VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Greendale Home
18180 Rich Valley Road
Abingdon, VA 24210
(276) 628-8595

Current Inspector: Rebecca Berry (276) 608-3514

Inspection Date: Sept. 13, 2023

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 BUILDINGS AND GROUND

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: 09/13/2023, 2:13pm to 3:14pm 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 07/17/2023 regarding allegations in the area(s) of: Building and grounds, and on 07/24/2023 in the area(s) of building and grounds and resident care and related services. Number of residents present at the facility at the beginning of the inspection: 55 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: N/A Number of interviews conducted with residents: 1 Number of interviews conducted with staff: 2 Observations by licensing inspector: Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the allegation(s) of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the complaint(s) 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 Becky Berry, Licensing Inspector at 276-608-3514 or by email at rebecca.berry@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-440-A
Complaint related:	No
Description:	Based on a review of resident records and interview with staff, the facility failed to ensure the Uniform Assessment Instrument (UAI) is completed at least annually. EVIDENCE: 1. The most recent UAI observed in the record for resident #1 was dated 07/06/2022. 2. Staff #1 confirmed a more recent UAI has not been completed. 3. Staff #2 provided documentation showing a fax was sent on 07/03/2023 to a local community agency responsible for conducting the UAI with a reminder that resident #1 was due for the annual UAI.
Plan of Correction:	UAl was obtained from the local community agency and ISP completed on 9-13-23 and placed in residents file. DON will continue to monitor residents files and send reminders to the appropriate agencies when IJAl's are due monthly. [SIC]
Standard #:	22VAC40-73-450-F
Complaint related:	No
Description:	Based on a review of resident records and interview with staff, the facility failed to ensure that the Individualized Service Plan (ISP) shall be reviewed and updated at least once every 12 months and as needed for a significant change of a resident?s condition. EVIDENCE: 1. The most recent ISP observed in the record for resident #1 was dated 07/06/2022. 2. Staff #1 confirmed a more recent ISP had not been completed.
Plan of Correction:	UAl was obtained from the local community agency and ISP completed on 9-13-23 and placed in residents file. DON will continue to monitor residents files and send reminders to the appropriate agencies when UAl's are due monthly. [SIC]
Standard #:	22VAC40-73-460-H
Complaint related:	Yes
Description:	Based on resident and staff interviews and review of facility documentation, the facility failed to ensure that personal assistance and care are provided to each resident as necessary so that the needs of the resident are met, including assistance or care with the activities of daily living, specifically bathing - at least twice a week, but more often if needed or desired. EVIDENCE: 1. Per interview with resident #1, he does not always receive two showers per week. 2. Per interview with staff #1, due to staffing issues, there are times when resident #1 may receive only one shower per week. 3. Per facility documentation via Resident Shower Log, resident #1 received only one shower per week during the weeks of: June 11, 2023; June 18, 2023; June 25, 2023; July 9, 2023; July 16, 2023; August 6, 2023; and August 27, 2023.
Plan of Correction:	The facility will ensure that personal assistance and care are provided to each resident as necessary so that the needs of the resident are met, specifically bathing ? at least twice a week. Direct Care will document shower or bed bath given at least twice a week. Direct Care will report to oncoming shift when a shower is missed due to short staff or other issue and the on coming staff will pick up shortage. DON will continue to hire staff to prevent staff shortages and to ensure resident care is not neglected due to staffing. [SIC]
Standard #:	22VAC40-73-870-D
Complaint related:	Yes
Description:	Based on observations made during a tour of the building and interview with staff, the facility failed to keep the building free from infestations of insects and vermin and to keep the grounds free of their breeding places. EVIDENCE: 1. Per interview with staff #1, there had been a bed bug infestation during the past two months, but no bugs had been observed recently. 2. Staff #1 reports the facility receives monthly extermination services to treat the bed bug infestation. 3. LI observed one bed bug crawling across the bed closest to the window in resident room #18 on the date of inspection. 4. LI observed several dead bugs on the brown metal bed frame of the bed closest to the window in resident room #18 on the date of inspection.
Plan of Correction:	Monthly extermination services inside and outside the building will be continued, maintenance staff will monitor each room and all community rooms for any insects and vermin daily. Housekeeping will report any signs of infestations or signs of insects to maintenance and will be addressed at that time. [SIC]