VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Gray Ridge Village LLC
155 Ridgefield Rd
Marion, VA 24354
(276) 521-0784

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: Dec. 15, 2020

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A complaint inspection was initiated on 12/15/2020 and concluded on 01/05/2020. A complaint was received by the department regarding allegations in the areas of Hospice Care. The administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation supported the complaint of non-compliance with standards or law, and violations were issued. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-310-M
Complaint related:	No
Description:	Based on documentation review, the facility failed to implement a written agreement between the assisted living facility and any hospice program that provides care in the facility. This also includes policies and procedures to ensure appropriate communication and coordination between the facility and the hospice program. EVIDENCE: 1. On 12/08/2020 physicians orders were written for a hospice evaluation for resident # 1. 2. On 12/09/2020 Kindred Hospice completed an evaluation for resident # 1 to begin Hospice services. 3. On 12/17/2020 an agreement between Hospice and resident #1 was signed to begin Hospice services for end stage pulmonary disease. 4. The facility administrator stated the facility does not have a current policy in place regarding Hospice Services and there is not an agreement between the facility and the Hospice Program.
Plan of Correction:	Policy for Hospice Care created and put in place. From here forward the facility will not have hospice residents. [sic]
Standard #:	22VAC40-73-450-D
Complaint related:	No
Description:	Based on on documentation review, the facility failed to ensure when hospice care is provided to a resident the services by each shall be included on the Individualized Service Plan (ISP). EVIDENCE: 1. On 12/08/2020 Hospice Services were added to resident # 1's ISP dated 11/30/2020. The ISP states Hospice services will be provided by Kindred Hospice. The ISP does not reflect the communication with the Hospice program and the agreed upon coordinated plan of care for the resident. The detailed information of what services are being provided by the Hospice Program are not included on the ISP.
Plan of Correction:	Care plan updated. Will continue to update care plan as needed until the resident is discharged from the facility as planned. [sic]