VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Abundant Care Assisted Living
5556 Paca Lane
Va beach, VA 23462
(757) 519-9100

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

Inspection Date: Aug. 5, 2019

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS

Comments:

Two Licensing Representatives conducted a monitoring inspection regarding a self-reported incident on August 5, 2019 from 10:44 a.m. to 12:31 p.m. There were 5 residents in care. During the inspection, resident and staff records were reviewed, and interviews were conducted. The following was discussed: emergency placement, Individualized Service Plans, resident rights, and documentation of incidents. Please submit your ?plan of correction? and ?date to be corrected? for each violation cited on the violation notice and return it within 10 calendar days. The plan of correction must indicate how the violation will be or has been corrected. The plan of correction must include: 1. Step(s) to correct the noncompliance with the standard(s) 2. Measures to prevent reoccurrence 3. Person(s) responsible for implementing each step and/or monitoring any preventative measures. If you have any questions, please contact your inspector Alexandra Poulter at 757-613-5133 or alexandra.poulter@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-70-A
Description:	Based on record review and interview, the facility failed to report to the regional licensing office within 24 hours any major incident that has negatively affected or that threatens the life, health, safety, or welfare of any resident. Evidence: 1. Staff #1 telephoned the regional licensing office on 07-19-19 and stated that resident #1 fell and had a seizure on 07-14-19 and required emergency assistance. 2. Resident #1?s record contained documentation on ?Abundant Care Assisted Living Communication Among Staff? of the fall on 07-14-19. Additionally, the resident was admitted to the hospital on 07-14-19 and was still hospitalized on date of inspection. There was no additional information in the record. 3. Staff #1 acknowledged the five-day delay in reporting the incident to the regional licensing office.
Plan of Correction:	Administrator will ensure that the facility will inform the regional licensing office within 24 hours of any major incident that negatively impacts or threatens the life, health, safety, or welfare of any resident. The facility will implement an ongoing in-service training of the standard 22VAC40-73-(2)-70-A to ensure compliance of the rules and regulations.
Standard #:	22VAC40-73-390-A
Description:	Based on record review and interview, the facility failed to ensure that at or prior to the time of admission, there was a written agreement/acknowledgment of notification dated and signed by the resident or applicant for admission or the appropriate legal representative, and by the licensee or administrator. Evidence: 1. Resident #1 was admitted on 04-19-19. The resident agreement was signed by resident #1?s legal representative on 04-24-19. 2. Staff #1 confirmed that the resident agreement was signed late and stated that resident #1 was an emergency placement. Staff #1 could not provide documentation nor approval from an adult protective services worker or an independent physician that confirmed resident #1 was an emergency placement. Additionally, the resident?s record did not contain any documentation indicating that the resident was an emergency placement.
Plan of Correction:	The facility acknowledged the failure to follow through with our trusted agency partner to sign off ALL legal admission documents prior to admission. The facility will ensure proper protocol and checklists must be adhered prior to admitting potential resident(s) to include proper documentation of emergency placement by an approval of an APS (Adult Protective Service) worker, or an independent physician that can confirm the resident is indeed an emergency placement. The facility will ensure proper inscription into the resident's personal record in event of emergency placement.