VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Home Eldercare
10704 Orchard Street
Fairfax, VA 22030
(703) 273-3640

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date: April 20, 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 ARTICLE 1 ? SUBJECTIVITY 32.1 REPORTED BY PERSONS OTHER THAN PHYSICIANS 63.2 GENERAL PROVISIONS 63.2 PROTECTION OF ADULTS AND REPORTING 63.2 LICENSURE AND REGISTRATION PROCEDURES 63.2 FACILITIES AND PROGRAMS 22VAC40-90 BACKGROUND CHECKS FOR ASSISTED LIVING FACILITIES 22VAC40-90 THE SWORN STATEMENT OR AFFIRMATION 22VAC40-90 THE CRIMINAL HISTORY RECORD REPORT 22VAC40-80 THE LICENSE

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: LI entered the facility at 9:10am on 4/20/2023 and exited at 12:00 pm on 4/20/2023. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 4 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 4 Number of staff records reviewed: 4 Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 0 Observations by licensing inspector: LI observed the storage of the medications. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. 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 Jamie Eddy, Licensing Inspector at (703) 479-5247 or by email at jamie.eddy@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-640-A
Description:	Based upon a review of records, the facility failed to ensure that methods for verifying that medication orders have been accurately transcribed to medication administration records (MARS) within 24 hours of receipt of a new order or change in an order were implemented. Evidence: On 4/20/2023, during the mandated monitoring inspection, LI found the following information documented in Resident #2?s record: a. The March 2023 and April 2023 Medication Administration Record (MAR) indicated that Atorvastatin 10mg is be administered one time a day to Resident #2 and that the scheduled dosage time is approximately 8:00 am. b. The physician?s order dated 4/21/2022 documenting that Resident #2 is to receive one 10mg tablet of Atorvastatin daily at bedtime.
Plan of Correction:	Will always check to see if the medication is given in the morning or evening. The error was corrected.
Standard #:	22VAC40-73-650-A
Description:	Based upon a review of records and interview, the facility failed to ensure that no medication shall be started, changed, or discontinued without a valid order from a physician, or other prescriber. Medications include prescription, over the counter, and sample medications. Evidence: 1. On 4/20/2023 LI reviewed the March and April 2023 Medication Administration Records (MARS) for Resident #2 and the physicians? orders dated 4/12/2023. Based upon a review of records and interview, the facility failed to ensure that no medication shall be started, changed, or discontinued without a valid order from a physician, or other prescriber. Medications include prescription, over the counter, and sample medications. Evidence: 1. On 4/20/2023 LI reviewed the March and April 2023 Medication Administration Records (MARS) for Resident #2 and the physicians? orders dated 4/12/2023. According to the MARS, Resident #2 is being administered ? tablet of 50mg of Trazadone one time a day at bedtime. The physicians? order dated 4/12/2023 in the record for Resident #2 did not include Trazadone as a prescribed medication. 2. On the same day, LI reviewed the medication packets from the pharmacy that the facility maintains for Resident #2. LI observed a pharmacy package containing Trazadone for Resident #2. 3. On the same day at approximately 11:30 am, LI interviewed the administrator, who said ?when the resident was admitted she did not come with the Trazadone and her son contacted the doctor directly and the doctor then contacted the pharmacy.? According to the administrator, the facility never received the order of the Trazadone from the doctor or the pharmacy but did receive the medication from the pharmacy.
Plan of Correction:	Will always make sure that I (administrator) get a copy of the medication that was called in to the pharmacy by the doctor. No medication will be given to the patient without proper orders from the doctor. This error was corrected.