VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Harmony Collection at Roanoke Independent Living
4428 Pheasant Ridge Road
Roanoke, VA 24014
(540) 400-6482

Current Inspector: Holly Copeland (540) 309-5982

Inspection Date: July 23, 2024

Complaint Related: No

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 07/23/2024 from 12:15 PM to 01:00 PM The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A self-report was received by VDSS Division of Licensing on 07/02/2024 regarding allegations in the area(s) of: Resident care and related services. Number of residents present at the facility at the beginning of the inspection: 76 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: 1 Number of interviews conducted with residents: 0 Number of interviews conducted with staff: 1 Observations by licensing inspector: N/A Additional Comments/Discussion: N/A An exit meeting will be conducted to review the inspection findings. The evidence gathered during the investigation supported the self-report of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the self-report 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 Holly Copeland, Licensing Inspector at 540-309-5982 or by email at holly.copeland@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-680-D
Description:	Based on record review and staff interview, the facility failed to ensure that medications are administered according to physician?s or other prescriber?s orders. EVIDENCE: 1. The uniform assessment instrument and individualized service plan for resident 1, dated 07/15/2024, indicates that this resident continues to require the assistance of RMAs or LPNs to safely administer medications. 2. The record for resident 1 contains physician?s orders, signed 06/17/2024, to start EXELON PATCH 4.6 MG/24 HR transdermal for a dementia diagnosis, which became effective on the medication administration record (MAR) for resident 1 on 06/19/2024 with the order ?RIVASTIGMINE 4.6 MG/24 HR PATCH ? APPLY 1 PATCH TO SKIN ONCE DAILY FOR DEMENTIA. REMOVE OLD PATCH FIRST, THEN APPLY NEW ONE. SIGN OFF ON EACH EVENT.? 3. On 07/02/2024, LI received a written report from the facility which indicated that at 08:00 AM on 07/02/2024, a medication staff member was giving resident 1 her medications when she noted three EXELON patches on the resident?s upper back. The report continues by adding that the medication staff member removed patches and reported findings to the Healthcare Director (HCD). 4. Per LI?s on-site interview with staff 2, on 07/23/2024, staff 2 indicated that during the morning medication pass on 07/02, staff 3 discovered three EXELON patches on resident 1?s upper back and notified staff 2. Staff 2 provided LI with photo evidence of the discovery in which one patch was labeled 06/30/24 and was initialed by staff 4, one patch was labeled 07/01/24 and was initialed by staff 1, and one patch was not labeled. 5. The June 2024 MAR for resident 1 was initialed as administered on ?Back, Upper Left? by staff 4 on 06/30, and the July 2024 MAR for resident 1 was initialed as administered by staff 1 on ?right backside of shoulder?; however, neither staff member indicated on the MAR that the previous EXELON patch had been removed prior to placement of the new patch.
Plan of Correction:	The patches were removed and the correct patch was placed. Clinical Specialist, Healthcare Director or designee will ensure that the community pharmacy has been instructed to separate the orders in order to make them easier to read. An order will be obtained for placing the Accuflo patch and a separate order will be obtained for removing the patch. The Health Care Director reviewed the 6 rights of giving medications with each of the Registered Medication Aide.