VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Timberview Crossing
351 New Market Road
Timberville, VA 22853
(540) 896-9858

Current Inspector: Jill James (540) 418-2631

Inspection Date: July 6, 2021

Complaint Related: Yes

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 complaint inspection was initiated on 07/06/21 and concluded on 07/11/21. A complaint was received by the department regarding allegations in the areas of resident care. The evidence gathered during the investigation supported the allegation of 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. Upon receipt of this violation notice, a plan of correction is requested for each violation. The plan of correction should include:1) steps to correct noncompliance; 2) measures to prevent reoccurrence of noncompliance; 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s); 4) the date by which the noncompliance will be corrected.

Violations:

Standard #:	22VAC40-73-70-A
Complaint related:	Yes
Description:	Based upon documentation review and communication received from the administrator, the facility failed to report to the licensing office, a major incident that has negatively affected or that threatens the life, health, safety, or welfare of any resident within 24 hours. EVIDENCE: 1) Communication via email received from the administrator on 07/05/21 indicates resident A "slipped on her own urine as she was transferring herself to toilet and at the time she did not complain of any pain and no visible injuries." Email also indicates "the family decided to take her to the hospital." The email did not indicate when the resident fell. 2) The administrator submitted a formal incident report on 07/08/21. The submitted report indicates fall occurred on 06/30/21 at 8:30pm and family took resident to emergency department.
Plan of Correction:	Facility administrator will report all falls regardless of injury as directed by licensing inspector and adult protective services.
Standard #:	22VAC40-73-450-C
Complaint related:	No
Description:	Based on review of resident's record, the facility failed to have a comprehensive Individualized Service Plan (ISP) that includes the assessed needs of the resident. EVIDENCE: 1) The UAI dated 02/02/21 for resident A indicates mechanical assistance is needed with toileting. The ISP dated 02/02/21 indicates no assistance is required. 2) The UAI dated 02/02/21 for resident A indicates no assistance is needed with transferring. The ISP dated 02/02/21 indicates use of wheelchair and grab bars. 3) The UAI dated 02/02/21 for resident A indicates supervision is needed with walking. This is not reflected on the ISP dated 02/02/21.
Plan of Correction:	ISP and UAI undated. Resident is non-compliant for asking or accepting assistance with transferring and toileting.
Standard #:	22VAC40-73-470-F
Complaint related:	Yes
Description:	Based on documentation review and communication received from the administrator, the facility failed to ensure when a resident suffers serious accident, injury, illness, or medical condition, or there is reason to suspect that such has occurred, medical attention from a licensed health care professional shall be secured immediately. EVIDENCE: 1) Facility form, "Resident Incident/Accident Report" prepared on 06/30/21 indicated resident A had a fall. Documentation shows "resident slipped in her urine; complains of pain on side." 2) Chart note dated 06/30/21 at 6:20pm indicated resident complained of right lower chest pain and administrator was notified by phone on 06/30/21 at 9:58pm. 3) DCA note dated 07/02/21 at 8:00am indicate "resident is complaining of left side pain from previous fall; gave PRN Tylenol; getting x-ray ordered for her; notified family and administrator." 4) DCA note dated 07/02/21 2pm-10pm shift indicates resident is still complaining of side pain and resident was sent to hospital by rescue squad. 5) Hospital records show resident A was admitted from 07/02/21 through 07/05/21 with three rib fractures on the left side. 6) There is no documentation resident was seen by a licensed health care professional prior to being sent to the hospital.
Plan of Correction:	Administrator was notified verbally at 1007pm of slip in urine. DCA that reported did not stated resident had any discomfort. On 7/2 when pain was communicated, facility administrator obtain order for x-ray. Resident representative did not want to wait for x-ray company as it was getting late and Dr. office was closing. Resident representative requested to be sent to ER. Facility Administrator will verbally ask when receiving notification of an incident if there are any injuries or pain expressed.