VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Brookdale Roanoke
1127 Persinger Road, S.W.
Roanoke, VA 24015
(540) 343-4900

Current Inspector: Holly Copeland (540) 309-5982

Inspection Date: July 11, 2023

Complaint Related: No

Areas Reviewed:

22VAC40-73 PERSONNEL 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Type of inspection: Monitoring - Self-reported incident Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 07/11/2023 from 01:30 PM until 03:00 PM The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self-reported incident was received by VDSS Division of Licensing on 06/22/2023 regarding allegations in the area(s) of: Provision of resident care and related services. 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: 1 Number of staff records reviewed: 1 Number of interviews conducted with residents: N/A Number of interviews conducted with staff: 1 Observations by licensing inspector: N/A Additional Comments/Discussion: N/A An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported some, but not all of the self-report; area(s) of non-compliance with standard(s) or law were: Resident care and resident rights violation. A violation notice was issued; any violation(s) not related to the self-report 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 Holly Copeland, Licensing Inspector at 540-309-5982 or by email at holly.copeland@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-550-C
Description:	Based on record review and staff interview, the facility failed to ensure that a resident of an assisted living facility has the rights and responsibilities as provided in ? 63.2-1808 of the Code of Virginia and assisted living facility regulations, including ensuring that a resident?s known needs are not neglected or ignored by personnel of the facility and is treated with courtesy, respect, and consideration as a person of worth, sensitivity, and dignity. EVIDENCE: 1. On the evening of 06/22/2023, LI received a self-report from staff 2 about a staff to resident incident. The report alleged that resident 1 had called for assistance while toileting between 03:00 AM and 03:30 AM on 06/22/2023. The report further alleged that staff 1 responded to the request for assistance but refused to assist resident 1. Then, staff 1 was reported to have pushed resident 1 and threw a plastic fork at him. The report added that there was no injury to resident 1 and that staff 2 was suspended pending an investigation. 2. During the on-site incident follow up on 07/11/2023, staff 2 revealed to LI that during their investigation, staff 1 did not confirm that an assault had occurred; however, staff 1 did admit that she felt uncomfortable helping resident 1 that morning, so staff 1 distanced herself from resident 1, left the room, and asked staff 3 to assist him with toileting instead, so staff 3 provided him assistance. 3. Further interview with staff 2 revealed that staff 3 did provide assistance to resident 1 at the time of the incident, and staff 1 is no longer employed at the facility.
Plan of Correction:	? Brookdale Roanoke, VA respectfully disagrees with citation as immediate actions were taken, the resident was unharmed, and care was provided. ? Executive Director and/or Health and Wellness Director made self-reports to APS, VDSS, Doctor and Family within appropriate time period for reporting. ? Executive Director and/or Health and Wellness Director noted associate had previously received training on dementia care, approach, UADC, and resident rights. ? Executive Director, Health and Wellness Director and/or Charge nurse suspended the associate and the associate was subsequently terminated. ? Executive Director (ED)/Health and Wellness Director (HWD)/Resident Care Coordinator (RCC) or designee will provide re-training to staff on Resident Rights by August 30, 2023.