VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Greendale Home
18180 Rich Valley Road
Abingdon, VA 24210
(276) 628-8595

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: June 27, 2022

Complaint Related: Yes

Areas Reviewed:

? 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 ACCOMMODATIONS AND RELATED PROVISIONS ? 22VAC40-73 BUILDINGS AND GROUND ? 22VAC40-73 EMERGENCY PREPAREDNESS

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 6/27/22 start: 9:15am conclude: 10:45am The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 6/14/22 regarding allegations in the areas of resident supervision and medication administration. The evidence gathered during the investigation supported the allegations in the complaint of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the complaint but identified during the course of the investigation can also be found on the violation notice. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Crystal B. Mullins Licensing Inspector at 276-608-1067 or by email at crystal.b.mullins@dss.virginia.gov Violation Notice Issued: Yes A copy of this document will be sent to the licensee/provider for signature.

Violations:

Standard #:	22VAC40-73-560-E
Complaint related:	Yes
Description:	Based on review of a resident record, the facility failed to keep current all resident records. EVIDENCE: 1. According to Staff #1, Resident #1 was returned to the facility on 6/10/22 at 11:16am from the hospital. 2. On the date of the investigation (6/27/22) there was no documentation in the resident?s file to show the 6/10/22 hospital visit. 3. There was no documentation in Resident #1?s file to show communication between the facility and the physician regarding whether or not Resident #1?s 8am medications should be administered upon her return from the hospital; which was at 11:16 am.
Plan of Correction:	All resident records shall be kept current, retained at the facility and kept in a locked area. Resident was transported to Hospital ER after a fall she had away from the facility. Residents report from Hospital report was misfiled in her chart. DON will filed reports in correct tab with the most recent being placed on top. [sic]
Standard #:	22VAC40-73-680-C
Complaint related:	Yes
Description:	Based on staff documentation review and staff interviews, the facility failed to administer medications not earlier than one hour before and not later than one hour after the facility?s standard dosing schedule, except those drugs that are ordered for specific times, such as before, after, or with meals. EVIDENCE: 1. The facility?s dosing schedule is 8am, noon, 4pm and 8pm. 2. According to Staff #1, Resident #1 was returned to the facility on 6/10/22 at 11:16am. 3. Staff #3 administered 11 of Resident #1?s 8am medications upon her return to the facility at 11:16 am.
Plan of Correction:	.Medications shall be administered in accordance with the physician's instructions and consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the VA BON, On 6-10-22 Staff #2, a RN that works at the facility received a voice order for a one time dose of AM medication to be administered out of time due to resident taking Buspirone (for anxiety), Eliquis (for CAD), Furosemide (for edema), Levetracetam (for seizures), Topiramate (for seizures), Ziprasidone (for psychosis). We do have a singed voice order for this now and in residents chart. DON will have voice orders signed within 10 days and placed in the chart. [sic]
Standard #:	22VAC40-73-680-D
Complaint related:	Yes
Description:	Based on documentation review and staff interviews, the facility failed to administer medications consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing. EVIDENCE: 1. Resident #1 was last seen on the facility camera at 1:27am on 6/10/2022 according to Staff #2. A written statement by Staff #2 documents, ?staff states she was in facility at 5:00am?. (referring to Resident #1) 2. According to Staff #1, Resident #1 was returned to the facility on 6/10/22 at 11:16am. 3. Staff #3 documented all 11 morning medications as administered for Resident #1 on the 8AM section of the Medication Administration Record for 6/10/2022.
Plan of Correction:	Medications shall be administered in accordance with the physician's instructions and consistent with the standards of practice outlined in the current registered medication aide curriculum approved by the VA BON, On 6-10-22 Staff #2, a RN that works at the facility received a voice order for a one time dose of AM medication to be administered out of time due to resident taking Buspirone (for anxiety), Eliquis (for CAD), Furosemide (for edema), Levetracetam (for seizures), Topiramate (for seizures), Ziprasidone (for psychosis). We do have a singed voice order for this now and in residents chart. DON will have voice orders signed within 10 days and placed in the chart. [sic]