VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Golden Homestead
120 Fourth Street
Coeburn, VA 24230
(276) 395-2808

Current Inspector: Crystal Mullins (276) 608-1067

Inspection Date: April 21, 2020

Complaint Related: No

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the governor of Virginia. A self-reported incident was received by the department on April 14, 2020 regarding issues with administration of medications. The Administrator of the facility was contacted by telephone and given a list of documentation required to complete the investigation. The evidence gathered during the inspection supported the self-report of non-compliance with standards of law and violations were issued. Any violations not related to the self-report but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-70-A
Description:	Based on information sent by the facility as part of a self-report, the facility failed to report to the regional licensing office within 24 hours any major incident that has negatively affected the life, health, safety, or welfare of any resident. EVIDENCE: 1. There was an incident that occurred on April 12, 2020 where 18 residents did not get there morning medication as reported by staff #1 due to a staffing issue within the facility. The incident was not reported to the regional licensing office until April 14, 2020.
Plan of Correction:	The reported incident is an isolated event, facility was reaching an outcome resolution with required professionals during the Coronavirus Pandemic. Facility waited for confirmation that nothing needed to happen to remedy the situation. Facility completely understand and does apologize for the additional hours required to report. In the future, facility will report any incident within the required time frame. Administrator will monitor for compliance.[sic]
Standard #:	22VAC40-73-680-D
Description:	Based on information received in a facility self-report, the facility failed to ensure that all medications were administered in accordance with physician's or other prescriber's instructions and consistent with standards of practice outlined in the current registered medication aide curriculum approved by the Virginia Board of Nursing for 18 residents in care. EVIDENCE: 1. Staff # 1 reported that on the morning of April 12, 2020 the medication aide scheduled to work had a medial emergency preventing this staff member from arriving to work. The Administrator was notified around 8:20 am. The Administrator arrived at the facility at approximately 8:55 am. Upon the administrator preparing for morning medications he noticed the time was up at 9:00 am for 8:00 am meds and the decision was made to not give morning medications to residents. 2. The following residents did not get their 8:00 am medications as prescribed on the morning of April 12, 2020, Physicians orders were verified for all medications listed below. Resident # 1- Acetaminophen 500 mg caplet take one tablet by mouth three times a day for OA, Calcium 600 plus vitamin D 400 tablets take 1 vitamin by mouth daily for vitamin insufficiency, Diphenhydramine 25 mg capsule take 1 capsule by mouth twice daily for Rhinitis, Divalproex SOD ER 500 mg tablets take 1 tablet by mouth every morning for mood stabilization, Furosemide 20 mg tablet take 1 tablet by mouth everyday for edema, Ibuprofen 600 mg tablet take 1 tablet by mouth three times a day for OA, Lithium Carbonate 300 mg capsule take 1 capsule by mouth every morning for mood, Montelukast Sod 10 mg tablets take 1 tablet by mouth everyday for seasonal allergies, Paliperdone ER 9 mg tablets take 1 tablet by mouth every morning for psychosis, Trihexyphenidyl 2 mg tablet take 1 tablet by mouth twice daily for EPS. Resident #2- Antacid 500 mg chew tablets chew and swallow 1 tablet by mouth daily for hypocalcemia, Carvedilol 6.25 mg tablet take 1 tablet by mouth twice daily for tachycardia, Divalproex Sod-DR 500 mg tablets take 1 tablet by mouth two times daily for mood stabilization, Hydrochlorothiazide 25 mg tablet take one tablet by mouth everyday for hypertesion, Levothyroxine 25 mcg tablet, take one tablet by mouth everyday for hypothyroidism, Lisinopril 30 mg tablet take one tablet by mouth everyday for hupertension, Lorazepam 1 mg tablet take 1 tablet by mouth two times daily for anxiety, Omeprazole DR 20 mg capsule take one capsule by mouth everyday for GERD, Sertraline HCL 100 mg tablet take two tablets every morning for depression, Simvastin 40 mg tablet take 1 tablet by mouth everyday for cholesterol. Resident #3- Amloipine Besylate 5 mg tablet take 1 tablet by mouth everyday for hypertension, Calcium 600 vitamin D 3 400 tablet take 1 tablet by mouth twice daily for vitamin insufficiency, Ferrous Sulfate 325 mg tablet take one tablet by mouth everyday for iron deficiency, Lisinopril-HCTZ 20-25 mg tablet take 1 tablet by mouth everyday for blood pressure, Eye wash, soak and wash both eyes every morning. Resident #4- Albuterol Sulfate 2.5 mg/3ML place 1 vial in nebulizer and inhale for 8 minutes four times daily for COPD, Antacid 500 mg chew tablets chew and swallow one tablet by mouth daily for hypocalcemia, Carvedilol 25 mg tablet take one tablet by mouth twice daily for HTN, Deep sea 0.65% nose spray instill two sprays in each nostril daily for deviated nasal septum, Ferrous Sulfate 326 mg tablet take one tablet by mouth everyday for iron deficiency, Furosemide 20 mg tablet take one tablet by mouth everyday for CHF, Lisinopril 2.5 mg tablet take one tablet by mouth everyday for hypertension, Mematine HCL 5 mg tablet take one tablet by mouth two times a day for dementia, Metformin HCL ER 500 mg tablet take one tablet by mouth twice daily for DM, -See attached word document.
Plan of Correction:	All staff members have been counseled to notify management, immediately, at any time the medication aides become unable to perform or carry out their duties. In the future, Direct Care staff will notify facility management, immediately, at any time the medication aides become unable to perform or carry out their duties. Supervisor will monitor for compliance. [sic]