VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Cana Adult Home
2004 Wards Gap Road
Cana, VA 24317
(276) 755-4338

Current Inspector: Holly Copeland (540) 309-5982

Inspection Date: April 3, 2023

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

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: 04/03/2023 from 09:45 AM until 02:00 PM The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. 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. 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 Holly Copeland, Licensing Inspector at 540-309-5982 or by email at holly.copeland@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-450-E
Description:	Based on record review, the facility failed to ensure that the individualized service plan (ISP) shall be signed and dated by the administrator, or his designee, and by the resident or his legal representative. EVIDENCE: The ISP on record for resident 6, dated 06/07/2022, was not signed by the resident or his legal representative.
Plan of Correction:	Administrator will have resident to sign their ISP and will make sure to keep up with signatures.
Standard #:	22VAC40-73-680-D
Description:	Based on record review and staff and resident interview, the facility failed to ensure that medications shall be administered in accordance with the prescriber?s instructions. EVIDENCE: 1. Resident 8 has signed physician orders, dated 09/29/2022, for LANTUS SOLOSTAR 100u/mL INJECTION to ?INJECT 30u SUB-Q TWICE DAILY FOR DIABETES?. In addition, resident 8 has signed orders, dated 10/20/2022, for ACCUCHECKS to ?CHECK BLOOD GLUCOSE EVERY MORNING. HOLD INSULIN FOR BLOOD GLUCOSE LESS THAN 150. RECHECK IF SYMPTOMATIC?. 2. While reviewing the March and April 2023 e-MARs for resident 8?s insulin administration against the prescriber?s special instructions, LI noted that on 03/25/2023, the ACCUCHECK reading at 06:00 AM was 147; however, the e-MAR also indicated that the prescribed insulin dose (30u/mL) was still given to resident 8 in the right anterior thigh at 08:00 AM on the same morning.
Plan of Correction:	Administrator shall have physicians' orders clarified and will instruct staff to follow all orders as written.