VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Independence
2077 South Independence Boulevard
Virginia beach, VA 23453
(757) 802-3665

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: June 6, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Technical Assistance:

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Comments:

An unannounced monitoring inspection was conducted on this date from 2:45p.m. until 6:00p.m . There were 56 residents in care . Four residents individualized service plans, progress notes , staff monitoring sheets, emergency room discharge summaries/instructions and other health providers notes were reviewed . There was discussion about documentation of the exact time of the two-hour check , alternate intervention following subsequent falls and noting the type of allergic reactions the residents may experience. Also there was discussion about adding to the ISP the services needed to prevent and /or monitor for injury to a resident with decrease feelings in his legs. The staff was advised to add to the ISP the doctor's notes dated the day of the inspection (6-6-19). The facility's policy about monitoring residents after a fall was reviewed. Management staff plans to review the 72 hour monitoring policy with all staff . The way the facility affirms the family/legal representative has reviewed the ISP was discussed. The staff talked about how emergency room discharge instructions are implemented, documented ,and how staff facilitate recommended follow-up medical appointments. 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 on 6-16-19. You will need to specify how the violation will be or has been corrected. Just writing the word ?corrected? is not acceptable. Your plan of correction must include: 1. steps to correct the noncompliance 2. measures to prevent reoccurrences 3. Person(s) responsible for implementing and monitoring each step of the corrective measures and / or the preventative measures

Violations:

Standard #:	22VAC40-73-450-F
Description:	Based on record review and interview the facility failed to ensure one of four individualized service plans(ISPs) had been updated as the condition of a resident changed. The update shall be performed by a qualified staff person and in conjunction with the resident and, as appropriate, with the resident's family, legal representative, direct care staff, case manager, health care providers, qualified mental health professionals, or other persons. Evidence 1. During a review of the residents ISPs with staff # 1 and #2 , the inspector found resident #1's , ISP dated and signed by the developer on 5-9-19 and reviewed with the family by telephone on 5-9-19, did not include the raise toilet ordered by the occupational therapist on 5- 22-19, and in the resident's bathroom on the day of the inspection (6-6-19). 2. Staff #1 stated she had not been made aware of the ordering or the delivery of the raised toilet.
Plan of Correction:	The Healthcare Coordinator added the raised toilet seat to resident # 1 care plan on the day of inspection on 06/06/2019. The Executive Director and Healthcare Administrator will meet with the therapy manager. The expectation will be that the therapy manager/designee will report any additional services and/or devices prior to the implementation. The RCD/Designee will monitor notifications from therapy to ensure continued compliance of the expectation.