VIRGINIA DEPARTMENT OF SOCIAL SERVICES

COMMONWEALTH SENIOR LlVING AT CHURCHLAND HOUSE
4916 West Norfolk Road
Portsmouth, VA 23703
(757) 483-1780

Current Inspector: Donesia Peoples (757) 353-0430

Inspection Date: Feb. 2, 2021 , Feb. 2, 2021 , Feb. 3, 2021 , Feb. 4, 2021 and Feb. 17, 2021

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 STAFFING AND SUPERVISION 22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS

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 complaint inspection was initiated on 2/1/21 and concluded on 2/17/21. A complaint was received by the department regarding allegations in the areas of medical care/nursing services and missed appointments. The Administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the Administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation did not support the allegation however, non-compliance with standards or law, and violations were issued. Any violations not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:

Standard #:	22VAC40-73-450-C
Complaint related:	No
Description:	Based on record review and discussion, the facility failed to ensure the Individualized Service Plan (ISP) included description of identified needs and date identified, and a written description of what services will be provided to address identified needs based upon the Uniform Assessment Instrument (UAI). Evidence: 1. Resident #3?s UAI dated 9/24/2020 documented orientation as, ?disoriented, some spheres, some of time, spheres affected situation?. The resident?s ISP dated 9/24/2020 documented ?Neurocognitive? in the Description of Services to be Provided. 2. The ISP also documented the description of need as ?Additional Services?. Documented in the Description of Services to be Provided is, ?due to incontinence?, resident requires occasional/monthly nursing services?ordering of supplies, scheduling of appointments, and other services?? 3. Laundry was identified as a need however; the ISP did not identify specifics of what, when, where or by whom. 4. Date identified for resident?s needs for bowel incontinence, bladder incontinence, wheeling, and money management was not documented on the ISP. 5. Staff #5 acknowledged the resident?s ISP did not document aforementioned information.
Plan of Correction:	RCD and ED will make corrections to Orientation removing person,place, and time. RCD and ED will make correction to ISP specifically listing additional services and provide detail of services and provide detail of services to be provided. RCD and ED will make corrections to ISP specifically who is providing laundry services, when they are providing laundry services, where the services will take place. RCD and ED will make corrections to ISP that will indicate date needs were identified for incontinence, wheeling and money management. RCD and ED will review ISP to ensure corrections were made to ISP.