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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: Aug. 8, 2022

Complaint Related: Yes

Areas Reviewed:
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

Comments:
Type of inspection: Complaint
Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 08/11/2022 start: 11:40am-3:08pm
The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection.
The evidence gathered during the investigation did not support the allegations of non-compliance with standard(s) or law. However, violation(s) not related to the complaint but identified during the course of the investigation can 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

Violations:
Standard #: 22VAC40-73-470-A
Complaint related: No
Description: Based on a review of resident records, the facility failed to ensure that the health care service needs of a resident was met.

EVIDENCE:

1. The record for resident 1 has documentation in physician progress notes dated 02/23/2022 for an Orthopedic Referral for a diagnosis of primary osteoarthritis of left knee. Facility progress notes have documentation on 02/23/2022 at 2:19pm of new orders for Orthopedic referral for left knee pain. The record for resident 1 does not have any documentation that an Orthopedic referral was made or of any progress notes from a visit.

2. The record for resident 1 has documentation on a physician orders form dated 02/21/2022 for resident 1 to receive physical therapy (PT) and occupational therapy (OT). The record for resident 1 does not have any documentation that a PT or OT evaluation was completed or of any therapy progress notes.

Plan of Correction: 1. Resident followed up with PCP and received updated orthopedic referral. Resident followed up with orthopedic and is receiving treatment. 2. PT and OT evaluation refused by resident.
Training to be completed with medication aides regarding follow up appointments being scheduled for referrals.
RCD or designee
10.26.2022- Training scheduled to be completed with RMAs, RCD, and ARCD [sic]

Standard #: 22VAC40-73-680-D
Complaint related: No
Description: Based on a review of resident records, the facility failed to ensure that medications were administered in accordance with physician?s or other prescribers instructions.

EVIDENCE:

1. The record for resident 1, admitted to the facility on 01/28/2022 has documentation on a report of resident physical examination on the admission orders page that was signed and dated on 01/11/2022 that the resident was prescribed Levothyroxine 88mcg daily for Hypothyroidism 22VAC40-73-680-D (B2) Based on a review of resident records, the facility failed to ensure that medications were administered in accordance with physician?s or other prescribers instructions.

EVIDENCE:

1. The record for resident 1, admitted to the facility on 01/28/2022 has documentation on a report of resident physical examination on the admission orders page that was signed and dated on 01/11/2022 that the resident was prescribed Levothyroxine 88mcg daily for Hypothyroidism and Lisinopril 20mg daily for Hypertension. The January and February 2022 medication administration records (MARs) for resident 1 do not have documentation that these medications were administered from 01/28/2022 through 02/23/2022. A physician progress note dated 02/25/2022 has documentation that the facility contacted resident 1?s physician to share an image of admission orders dated 01/28/2022 that had the prescribed medications Levothyroxine 88mcg and Lisinopril 20mg daily that had been found just the night before. The progress note further explains that the facility nursing requested a hold order for the Lisinopril. The Physician after further communication established that the medications had not been implemented and gave an order on 02/25/2022 to disregard until his face-to-face visit the next week.

Plan of Correction: Internal Investigation completed resulting in the termination of ARCD. RMA and RCD educated on verifying incoming resident?s orders are updated and correct on resident MAR.Training completed with RMA and RCD on order verification and new resident admission process.RCD or designee 10.26.2022- Training follow up scheduled to be completed with RMAs, RCD, and ARCD. [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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