VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Valley View Retirement Community
1213 Long Meadows Drive
Lynchburg, VA 24502
(434) 237-3009

Current Inspector: Jennifer Stokes (540) 589-5216

Inspection Date: July 15, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-80 COMPLAINT INVESTIGATION.

Comments:

A non-mandated complaint inspection was initiated on 07/15/2021 and concluded on 07/29/2021. A complaint was received by the department regarding allegations in the areas of resident care and related services. The Community Director was contacted by telephone to conduct the investigation. The licensing inspector emailed the Community Director a list of documentation required to complete the investigation. The licensing inspector conducted an on-site observation at the facility on 07/20/2021. The evidence gathered during the investigation did not support the allegations of non-compliance with standards or law. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-440-D
Complaint related:	No
Description:	Based on resident record review and staff interview, the facility failed to complete the Uniform Assessment Instrument (UAI) as required. EVIDENCE: 1. The private pay UAI for resident 1, dated 02/13/2021, showed the resident needs no assistance with eating/feeding. 2. Interviews with staff revealed that the resident does need her food cut up for her. Interview with staff 1 confirmed that the UAI is incorrect and that resident 1 needs mechanical help with eating/feeding.
Plan of Correction:	1. UAI for resident 1 dated 2/13/2021 does not reflect assistance needed with eating/feeding. At the time the UAI was completed this was correct. 2. Resident 1 now requires mechanical assistance with cutting up some foods and ISP has been corrected on 7/19/2021 to show that food is to be cut up in bite size pieces as needed.
Standard #:	22VAC40-73-680-E
Complaint related:	No
Description:	Based on resident record review, staff interview and staff written statements, the facility failed to ensure medical treatments ordered by a physician or other prescriber were provided according to his instructions, documented, and the documentation was maintained in the resident?s record. EVIDENCE: 1. The record for resident 1 contains a physician?s order, dated 03/09/2021, to ?check blood pressure once a week ? if blood pressure is >150 then PT needs to be seen?. 2. The document, ?BLOOD PRESSURE SHEET?, for the months of March, April, May, June and July 2021 for resident 1 showed the following blood pressure readings: 03/10/2021; 154/69, 03/17/2021; 154/71, 03/31/2021; 171/69, 04/21/2021; 180/64, 04/28/2021; 163/73, 05/05/2021; 152/73, 05/12/2021; 165/78, 05/26/2021; 183/77, 06/02/2021; 191/79, 06/16/2021; 186/66, 06/23/2021; 187/79, 06/30/2021; 170/60, 07/07/2021; 183/74, 07/14/2021; 168/93. 3. The record for resident 1 does not contain documentation that the resident was seen by her personal physician regarding these blood pressure readings. Interview with staff 2 confirmed this was accurate.
Plan of Correction:	1. The physician's order for resident 1 dated 3/9/2021 to check BP once a week and if 150 or over resident must be seen has been amended. New order dated 7/23/2021 states that resident 1 BP needs to be checked once a week and if 150 to be faxed to physician's office for review. 2. Resident 1 "Blood Pressure Sheet" did not reflect notes that resident 1 had been seen by physician each time BP was 150 or over. There were several dates noted that resident 1 had been seen on 3/9/21, 5/21/21 and 7/22/21 COVID restrictions did not allow for resident 1 to always been seen however notes must be in file by Nurse/Admin. 3. There were (3) dates noted in file that resident 1 was seen in office for BP. New orders will not require that a fax be sent.