VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Spring Hill
8350 Mountain Larkspur Drive
Fairfax, VA 22079
(571) 348-4970

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: March 2, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced focused-monitoring inspection was conducted on 3/2/20 to follow-up on high-risk violations that were cited on 12/23/19. Medication administration was observed. Blood glucose monitoring devices were checked and facility documentation was reviewed. 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 observation and documentation, the facility failed to ensure that medications are administered in accordance with the physician's instructions. Evidence: Resident #1's morning medication administration was observed during the inspection. The resident's medications were placed into a pill cup and the medication packages were returned to the cart. Before the medications were administered, the licensing inspector asked about Resident #1's Alendronate Sodium. Resident #1's Alendronate Sodium order, dated 1/18/20, called for the resident to receive the medication 30-45 minutes prior to taking other medications. Resident #1's pill cup contained several other medications, in addition to her Alendronate Sodium. Resident #2's morning medication administration was observed during the inspection. Resident #2 had a Lidocaine patch applied during the administration. The patch from the previous day was still applied. Resident #2's chart contained an order for the Lidocaine patch, dated 2/16/20, that called for the patch to be removed per the facility's schedule. The facility treatment administration record (TAR) called for the patch to be removed at 8:00 PM, and a new patch to be applied at 8:00 AM.
Plan of Correction:	Staff were re-educated on proper medication administration procedures on the medication Alendronate Sodium. The Healthcare Director and Harmony Square Director performed a medication pass audit to confirm that medication processes for those requiring additional measures were properly implemented. No issues were identified. The Healthcare Director will verify orders for specific medication requirements upon admission and will verify new orders. The Executive Director, (ED), or designated Coordinator is responsible for confirming implementation and ongoing compliance with the components of this Plan of Correction and addressing and resolving variances that may occur. Resident #2?s physician was contacted and there were no adverse effects from the patch not being removed as per the Treatment Administration Record, (TAR). Staff were re-educated and corrective disciplinary action was taken. The Executive Director, (ED), or designated Coordinator is responsible for confirming implementation and ongoing compliance with the components of this Plan of Correction and addressing and resolving variances that may occur.