VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Commonwealth Senior Living at Christiansburg
201 Wheatland Court
Christiansburg, VA 24073
(540) 382-5200

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: Jan. 4, 2022

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Two licensing inspectors conducted a one day monitoring licensing inspection at Commonwealth Senior Living-Christiansburg. The monitoring inspection began at 4:02pm and concluded at 5:02pm. The licensing inspectors reviewed resident records and requested additional records to follow. An exit meeting was held with the administrator of the facility on 02/07/2022. One violation is being cited as a result of this monitoring inspection. If you have any questions or concerns please do not hesitate to contact your inspector at 276-608-1067. Thank you for your cooperation and assistance.

Violations:

Standard #:	22VAC40-73-680-D
Description:	Based on observations made during the review of the resident record, the facility failed to administer medications in accordance with the physician?s or other prescriber?s instructions and consistent with the standard of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing. EVIDENCE: 1. Resident #1 was admitted to the facility on 05/13/2020. 2. Resident #1 had a physician?s order dated and signed on 05/06/2020 for Fentanyl Transdermal Patch 72 hour 25MCG/HR, apply one patch to exposed skin every 72 hours. Staff #1 signed the MAR (Medication Administration Record) and administered the Fentanyl to Resident #1 on 11/12/2021. 3. Per an interview with Staff #1, when she returned to work on 11/21/2021 the same Fentanyl Patch she administered to Resident #1 on 11/12/2021 was visible and still placed on Resident #1. This was able to be determined due to the initials of Staff #1 and date on the patch when it was administered to Resident #1 on 11/12/2021. According to physician?s orders, the patch should have been administered again in 72 hours, on 11/15/20221 and again on 11/18/2021. According to documentation on the ?controlled drug record? the Fentanyl Patch was not signed for on 11/15/2021 or 11/18/2021, indicating the medication was not administered. 4. Staff #2 initialed the MAR on 11/15/2021 and 11/18/2021 indicating the medication was administered. According to an interview with Staff #2, Resident #1 refused the Fentanyl Patch on 11/15/2021 and 11/18/2021. The MAR did not indicate that Resident #1 refused the medication. 5. Resident #1 was not administered the Fentanyl Transdermal Patch every 72 hours as prescribed by the physician?s order dated 05/06/2020.
Plan of Correction:	Supervisor reviewed the process of properly documenting refusals of medication/narcotics with associate on day of occurrence and will train all staff providing medication services. Resident Care Director will train all nurses and registered medication aids on completing the patch placement checks for each shift and signing off on medication administration records for application, checks and refusals. [sic]