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: Dec. 8, 2021

Complaint Related: No

Areas Reviewed:

22VAC40-73 GENERAL PROVISIONS 22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 22VAC40-73 PERSONNEL 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 22VAC40-73 EMERGENCY PREPAREDNESS 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Facilities and Programs.. 22VAC40-90 Background Checks for Assisted Living Facilities 22VAC40-90 The Sworn Statement or Affirmation 22VAC40-90 The Criminal History Record Report

Comments:

A renewal inspection was initiated on 12/08/2021 and concluded on (12/15/2021. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 26. The inspector emailed the administrator a list of items required to complete the remote documentation review portion of the inspection. The inspector reviewed three resident records, three staff records, fire drills, pharmacy review and criminal history reports submitted by the facility to ensure documentation was complete. An exit interview was conducted with the Administrator on the date of inspection, where findings were reviewed and an opportunity was given for questions, as well as for providing any information or documentation which was not available during the inspection. Information gathered during the inspection determined non-compliance(s) with applicable standards or law, and a violation was documented on the violation notice issued to the facility. 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 non-compliance; 2) measures to prevent reoccurrence of non-compliance; 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s); 4) the date by which the non-compliance will be corrected.

Violations:

Standard #:	22VAC40-73-450-D
Description:	Based on review of residents' records, the facility failed to ensure services provided by hospice are included on the Individualized Service Plan (ISP) EVIDENCE: The hospice plan of care for resident 1 indicates social worker, skilled nursing and hospice aide services are provided. These are not included on the ISP.
Plan of Correction:	Administrator will review Hospice plan of care to ensure that all participants providing care from Hospice are noted within the ISP. Hospice services are added the ISP for resident 1.