VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Senior Living at King's Grant House
440 North Lynnhaven Road
Va. beach, VA 23452
(757) 431-8825

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: Aug. 14, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced monitoring inspection was conducted by the Licensing Inspector from the Eastern Regional Office on 08/14/2019 from 9:30 AM to 2:42 PM. There were 68 residents in care at the time of the inspection. Interviews were conducted on and off site. 1 resident record and 3 staff records were reviewed. Video footage and staff schedules were also reviewed. The facility received a violation "under" Resident Care and Related Services. The area of noncompliance was discussed with the Administrator and RCD throughout the inspection and during the exit interview. Please complete the -Plan of Correction- for each violation cited on the violation notice and return it to me within 10 calendar days from today, on 08-30-2019. You will need to specify how the violation will be or has been corrected. Just writing the word corrected is not acceptable. Your plan of correction must include: 1. steps to correct the noncompliance 2. measures to prevent reoccurrences 3. person(s) responsible for implementing and monitoring each step of the corrective measures and / or the preventative measure.

Violations:

Standard #:	22VAC40-73-650-A
Description:	Based on record review and interview, the facility failed to ensure no medication is started by the facility without a valid order from a physician or other prescriber. Evidence: 1. During resident #1?s record review with staff #1 and staff #2, the physician?s order on file dated 08-05-2019 documented the following medications were discontinued: Vitamin D 2,000 units, Atorvastatin 40mg, Myrbetriq 50mg, and Warafin 3mg. 2. Upon review of resident #1?s August 2019 Medication Administration Record (MAR), the staff initialed the MAR documenting the resident received the Vitamin D 2,000 units, Atorvastatin 40mg, Myrbetriq 50mg, and Warafin 3mg on 08-06-2019 and on 08-09-2019 through 08-14-2019. 3. Additionally, resident #1?s record contained a current physician?s order that was signed and dated on 08-07-2019 to restart the Atorvastatin 40mg, Myrbetriq 50mg, and Warafin 3mg; however, there was no order on file to restart the Vitamin D2 2,000 units. The August 2019 MAR documented the resident received the Vitamin D 2,000 units on 08-06-2019 through 08-14-2019. 4. During interview, staff #1 and staff #2 acknowledged the facility administered the Vitamin D 2,000 units, Atorvastatin 40mg, Myrbetriq 50mg, and Warafin 3mg to resident #1 on the aforementioned dates without a valid order from a physician or other prescriber.
Plan of Correction:	Resident #1 received a signed order from the physician. Re-in-serviced Resident Care Director and Assistant Resident Care Director on verification & clarification of Orders policy MD09 and Medication Orders policy MD40. Resident Care Director or designee will perform a random chart audit to include verification of orders a minimum of 4 times per month to ensure ongoing compliance.