VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Hills Home for Adults
1443 Commerce Avenue
Chesapeake, VA 23324
(757) 545-8797

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: July 14, 2021 , July 20, 2021 , July 21, 2021 and July 23, 2021

Complaint Related: No

Areas Reviewed:

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 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Comments:

A renewal inspection was initiated on 07-14-2021 and concluded on 07-23-2021. The Business Office Manager/RMA was contacted by telephone to initiate the inspection. The Business Office Manager/RMA reported that the current census was 43. The inspector emailed the Business Office Manager/RMA a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed 3 resident records, 3 staff records, activities calendar, menus, staff schedules, fire and health inspection reports, fire drills, healthcare oversight, and dietary oversight submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 07-20-2021. An exit interview was conducted with the Business Office Manager/RMA on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliances with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-70-A
Description:	Based on record review and interview, the facility failed to report to the regional licensing office within 24 hours any major incident that has negatively affected or that threatens the life, health, safety, or welfare of any resident. Evidence: 1. Resident #1?s hospital ?After Visit Summary? dated 01-09-2021 documented the resident was seen for foot pain and was diagnosed with a closed fracture of distal end of right fibula. Staff #1 stated ?the resident had fallen while out of the facility, and when the resident returned, the facility sent the resident out to the E.R. [Emergency Room].? 2. Resident #1?s ?Nurse?s Notes? dated 02-27-2021 documented ?? resident fell of out chair in the dining room and hit [resident?s] head on the floor.? The resident?s hospital ?After Visit Summary? dated 02-27-2021 documented the resident was seen for a fall and had a diagnosis of closed head injury, and abrasion to left eyebrow. 3. The regional licensing office did not receive incident reports from the facility regarding the aforementioned incidents involving resident #1. 4. Staff #1 acknowledged the aforementioned incidents were not reported to regional licensing office.
Plan of Correction:	? Hill's Home for Adults management will make sure staff report and document all incidents correctly. Hill's Home for Adults management will notify regional licensing soon as any severe injuries or incidents occur. Hill's Home for Adults management will continue to make sure the proper steps are taken and reported within 24 hours.
Standard #:	22VAC40-73-320-A
Description:	Based on record review and interview, the facility failed to ensure a physical examination was completed by an independent physician within the 30 days preceding the resident?s admission. The physical examination did not contain the required information: resident?s address and phone number; any recommendations for care including therapy; a statement that the resident does not have any prohibitive conditions, or a statement that specifies whether the resident is ambulatory or non-ambulatory. Evidence: 1. Resident #2 admitted to the facility on 03-10-2021. The resident?s admission physical examination report (identified by staff #1 as the ?EVMS Medical Group? form) dated 01-21-2021, did not include resident?s address and phone number; any therapy recommendations; a statement that the resident does not have any prohibitive conditions; or a statement that specifies whether the resident is ambulatory or non-ambulatory. 2. Staff #1 acknowledged resident #2?s admission physical examination report was not completed within 30 days preceding the resident?s admission and did not include the aforementioned required information.
Plan of Correction:	? Hill's Home for Adults will make sure upon admission that all requested paper work is correct and meet all the requirements as per state policies. Hills Home for Adults management will thoroughly review all requested paperwork upon admission to make sure it meets ALF requirements. Hill's Home for Adults management will continue to review all paperwork upon admission to ensure that all the paperwork given is correct before admission.
Standard #:	22VAC40-73-680-D
Description:	Based on record review and interview, the facility failed to administer medications in accordance with the physician's instructions. Evidence: 1. Resident #3?s current signed physician?s order dated 05-18-2021 documented ?Wixela Inhub 250-50mcg- 1 puff by mouth every 12 hours, every day.? 2. Resident #3?s June 2021 and July 2021 Medication Administration Record documented staff administered the Wixela Inhaler on 06-01-2021 through 07-13-2021 at 6:00 AM and 7:00 PM. 3. Staff #1 acknowledged resident #3?s Wixela Inhaler was not administered every 12 hours as ordered by the physician.
Plan of Correction:	? Hill's Home for Adults will make sure that all medications are given in the order written by a physician as per state policy. Hill's Home for Adults management will make sure that all medication orders are followed correctly. Hill's Home for Adults Nursing Supervisor and management will continue to make sure that physician orders for every resident is checked monthly and given correctly as prescribed by physician.
Standard #:	22VAC40-73-680-E
Description:	Based on record review and interview, the facility failed to arrange for specialized rehabilitative services by a qualified personnel as needed for the resident, to include speech-language pathology services. Evidence: 1. Resident #2 admitted to the facility on 07-31-2020. The ?Report of Resident Physical Examination? dated 07-17-2020 (signed by the physician on 07-14-2020) documented ?Pt. will benefit from physical therapy.? 2. Staff #1 could not provide documentation that the facility arranged for Physical Therapy (PT) services, or documentation verifying resident #2 was evaluated by PT upon admission to the facility. 3. Staff #1 confirmed and acknowledged the facility did not arrange for PT services for resident #2 upon admission as recommended by the physician.
Plan of Correction:	? Hill's Home for Adults will make sure that all resident physical examinations and any orders requested upon admission will be followed and documented. Hills Home for Adults management will check all physical examinations with recommended orders by a physician will be followed through upon admission. Hill's Home for Adults management will continue to make sure the proper steps are met.
Standard #:	22VAC40-73-870-E
Description:	Based on observation and interview, the facility failed to ensure all fixtures, bathtubs, and toilets were maintained in good repair. Evidence: 1. During the tour of the facility with staff #1, the following areas observed were not maintained in good repair: A. In the men?s bathroom (Room #2), the toilet had a plastic cover over the seat, and a brown substance was observed covering the floor and sides of the bathtubs. B. In the men?s bathroom (Room #1), a square wall tile was missing on the wall near the bathtub, and a brown substance was observed on the floor and sides of both of the bathtub. C. In bathroom #7, the light fixture above the sink was covered in rust, the light switch on the wall was broken, and the shower had an ?Out of order? sign. 2. Staff #1 acknowledged the aforementioned areas were not maintained in good repair.
Plan of Correction:	? Hill's Home for Adults management and maintenance will make sure all bathrooms and repairs are completed in accordance to state guidelines. Hills Home for Adults management and maintenance will ensure all repairs are completed in a timely fashion. Hill's Home for Adults management and maintenance will continue to ensure that all work orders are maintained and in good repair.
Standard #:	22VAC40-73-890-C
Description:	Based on observation and interview, the facility failed to ensure coverings were used for lights when necessary to reduce glare. Evidence: 1. During the tour of the facility with staff #1, light covers were missing on the light fixtures in the women?s bathroom (Room #3) and in bathroom #7. 2. Staff #1 acknowledged the aforementioned light fixtures did not include coverings.
Plan of Correction:	? Hill's Home for Adults management- and maintenance will ensure all light fixtures has coverings and in good condition. Hills Home for Adults management and maintenance will ensure all lights that require coverings are covered and repaired as needed. Hill's Home for Adults management and maintenance will make sure all light fixtures has coverings.