VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Cana Adult Home
2004 Wards Gap Road
Cana, VA 24317
(276) 755-4338

Current Inspector: Holly Copeland (540) 309-5982

Inspection Date: May 31, 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 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.

Comments:

On 5/31/2019 one inspector conducted an annual monitoring visit (9:15am to 2:45pm); a renewal was not required at this time because the facility currently has a two-year license. 22 residents were in care. Six resident files and three staff files were fully reviewed, and additional resident files were partially reviewed. There have been no new staff people hired since the prior inspection. A physical plant tour was done, staff and residents were interviewed, a medication pass and meal were observed, and the medication cart was checked. The LI and Administrator discussed different ways to show who in charge on the schedule, medications orders kept in current charts if the medication is still being administered (not thinning it out of the current chart), fall risk rating forms, reviewing components of oxygen orders and frequently seen problems, and potential use of bed rails for mobility or positioning. The call bell system was discussed.

Violations:

Standard #:	22VAC40-73-320-A
Description:	Based on document review, the facility failed to ensure that a pre-admission physical was complete. EVIDENCE: 1. The physical exam for for resident 2, admitted on 11/2/2018, lacks a physician determination of whether this resident can administer his own medications or not.
Plan of Correction:	The facility will attempt to get the information from the physician and document the procedure.
Standard #:	22VAC40-73-390-A
Description:	Based on review of resident records, the facility failed to have some required sections in the written resident agreement. EVIDENCE: 1. The written resident agreements with the facility for residents 2 through 6 are lacking required sections of the agreement as outlined in subsections A-1-c, and 4-c, e, g, h, and n of this standard. Information regarding subsections 4-e, f, and j needs to be updated.
Plan of Correction:	The Administrator will update resident agreements to meet the regulations.
Standard #:	22VAC40-73-440-A
Description:	Based on document review and staff interview, the facility failed to have a correct assessment on a private pay individualized service plan (UAI). EVIDENCE: 1. The UAI for resident 2, dated 11/2/2018 shows that professional nursing staff are required to administer medications, and that supervision with bathing is required. The comprehensive individualized service plan (C-ISP) showed that registered medication aides (lay persons) administered medication, and that the resident was given physical assistance with bathing. Interview with staff shows that the services on the C-ISP are correct and the assessments on the UAI are incorrect.
Plan of Correction:	The Administrator will update the UAI to reflect the actual needs of the resident.