviews were completed as required. EVIDENCE: 1. The records for residents 1, 2 and 3 do not have documentation of a medication review being completed for these residents.
Plan of Correction:	The administrator will send medication lists to all physicians to request medication reviews.