VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Brookdale Staunton
1900 Hillsmere Lane
Staunton, VA 24401
(540) 885-9500

Current Inspector: Jessica Gale (540) 571-0358

Inspection Date: Feb. 9, 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 63.2 Protection of adults and reporting. 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Comments:

A monitoring inspection was initiated on 02/09/2022 and concluded on 02/09/2022. There were a total of 83 residents in care. The facility was clean and free from any foul odors. The outside postings were current as were related drills. Six resident, one discharge and five staff records were reviewed. An exit interview was conducted with the Administrator and Director of Nursing 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. There was one violation during this monitoring inspection. Details of non-compliance can be viewed in the violation report of this inspection. If you have any questions, please contact the licensing inspector at (540) 292-5932 or email rhonda.whitmer@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-1090-A
Description:	Based on review of residents' records, the facility failed to ensure prior to admission to a safe, secured environment, the documented assessment by an independent clinical psychologist licensed to practice in the Commonwealth or by an independent physician, indicated the resident as having a serious cognitive impairment due to a primary psychiatric diagnosis of dementia with an inability to recognize danger or protect his own safety and welfare. EVIDENCE: 1. The Assessment of Serious Cognitive Impairment for resident 1, dated 01/07/2022 indicates the resident does not have a serious cognitive impairment due to a primary diagnosis of dementia. 2. The Assessment of Serious Cognitive Impairment for resident 1, dated 01/07/2022 does not include the address of the resident or the address of the physician who completed the assessment.
Plan of Correction:	?Resident 1 has a diagnosis of dementia but was not listed on the Assessment of Serious Cognitive Impairment form. Her current physician has reviewed her information and completed a new assessment form with the dementia diagnosis and her address was completed on the form on Feb 15th 2022 to ensure proper compliance. ?The HWD and HWC will audit all residents? forms in the secured unit for any inconsistency with the Assessment of Serious Cognitive Impairment form by February 18th 2022. ?For any inconsistency?s identified the HWD and HWC will contact resident current physician for re-evaluation and correction of the Assessment of Serious Cognitive Impairment form. ?To assist with ongoing compliance The HWD and HWC will review all new admission to the secure unit to validate the proper completion of the Assessment of Serious Cognitive Impairment form prior to residents moving into the secure unit per the Virginia regulations.