VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Meadow Hills Assisted Living Facility
5046 Williamson Road
Roanoke, VA 24012
(540) 400-7253

Current Inspector: Angela Marie Swink (276) 623-6575

Inspection Date: Feb. 25, 2019

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

The Piedmont Licensing Office received a complaint in regards to a resident at Meadow Hills Assisted Living Facility. The complaint alleges that a resident was not receiving medication that is prescribed for their mental health diagnosis for several weeks. The LI for Meadow Hills Assisted Living conducted an unannounced complaint investigation at the facility on 2/25/19 from 1pm until 4pm. Resident records and medication administration records were reviewed and interviews were conducted with staff. Based on all evidence available for review this complaint is founded and violations were cited. If you have any questions please feel free to contact your LI at 540-309-2968.

Violations:

Standard #:	22VAC40-73-680-D
Complaint related:	No
Description:	Based on resident record review and staff interviews, the facility failed to ensure that medications for resident 1 were administered in accordance with physician instructions. EVIDENCE: 1. The record for resident 1 has a physician order for Clozapine 100mg, 1 and a half tabs twice a day for schizophrenia. The January 2019 MAR has staff initials that are circled 22 times for not administering this medication from 1/10/19 through 1/31/19. The February 2019 MAR has staff initials that are circled for not administering this medication at 8am and 8pm for every dose from 2/1/19 through 2/12/19. The record for resident 1 has documentation from the residents pharmacy dated 1/17/19 that the blood work results they had received was not the right blood work and that current blood work was needed to be able to fill resident 1's Clozapine order. Resident 1 did not have his blood work drawn until 1/29/2019 and as of 2/12/19 the blood work was not received by the pharmacy to be able to fill the Clozapine order. Interviews with staff persons 1 and 2 expressed that resident 1 had not received any Clozapine from 1/10/19 through 2/12/19 as it was not in the facility to administer. No documentation was noted in the record of the facility notifying resident 1's physician of the omission of this medication until 2/12/19 when resident 1's physician requested that resident 1 be sent to the emergency room.
Plan of Correction:	The Administrator had in-services for all medication aides on the importance of medication administration. A calendar had been created for all residents requiring routine blood work and facility staff are ensuring/transporting residents to these appointments.The health care oversight is auditing resident records for compliance.
Standard #:	22VAC40-73-680-I
Complaint related:	No
Description:	Based on medication administration record (MARs) reviews, the facility failed to ensure that all required documentation was included on resident 1's MARs. EVIDENCE: 1. The January 2019 MAR for resident 1 has staff initials for the administration of the prescribed medication Clozapine 100mg, 1 and a half tabs at 8am on 1/22/19 and at 8pm on 1/14/19 through 1/17/19 and 1/21/19 through 1/27/19. It was confirmed during the inspection that this medication was not available at the facility for administration on these dates. Staff initials were not circled to indicate the omission and no documentation was noted on the MAR that the medication was not administered. No staff initials/documentation were present on the January 2019 MAR for the 8am or 8pm dose on 1/29/19 through 1/31/2019 to indicate any information about the administration or omission of this medication.
Plan of Correction:	The Administrator had in-services for all medication aides on the importance of proper documentation on resident MAR and ensuring that medications are administered as ordered. Staff have been trained on contacting the administrator/pharmacy for medication issues.