VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Hillside Residential Living
403 N. Coalter Street
Staunton, VA 24401
(540) 885-0191

Current Inspector: Jessica Gale (540) 571-0358

Inspection Date: Aug. 3, 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 ACCOMMODATIONS AND RELATED PROVISIONS 22VAC40-73 BUILDINGS AND GROUND 22VAC40-73 EMERGENCY PREPAREDNESS 32.1 REPORTED BY PERSONS OTHER THAN PHYSICIANS 63.2 GENERAL PROVISIONS 63.2 PROTECTION OF ADULTS AND REPORTING 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT

Technical Assistance:

Recommend administrator become more familiar with quick books system. Contact the local fire department or rescue squad for assistance getting additional CPR/First Aid classes. Reviewed a resident whose status as residential only is questionable and under review by local DSS.

Comments:

Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 8/3/22(10-3) The Acknowledgement of Inspection form was signed and left at the facility the date of the inspection. Number of residents present at the facility at the beginning of the inspection: 49 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 8 Number of staff records reviewed: 4 Number of interviews conducted with residents: 6 Number of interviews conducted with staff: 2 Observations by licensing inspector: Work continues on the interior of the facility with bathrooms a primary focus and room remodeling as residents are relocated within the facility temporarily or leave the facility. The elevator in the building has been serviced and inspected but there is discussion regarding discontinuing its use in the future due to age and lack of availability of parts. Additional Comments/Discussion: Healthcare oversight and pharmacy review complete. The facility has no special diets. Fire Inspection as of this rewrite 9/22/2022 Health Inspection ? Certificate Only ? expires 12/31/22 ? awaiting inspection since June 2022. An exit meeting was conducted to review the inspection findings. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. 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. Should you have any questions, please contact Sharon DeBoever, Licensing Inspector at (540) 292-5930 or by email at sharon.deboever@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-390-A
Description:	Based on a review of resident records residents A,B,C,D and E had either an incomplete agreement, did not reflect the new grant rate or no agreement at all in their record. It was noted that several new residents reviewed had complete agreements.
Plan of Correction:	Administrator and assistant administrator will review all records and correct as applicable. They will maintain compliance as well.
Standard #:	22VAC40-73-410-A
Description:	There was no documentation of resident orientation in any of the files reviewed. Residents interviewed indicated that they were told when meals were and basic house rules. They had participated in fire and emergency drills.
Plan of Correction:	Residents typically receive orientation at the time the initial plan is developed upon arrival. The facility staff completing the service plans will provide clearer documentation of such on the plans going forward. The administrator assumes responsibility for monitoring and maintaining compliance.
Standard #:	22VAC40-73-450-F
Description:	Although the individualized service plans for residents B and D were current by date they did not reflect the needs of the individuals as described by staff and both had outdated UAIs. The service plan for resident A did not reflect assistance provided paying bills or the stand by assistance needed when showering. The service plan for resident C did not reflect allergies to foods, medications or bee stings which require the use of an epi pen or the need for a soft diet due to lack of teeth. Code status is also missing from several ISPs.
Plan of Correction:	Service plans and UAIs will be reviewed by administrator and assistant. As per discussion services are occurring and staff is aware but documentation is lacking due to parties named above also assisting with floor duties due to universal health care staffing issues. Administrator assumes responsibility for correction and compliance.