VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Valley View Retirement Community
1213 Long Meadows Drive
Lynchburg, VA 24502
(434) 237-3009

Current Inspector: Jennifer Stokes (540) 589-5216

Inspection Date: June 5, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

On 6/5/2019 two inspectors conducted a focused monitoring inspection to follow up on prior high risk violations. Three repeat violations were found, as well as one additional (low risk) violation. Resident records and medication carts were checked, and a physical plant observation was made.

Violations:

Standard #:	22VAC40-73-290-B
Description:	Based on observation, the facility failed to implement a procedure for posting the name of the current on-site person in charge in a place in the facility that is conspicuous to the residents and the public. EVIDENCE: 1. The "In Charge" posting had no name posted.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-610-D
Description:	Based on observations and resident record review, the facility failed to ensure that special diets were prepared and served according to physician orders. EVIDENCE: 1. The record for resident 5 has a diet order dated 5/21/2019 that shows the no added salt (NAS) part of the special diet was discontinued. The kitchen list shows resident 5 is served a NAS diet with diabetic deserts. This was observed on 6/5/2019.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-640-A
Description:	Based on observations and resident record reviews, the facility failed to implement required sections of the medication management plan regarding preventing the use of outdated medication, and having medications refilled to be available to administer to the resident. EVIDENCE: 1. An Advair Discus inhaler with an open date of 3/26/2019 was in the medication cart for resident 15. This was noted on 6/5/2019. The medication administration record (MAR) shows that one puff is to be administered two times a day, and has been done so in May and June 1019. The manufactures web site (https://www.gsksource.com/pharma/content/dam/GlaxoSmithKline/US/en/Prescribing_Information/Advair_Diskus/pdf/ADVAIR-DISKUS-PI-PIL-IFU.PDF) shows this medication is to be discarded when the dose shows "0" or after one month, whichever comes first. The Advair Diskus for resident 15 was opened more than 30 days ago, and the number of doses left shows "21". 2. The record for resident 10 has a physician order for daily weights and to notify the physician of change of 2 to 3 pounds overnight or 5 pounds a week. Documentation of the resident's daily weight sheet shows a 2 pound increase from 6/2/2019 to 6/3/2019 and documentation shows this was not faxed to the physician until 6/5/2019. 3. The medication cart has Ventolin HFA for Resident 12 that shows the expiration date was 3/2019. This was noted 6/5/2019. This medication is listed on the current MAR to be used as needed. The facility does not have this medication on hand to administer to the resident if needed. 4. The medication cart has Wixela for resident 15 with no open date on it. The medication was filled on 5/7/2019 and there are 54 doses left. Packaging shows this medication is to be discarded one month after opening or when the meter reads 0, whichever comes first. Without an open date on the medication, it is unknown when to discard it.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-680-D
Description:	Based on observations and resident record review, the facility failed to ensure that medications were administered in accordance with physician instructions. EVIDENCE: 1. A bottle of Flonase Nasal Spray for resident 14 was between one-half to 3/4 full. It was marked with an open date of 5/10/2019, and the May and June 2019 medication administration records (MAR) show that this medication was administered to resident 14 as ordered. The bottle holds 120 metered sprays, and a total of four sprays per day should have been administered. Based on this scheduled rate of use, the bottle should have been almost empty on the day of the inspection (6/5/2019).
Plan of Correction:	Not available online. Contact Inspector for more information.