VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Harmony at Spring Hill
8350 Mountain Larkspur Drive
Fairfax, VA 22079
(571) 348-4970

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: Nov. 10, 2022

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

An unannounced focused monitoring inspection was conducted to follow-up on high-risk violations that were cited on 9/8/22 (8:30 AM ? 6:10 PM). Medication administration and resident records were observed. Violations were discussed and an exit meeting was held. 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. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Marshall Massenberg, Licensing Inspector at (703) 431-4247 or by email at m.massenberg@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-640-A
Description:	Based on documentation and observation, the facility failed to implement a written plan for medication management. Evidence: Resident #1?s November MAR was reviewed during the inspection. Resident #1?s MAR states that his Hydralazine was held on 11/7/22 (8 PM administration) and the note states his ?BP is low.? Resident #1?s record contained a medication list from a physician?s visit, dated 10/6/22. The medication list included a note for Resident #1?s Hydralazine to be held if his SBP (Systolic Blood Pressure) was less than 130. Resident #1?s MAR states that his Hydralazine was administered on: 11/1/22 (8 PM) when his SBP was 121; 11/6/22 (8 AM) when his SBP was 115; 11/8/22 (2 PM) when his SBP was 121; 11/8/22 (8 PM) when his SBP was 122; and 11/9/22 (8 AM) when his SBP was 105. Resident #1?s MAR does not list any parameters for the administration of Resident #1?s Hydralazine. Resident #4?s medication administration was observed during the inspection. Resident #4 was administered Cyclobenzaprine 5mg during the morning medication administration. Resident #4 was taken to the hospital on 10/18/22. The hospital medication list included Cyclobenzaprine 10mg. The hospital summary instructed Resident #2 to have an appointment with her physician 2 days after the hospital visit (around 10/20/22). No documentation was included in the resident record about a physician?s follow-up appointment with Resident #4 or the physician?s review of the hospital medication list.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-660-A-1
Description:	Based on observation, the facility failed to ensure that the medication storage area remains locked. Evidence: Shortly after 9 AM, the memory care nursing station was unlocked and unattended. A bottle of Milk of Magnesia was accessible in the nursing station.
Plan of Correction:	Not available online. Contact Inspector for more information.
Standard #:	22VAC40-73-680-D
Description:	Based on documentation, the facility failed to ensure that medications are administered in accordance with the physician?s or other prescriber?s instructions and consistent with the standards of practice outlined in the current medication aide curriculum approved by the Virginia Board of Nursing. Evidence: Resident #1?s November medication administration record (MAR) was reviewed during the inspection. Resident #1?s MAR states that he was administered Valsartan on 11/9/22 (8 AM administration) when his blood pressure was 105/64. The MAR calls for the resident?s Valsartan to be held when his systolic blood pressure is less than 110. Resident #2?s November MAR was reviewed during the inspection. Resident #2?s MAR states that she was not administered Sucralfate on 11/1/22 (5:00 PM administration) as the medication was ?Pending from Pharmacy.? Resident #3?s November MAR was reviewed during the inspection. Resident #3?s MAR calls for her insulin to be administered per the following sliding scale: 0U (BS: 0-200), 2U (BS: 201-250), 4U (BS: 251-300), 6U (BS: 301-350), 8U (BS: 351-400), 10U (BS: >400). Resident #3?s MAR states that she was administered 4 units of Insulin on 11/1/22 (4:30 PM administration) when her blood sugar reading was 302.
Plan of Correction:	Not available online. Contact Inspector for more information.