VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harbourway Assisted Living
1217 Alliance Drive
Va beach, VA 23454
(757) 716-2150

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: Feb. 10, 2020 and Feb. 11, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report 22VAC40-80 THE LICENSE.

Technical Assistance:

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Comments:

An unannounced monitoring inspection was conducted on 2-10-20(8:02 a.m.until 5:40 p.m.) and on 2-11-2020 (9:20 a.m. until 3:15 p.m.) There were 63 residents in care. Four staff records and 12,resident records were reviewed .Medications were observed administered in the assisted living section and on the secured unit. Interviews were conducted with family, a collateral contacts and residents. A LPN is on duty 24 hours daily. Observed the breakfast meal :toast, bacon, hash browns, juice and coffee. Observed the posted activity of balloon toss in the morning and bingo in the p.m. The facility was advised that the inspector cannot open encrypted email. The facility agreed to fax incidents reports and alert the inspector by email when a report has been sent . There was discussion and review of follow-up recommendations from the health care oversight and the medication and dietary reviews, responses to the residents' concerns listed in council minutes, methods of communicating between all shifts, fall risk rating after each fall, acknowledging review of ISPs via email, text,etc. and private duty paperwork. 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 2-28-20 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 measures A staff skills fair is held semi-annually.

Violations:

Standard #:	22VAC40-73-650-E
Description:	Based on record review,observation,and interview the facility failed to ensure a resident's record shall contained the physician's or other prescriber's signed written order or a dated notation of the physician's or other prescriber's oral order. Evidence 1. On 2-10-20, around 9:35 a.m. staff #1 administered resident # 1 a Lasix 20 mg tablet every 24 hours (fluid retention) ordered on 1-13-20. 2. While reviewing the resident's record with staff # 5, no signed order could be located in resident # 1's electronic record . 3. Staff #6 searched but could not locate a signed paper copy of the 1-13-20 Lasix order. 4. At the time of the inspection the staff acknowledged a signed copy of the Lasix 20 mg order could not be located.
Plan of Correction:	1. Lasix order was entered and signed off by the provider on 1-10-20. It was updated on the computer system to reflect a time change, but was entered as "prescribed written" instead of verbal order. Order has been printed by Unit Manager and given to provider for signature. 2. Audit will be conducted by Unit Manager to ensure all orders entered as"prescribed written" have the providers' signature. 3. Training will be conducted to all licensed nurse and medication aides to ensure proper process is followed when entering orders into system