VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Fairview Home
5140 Hatcher Road
Dublin, VA 24084
(540) 674-5260

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: June 5, 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 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE.

Comments:

Two licensing inspectors conducted a one day unannounced mandated monitoring inspection at Fairview Home on 06/05/2019. The inspection started at 9:40 am and concluded at 1:45 pm. A sample of resident and staff files were reviewed. Required Posting's were checked. The noon medication pass was observed and medication cart audits were conducted. Lunch and snacks were observed being served. Activities were observed along with staff interacting with residents throughout the inspection. An exit meeting was conducted with the assistant administrator and other key staff on 06/05/2019 and at that time opportunity was given to find items that were not available in files. As a result of this inspection 6 violations are being cited. Please develop a plan of correction for each of the cited violations along with a date of correction and return a signed and dated copy to the licensing office within 10 calendar days (06/16/2019) of receipt. If you have any questions or concerns please contact your inspector at 276-608-3514. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-73-100-A
Description:	During a medication/treatment cart audit, the facility failed to implement an infection control program addressing the surveillance, prevention, and control of disease and infection that is consistent with the Center for Disease Control and Prevention (CDC) guidelines and the federal Occupational Safety and Health Administration (OSHA) blood borne pathogens regulations. EVIDENCE: 1. Resident # 11 and Resident # 13 both had glucometers stored on the treatment cart and there was no label on the backs of their individual glucometers. One glucometer storage bag had the Resident?s first and last name written on it and the other storage bag only had the Resident?s first name written on it.
Plan of Correction:	Nursing department supervisors will monitor and assure all glucometers and bags are labeled with fill names when new glucometers come in. [sic]
Standard #:	22VAC40-73-640-A
Description:	During the medication cart audit, the facility failed to implement their medication management plan in regards to methods to prevent the use of outdated, damaged, or contaminated medications. EVIDENCE: 1. Resident #6 had a Levalbuterol HFA 45mcg inhaler stored in the medication cart that was observed to be opened and used. There was no open date listed on the inhaler itself nor the box it came in.
Plan of Correction:	Reminded all meds staff to date all meds requiring such. Each residents meds will be QA'd at least monthly to monitor compliance and nursing department supervisors will oversee QA activity. [sic]
Standard #:	22VAC40-73-650-A
Description:	During the medication cart and Medication Administration Record (MAR) audit, the facility failed to have a physician?s order to start, change, or discontinue a medication. EVIDENCE: 1. Resident # 9 had Trolamine Salicylate 10% cream listed on the June 2019 MAR. This medication was prescribed on September 11, 2017. 2. The most recent physician?s order dated 02/01/2019 for this medication in Resident # 9?s chart ordered the Trolamine Salicylate to be applied to the right knee three times daily as needed for knee pain. 3. The medication was not present on the medication cart. 4. Staff # 1 stated that resident # 9 has not used this medication for at least six months after reviewing the MARs. Staff # 1 stated this medication has been discontinued. 5. There was no discontinue order found in resident # 9?s file.
Plan of Correction:	D/C order received. Reminded medication administration on staff to not pull any meds until the d/c order is received. Each residents meds will be QA'd at least monthly and nursing supervisor will oversee QA activity. [sic]
Standard #:	22VAC40-73-860-G
Description:	During the tour of the building, the facility failed to ensure hot water taps were maintained within a range of 105 F and 120 F EVIDENE: 1. The women?s common bathroom across from Resident room #14 and #15 was observed to have a hot water temperature of 127.3 in the middle sink.
Plan of Correction:	Corrected: Housekeeping supervisor will monitor water temperatures at least monthly. [sic]
Standard #:	22VAC40-73-870-A
Description:	During the tour of the outside of the building, the facility failed to maintain the interior and exterior of the building in good repair and kept clean and free of rubbish. EVIDENCE: 1. In the gazebo, one of the two wooden benches was turned up on its side making it not usable to the residents. 2. The bench outside of the exit from the TV room was noticed to have a very strong urine odor and licensing inspector observed a puddle in the dirt. The same bench had approximately five empty cigarette packs and two to three candy wrappers thrown under it. There were at least 50-75 cigarette butts laying on the ground in front of and around this bench. 3. The bench in the front of the building with 2x4?s for seating was observed to have the middle plastic leg broken and the plastic legs were observe to be dark in color and had mildew stains present.
Plan of Correction:	1. Corrected 2. Corrected and will monitor 3. Will be disposed of. Housekeeping staff will monitor conditions of grounds and outdoor furniture as past of their daily rounds. [sic]
Standard #:	22VAC40-73-980-A
Description:	During the tour of the building, the facility failed to ensure the first aid kit contained all necessary items with expiration dates that have not passed. EVIDENCE: 1. The hand sanitizer in the first aid kit had an expiration date of ?190428? which means April 28, 2019.
Plan of Correction:	Corrected. Nursing staff will monitor the expiration date when the first aid kit is checked monthly. [sic]