VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Chantilly
2980 Centreville Road
Herndon, VA 20171
(703) 994-4561

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: July 24, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

Comments:

An unannounced focused monitoring inspection was conducted on 7/24/19 (7:30 AM - 10:30 AM) to follow-up on high-risk violations that were cited on 5/24/19. Medication administration was observed and resident records were reviewed. Violations were discussed and an exit meeting was held. Areas of non-compliance are identified on the violation notice. Please complete the 'plan of correction' and 'date to be corrected' for each violation cited on the violation notice and return to the licensing office within 10 calendar days. Please specify how the deficient practice will be or has been corrected. Just writing the word 'corrected' is not acceptable. The 'plan of correction' must contain: 1) Steps to correct the non-compliance with the standards, 2) Measures to prevent the non-compliance from occurring again, and 3) Person responsible for implementing each step and/or monitoring any preventative measures. Thank you for your cooperation and if you have any questions, please contact me via e-mail at m.massenberg@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-660-A
Description:	Based on observation, the facility failed to ensure that a medicine cabinet is used for the storage of medications and dietary supplements prescribed for residents when such medications and dietary supplements are administered by the facility. Medications shall be stored in a manner consistent with current standards of practice. Evidence: The morning medication administration, for Resident #1, was observed during the inspection. The room was observed to contain Pepto Bismol, Metamucil, and Saline Nasal spray were Resident #3 was observed eating a pastry in the dining area of the memory care unit. A medication tablet, with an imprint of "262," was observed on the floor near Resident #3. The tablet was observed to be consistent with the Quetiapine tablet that is ordered for Resident #3.
Plan of Correction:	Medication removed from room of resident #1. Daily room observations by med aides and nurse aides. Started to retrieve any over the counter medications. Letter sent to family members reviewing medication policy and regulations for assisted living. Pill was disposed of properly. In-service training for all medication staff scheduled with provider pharmacy.
Standard #:	22VAC40-73-680-D
Description:	Based on documentation, the facility failed to ensure that medication is administered in accordance with the physician's instructions. Evidence: Resident #1's July medication administration record (MAR) was reviewed during the inspection. The MAR stated that the resident's Atorvastatin 10mg was awaiting delivery from the pharmacy on 7/9/19. Resident #2's July MAR was reviewed during the inspection. The MAR stated that the resident's Melatonin was not found in the medication cart on 7/9/19.
Plan of Correction:	HCC re-educated medication staff on medication policy and observed med passes. Engaged outside nurse consultant for medication improvement plan-completed 8-13. In-Service Training for all medication staff scheduled with provider pharmacy to be completed by 9/15.