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Vienna Manor I, LLC
2151 Chain Bridge Road
Vienna, VA 22182
(703) 938-7080

Current Inspector: Alexandra Roberts

Inspection Date: Feb. 12, 2020

Complaint Related: No

Areas Reviewed:
22VAC40-73 GENERAL PROVISIONS
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
63.2 General Provisions.
63.2 Protection of adults and reporting.
63.2 Licensure and Registration Procedures
63.2 Facilities and Programs..
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.
22VAC40-80 THE LICENSING PROCESS.

Comments:
An unannounced renewal inspection was conducted on 2/12/20. At the time of entrance, eight residents were in care. Meals and activities were observed. Medication records were reviewed. Building and grounds were inspected and additional records were reviewed. The sample size consisted of four resident records and three staff records. The violation was 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 #: 22VAC40-73-680-D
Description: Based on record review, the facility failed to ensure that medication is administered in accordance with the physician's instructions and consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing.
Evidence: The medication administration record (MAR) for Resident #1 was reviewed during the inspection. Resident #1's record contained a physician's order, dated 1/28/20, for the resident to receive Seroquel 1.25mg twice per day. The January MAR indicated that Resident #1 received 12.5mg of Seroquel twice per day on 1/30/20 and 1/31/20. The February MAR indicates that Resident #1 received 25mg of Seroquel twice per day from 2/1/20 - 2/3/20, and that the resident also received a 25mg dose of Seroqeul during the morning medication administration on 2/4/20.

Plan of Correction: The administrator/Nurse immediately corrected the MAR based on the current order of Seroquel 12.5 mg BID. The most updated order for resident # 1 is Seroquel 12.5mg BID, Pharmacy failed to update the MAR with the current order for February MAR. Resident received the right meds of Seroquel 12.5mg, but MAR was not updated to Seroquel 12.5mg BID.

The administrator notified the Pharmacy right away to update their records. MT and the administrator will review our MAR every month to make sure it reflect the current order.

Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.

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