VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Runk & Pratt of Forest
208 Gristmill Drive
Forest, VA 24551
(434) 385-0297

Current Inspector: Jennifer Stokes (540) 589-5216

Inspection Date: June 15, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 PERSONNEL 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

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 focused monitoring inspection was initiated on 06/15/2021 and concluded on 06/15/2021 to determine correction and compliance with B2 violations cited during the facility's renewal inspection and a recent complaint inspection in the areas of personnel, resident care and additional requirements for facilities that care for adults with serious cognitive impairments in the facility's safe, secure environment. The licensing inspector spoke with the Administrator via phone and emailed the Administrator a list of documents needed to complete the inspection. The licensing inspector reviewed two resident records (physicians' orders and medication administration records), the facility schedule for the past five days and staff training provided by the facility. Previous violations were reviewed, violations were cited and can be found on this notice.

Violations:

Standard #:	22VAC40-73-1130-C
Description:	Based on document review and staff interview, the facility failed to ensure during night hours that when more than 40 residents are present, at least four direct care staff members plus at least one more direct care staff member for every additional 10 residents, or portion thereof, shall be awake and on duty at all times in each special care unit and shall be responsible for the care and supervision of the residents. EVIDENCE: 1. Interview with staff 1 revealed that the facility?s census for the time period of 06/10/2021 through 06/15/2021 was 54 each day and that the night hours for the facility are 11PM through 7AM. Based on the census, there should have been 6 direct care staff on duty at all times during the night hours on 06/10/2021 through 06/14/2021. The staff schedule showed that only five direct care staff worked on the 11PM through 7AM shift beginning at 11PM on the nights of 06/10/2021, 06/12/2021 and 06/13/2021. Interview with staff 1 confirmed that this was accurate.
Plan of Correction:	Administrator or Designee will ensure staffing is appropriate for numbers of residents residing in facility.
Standard #:	22VAC40-73-650-C
Description:	Based on resident record review, the facility failed to have a physician?s or other prescriber?s oral orders reviewed and signed by a physician or other prescriber within 14 days. EVIDENCE: 1. The May 2021 medication administration record (MAR) for resident 2 showed that the resident was administered ?Vitafusion Power Zinc Gummy take 3 gummies by mouth and chew every day for supplement? from 05/01/2021 through 05/21/2021 daily at 7AM. 2. The record for resident 2 contained a telephone order taken by staff 1, dated 05/21/2021, to ?Discontinue Vitafusion power zinc gummies?. This order had not been signed by a physician or other prescriber as of the date of inspection, 06/15/2021.
Plan of Correction:	The facility will ensure that physician orders are reviewed and signed by the physician or prescriber within 14 days.
Standard #:	22VAC40-73-680-D
Description:	Based on resident record review, the facility failed to administer medication in accordance with the physician?s or other prescriber?s instructions. EVIDENCE: 1. The record for resident 1 contained a telephone order taken by staff 1, dated 06/05/2021 at 7:54 PM, ?Acephen suppository given rectally for verbalized pain 650mg?. 2. The June 2021 MAR for resident 1 did not contain documentation that resident 1 was administered this medication. Interview with staff 1 confirmed that in speaking with staff 2, staff 2 stated that she did not administer this medication to resident 1.
Plan of Correction:	Staff 2 educated on following physician orders