VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Oakbrooke
301 Clearfield Avenue
Chesapeake, VA 23320
(757) 315-6900

Current Inspector: Alyshia E Walker (757) 670-0504

Inspection Date: Oct. 29, 2019

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced complaint inspection was conducted by the Licensing Inspector from the Eastern Regional Office on 10-29-2019 from 10:59 AM to 1:21 PM. The complaint alleged concerns regarding infection control. There were 75 residents in care at the time of the inspection. A tour of the special care unit was conducted and the facility's infection control policy was reviewed. 2 resident record were reviewed and interviews were conducted. The facility received a violation "under" Resident Care and Related Services. The following was discussed with the Administrator and Resident Care Director: communication with hospice and physician's orders. The area of non compliance was discussed with the Administrator and Resident Care Director throughout the inspection and during the exit interview.Based on the information reviewed during this inspection, the complaint was found not valid. Please complete the -Plan of Correction- for each violation cited on the violation notice and return it to me within 10 calendar days from today, 12-19-2019. The provider's responses for the "plan of correction" was not received as of 12-20-2019 and will not appear on this Violation Notice.

Violations:

Standard #:	22VAC40-73-680-D
Complaint related:	No
Description:	Based on record review and interview, the facility failed to ensure medications are administered in accordance with the physician's instructions. Evidence: 1. During resident #1?s record review with staff #1, the following was documented: A. The resident was admitted to a rehabilitation center on 05-07-2019 and was discharge back to the facility on 05-23-2019. The Progress Notes from the rehabilitation center dated 05-23-2019 documented ?[The residents] stool was found positive for c.diff?. Continue oral Vancomycin regimen to complete the course after discharge- Vancomycin 125mg BID (5/20/19-5/30/19), then Vancomycin 125mg daily (5-31-19- 6-20-19) and then stop. B. The Vancyomycin 125mg was not documented on the May and June 2019 Medication Administration Record (MAR). Additionally, there was no documentation on file to verify the Vancyomycin 125mg was administered to the resident as ordered. C. The physician?s orders dated 05-21-2019 documented ?Firvanq 50mg/mL oral solution- give 2.5 milliliters (125mg) by oral route 2 times per day for 21 doses. Diagnosis: Enterocolitis due to Clostridium difficile.? The documented start date/time was 05-20-2019 12:00 AM. In addition, the physician?s order documented ?Firvanq 50mg/mL oral solution- give 2.5 milliliters (125mg) by oral route once daily for 21 doses. Diagnosis: Enterocolitis due to Clostridium difficile.? The documented start date/time was 05-27-2019 12:00 AM. The orders also documented ?Patient is to discharge with remaining meds in nursing med cart.? D. Staff #1 could not locate and/or provide a discontinued order on file for the Vancomycin 125mg. 2. During interview, staff #1 acknowledged the facility did not administer the Vancomycin (Firvanq)125 mg to resident #1.
Plan of Correction:	Upon receiving a resident from Hospital, Rehab or doctor?s appointment, Designee/Person in Charge will review paperwork for new or changed orders. Designee/Person in Charge will follow Harmony Senior Services policy on new orders and the approval process.