VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Harmony Collection at Roanoke Memory Care
4414 Pheasant Ridge Road
Roanoke, VA 24014
(540) 685-4900

Current Inspector: Holly Copeland (540) 309-5982

Inspection Date: Oct. 3, 2022

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS 22VAC40-80 COMPLAINT INVESTIGATION

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 10/03/2022 11:30 AM ? 03:00 PM The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 09/20/2022 regarding allegations in the area(s) of: Failure to obtain medical attention from a licensed healthcare professional for an injured resident after a fall. Number of residents present at the facility at the beginning of the inspection: 43 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 1 Number of staff records reviewed: 0 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 2 Observations by licensing inspector: N/A Additional Comments/Discussion: N/A An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the allegation(s) of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the complaint(s) but identified during the course of the investigation can also be found on the violation notice. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov. Should you have any questions, please contact Holly Copeland, Licensing Inspector at 540-309-5982 or by email at holly.copeland@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-325-B
Complaint related:	No
Description:	Based on record review, the facility failed to ensure that the fall risk rating was reviewed and updated after a fall. EVIDENCE: Facility progress notes for resident 1 contain documentation of falls on 08/03/2022 and 08/23/2022; however, the fall risk ratings in the record for resident 1 were dated 06/23/2022 and 08/29/2022.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-470-F
Complaint related:	Yes
Description:	Based on record review, the facility failed to ensure that when the resident suffers serious accident, injury, illness, or medical condition, or there is reason to suspect that such has occurred, medical attention from a licensed health care professional shall be secured immediately. EVIDENCE: 1. Facility direct care staff progress notes for resident 1 indicate the following: a. Per staff 4, on 08/03/2022 at 02:22 PM, resident 1 was found on the floor in the movie theater by therapy staff. When staff 4 arrived, the resident could not state what happened and the resident told staff 4 that he had no pain nor any other issues. Resident 1 was assisted back into his wheelchair with no complaints. Resident?s POA was notified and staff 4 will continue to monitor. b. Per staff 3, on 08/04/2022 at 06:38 AM, resident rested through the night with no complaints from the previous fall and no signs or symptoms of pain nor discomfort. Staff 3 will continue to monitor. c. Per staff 3, on 08/23/2022 at 06:27 AM, the resident was found on floor and assisted up off the floor with no injuries noted. Staff 3 assisted him to bed. He had on a clean dry brief. The healthcare director, responsible party, and collateral 2 were notified. d. Per staff 4, on 08/23/2022 at 02:32 PM, the resident had no complaints of pain nor distress due to the prior fall and staff 4 will continue to monitor. e. Per staff 3, on 08/24/2022 at 06:30 AM, the resident rested through the night with no complaints from the previous fall. The resident showed no signs or symptoms of pain nor discomfort, and staff 3 will continue to monitor. f. Per staff 4, on 08/24/2022 at 02:34 PM, the resident had no complaints of pain or distress due to prior fall and staff 4 will continue to monitor. g. Per staff 3, on 08/25/2022 at 07:00 AM, the resident rested through the night with no complaints from the previous fall. The resident showed no signs or symptoms of pain nor discomfort and staff 3 will continue to monitor. h. Per staff 4, on 08/26/2022 at 06:27 AM, the resident slept through the night with no complaint or any signs or symptoms of pain or discomfort, and staff 4 will continue to monitor. i. Per staff 4, on 08/29/2022 at 10:39 AM, the resident?s POA came to staff 4 stating that the resident is complaining of severe left hip pain due to the previous fall, and his wife stated that she was going to order an x-ray. Staff 4 noted that his wife was informed that a doctor?s order would be needed, so the resident?s POA stated for staff 4 to send the resident out to the hospital to get checked out. EMS came and transported the resident to RMH, and staff 4 will continue to monitor. Resident could not state what happened. j. Per staff 5, on 08/29/2022 at 05:25 PM, the resident?s wife called at 16:30 and informed staff 5 that the resident was admitted to RMH in reference to a broken hip. 2. Hospital Emergency Department to Hospital admission notes, dated 08/29/2022, indicate that resident 1 presents to the ED with the complaint of acute left hip pain post fall. The same documentation also indicates that resident 1 was evaluated at bedside and displayed intense discomfort on motion of the left hip and x-ray imaging shows ?suspicious fracture?. 3. Hospital discharge notes, dated 09/01/2022, indicate that closed reduction percutaneous pinning (CRPP) surgery was performed by collateral 3 on resident 1?s left hip on 08/30/2022. 4. The Regulations Governing the Registration of Medication Aides, effective 02/06/2020, reg. 18VAC90-60-110-B #2 indicates the following: ?B. A medication aide shall not: 2. Make an assessment of a client?? 5. Per interviews with staff 1 and 2 and per the facility staff roster that was obtained on the date of inspection, staff 3 and staff 4 are RMAs and not licensed healthcare professionals.
Plan of Correction:	Not available online. Contact Inspector for more information.