VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Senior Living at Hillsville
100 Kyle Drive
Hillsville, VA 24343
(276) 728-5333

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Sept. 23, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 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 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

Comments:

A monitoring inspection was initiated on 09/20/2021 and concluded on 09/23/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 48. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed three resident records, and three staff records another other documents submitted by the facility to ensure documentation was complete. The inspector conducted the on-site portion of the inspection on 09/23/2021. An exit interview was conducted with the Administrator on 09/23/2021, 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 #:	22VAC40-73-640-A
Description:	Based on observations made during the audit of the medication cart, the facility failed to adhere to methods to prevent the use of outdated, damaged, or contaminated medications on one medication. EVIDNECE: 1. Resident #3 is prescribed Ventolin Inhalation-Albuterol Sulfate, Inhale two puffs by mouth every four hours as needed for shortness of breath. Resident is allowed to at her bedside per the physician's order. 2. This medication did not have an open date documented on the box from the pharmacy which is kept in the A&B medication cart, nor did the actual inhaler device kept on the resident's bedside have an open date documented.
Plan of Correction:	Resident Care Director ordered new inhaler for Resident #3. New inhaler arrived at community on 9.24.21. Inhaler was dated with open date and old inhaler discarded. Resident Care Director or designee will audit medication carts randomly to ensure open dates are on all medications. [sic]
Standard #:	22VAC40-73-980-H
Description:	Based on observations made during the tour of the building, the facility failed to ensure the availability of a 48 hour supply of drinking water on site at any given time. EVIDENCE: 1. According to the stock room in the kitchen area, there were 49 gallons of water available on site. Today's (09/23/2021)census was 48.
Plan of Correction:	Dining Services Director increase the gallons of water to ensure 48 hour supply of drinking water is on site. Dining Services Director or designee will audit emergency supply randomly to ensure there is enough supply on hand. [sic]