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Commonwealth Senior Living at Abingdon
860 Wolf Creek Trail NW
Abingdon, VA 24210
(276) 628-1621

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Jan. 11, 2022

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:
Two licensing inspectors conducted a one day renewal inspection at Commonwealth Senior Living at Abingdon on 01/11/2022. The inspection started at 10:02 am and concluded at 3:37 pm. The facility had 60 residents in care on the day of the inspection. Resident records, the noon medication pass, lunch, Medication Administration Records (MAR), medications, and physicians orders were all reviewed. A tour of the building and grounds was completed, residents and collaterals were interviewed. The first aid kit and blood glucose monitoring supplies were observed and reviewed. Required postings were observed in the facility. Areas of non-compliance are identified on the attached violation notice. An exit meeting was conducted with the administrator and additional staff on 01/11/2022 and the findings were reviewed. Opportunity was given to find items that were not available in the records. Please completed the columns for description of action to be taken and dated to be corrected for each violation cited on the violation notice and then return a signed and dated copy to the licensing office within 10 calendar days (02/05/2022) of receipt. If you have any questions or concerns, please feel free to contact your inspector at 276-608-1067. Thank you for your cooperation and assistance.

Violations:
Standard #: 22VAC40-73-450-C
Description: Based on observations made during review of resident records, the facility failed to include a start date and/or expected outcomes dates for each service listed on the Individualized Service Plan (ISP) for three out of nine resident's Individualized Service Plans (ISP).
1. Resident #1 does not have any start dates or expected outcome dates listed for any of the 27 services listed on his ISP.
2. Resident #7 does not have start dates listed for any of the 21 services listed on her ISP.
3. Resident #9 does not have start any start dates or expected outcome dates listed for any of the 26 services listed on his ISP.

Plan of Correction: ISPs reviewed and updated by ED, RMA. ISPs reviewed with family. ISP goals and start dates will be printed clearly on Yardi's assessment report. Executive Director will review for completeness. ISP trained staff. Training completed by DSS. [sic]

Standard #: 22VAC40-73-450-E
Description: Based on observations made during the review of resident records, the facility failed to include a signature of the administrator or designee and the resident or legal representative for three out of nine residents on the Individualized Service Plan (ISP).
EVIDENCE:
1. Resident #1 has an ISP dated 11/25/2021. There were no signatures on the ISP.
2. Resident #7 has an ISP not dated and did not include any signatures.
3. Resident #9 has an ISP dated 11/26/2021. There were no signatures on the ISP.

Plan of Correction: ED has reviewed care plans with RP, Resident, POA. ED has gained signatures or reviewed virtually with family-verbal signature completed. ED wil review all care plans bi-annually with family members/POA and resident. After the care plan is reviewed the ED will document the verbal signature and/or gain the signature. [sic]

Standard #: 22VAC40-73-640-A
Description: Based on review of documentation and the medication cart audit, the facility failed to implement and follow their medication management plan to prevent the use of outdated, damaged, or contaminated medications.
EVIDENCE:
1. The facility medication management plan states "all medications will be returned to the pharmacy or destroyed within 72 hours of discontinuance".
2. Resident # 10 is prescribed Lantus Solostar Subcutaneous Pen-injector 100 units inject 15 units sub-q at bedtime for diabetes mellitus II use within 28 days once opened. This insulin pen did not have an open date documented.
3. Resident # 1 was prescribed Ondansetron 4mg tablets which was discontinued on 10/23/2021 due to allergy. This medication was still on the medication cart on the day of inspection 01/11/2022.

Plan of Correction: Medication removed from cart on the date of DSS inspection. Training completed with medication aides regarding disposal/returning D/C'd medications to the community. ARCD has been talked with weekly cart audits to ensure medication on the cart are current. [sic]

Standard #: 22VAC40-73-650-A
Description: Based on observations made during the noon medication pass, the facility failed to ensure no medication, dietary supplement, diet, medical procedure, or treatment shall be started, changed or discontinued by the facility without a valid order from a physician or other prescriber.
EVIDENCE:
1 Resident # 1 is prescribed Hydrocodone-Acetaminophen 10-325 mg oral tablet take four tablets by mouth four times daily for pain, Ropinirole HCL Oral 1 mg tablets take one tablet by mouth four times daily for Parkinson Disease, Diazepam 2 mg oral tablets take ? tablet (1mg) by mouth three times daily for anxiety, Gabapentin 100 mg oral capsules take 2 capsules (200mg) by mouth three times daily for nerve pain, Carbidopa-Levodopa 25-250 mg oral tablets take one tablet by mouth three times daily for Parkinson?s disease. The LI observed Staff # 2 administer these medication to Resident # 1 in Applesauce. There was no corresponding physician?s order to administer these medications in applesauce.
2. Resident # 10 is prescribed Carbidopa-Levodopa 25-100 mg oral tablets, take 1.5 tablets by mouth four times daily for Parkinson?s. The LI observed Staff # 2 administer this medication to Resident # 10 in Applesauce. There was no corresponding physician?s order to administer this medication in applesauce.

Plan of Correction: New order sheets have been completed by MD. These include information orders of administering edications in applesauce, yogurt, or pudding. Order sheet will be reviewed and signed by-annually by the PCP. [sic]

Disclaimer:
This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.

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