VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Bickford of Chesapeake
361 Great Bridge Boulevard
Chesapeake, VA 23320
(757) 819-9500

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: Dec. 16, 2022

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

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: 12/16/2022 from 12:30 pm to 3:45 pm. 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 12/09/2022 regarding allegations in the area(s) of: Part IV Staffing and Supervision and Part VI Resident Care and Related Services. Number of residents present at the facility at the beginning of the inspection: 54 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 3 An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported some, but not all of the allegation(s); area(s) of non-compliance with standard(s) or law were: Part VI Resident Care and Related Services. A violation notice was issued; any violation(s) not related to the complaints 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 M. Tess Pittman, Licensing Inspector at (757) 641-0984 or by email at tess.pittman@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-640-A
Complaint related:	No
Description:	Based on documentation, the facility failed to implement their written plan for medication management which includes methods to ensure that each resident's prescription medications and any over-the- counter drugs and supplements ordered for the resident are filled and refilled in a timely manner to avoid missed dosages. Evidence: 1. During review of the November 2022 MAR for Resident #1, Gabapentin 600 mt tablet (1 tablet to be administered three times daily) was not administered on 11/08/2022 as the medication was not available. The MAR also does not document the medication being administered for two doses on 11/07/2022. 2. During review of the November 2022 MAR for Resident #2, Diltiazam 120 mg capsule (1 tablet to be administered once daily) was not administered on 11/02/2022, 11/03/2022, and 11/05/2022-11/07/2022 as the medication was not available. Additionally, Duloxetine 30 mg capsule (1 capsule to be administered once daily) was not administered on 11/05/2022-11/07/2022 as the medication was not available. 3. During review of the December 2022 MAR for Resident #3, Melatonin 3 mg tablet (2 tablets to be administered at bedtime) was not administered on 12/01/2022 as the medication was not available.
Plan of Correction:	Med Management Policy reviewed w/ RMA's and LPN's on 12/18/2022. If the Resident uses the Branch?s preferred pharmacy, the Branch will request a refill of all prescription medications managed by the Branch when the quantity of medications on hand is enough for seven days.