VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Vitality Living Arlington
3821 Wilson Boulevard
Arlington, VA 22203
(703) 294-6875

Current Inspector: Alexandra Roberts

Inspection Date: Nov. 14, 2019 and Nov. 15, 2019

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 BUILDING AND GROUNDS 22VAC40-73 EMERGENCY PREPAREDNESS 22VAC40-73 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity 32.1 Reported by persons other than physicians 63.2 General Provisions. 63.2 Protection of adults and reporting. 63.2 Licensure and Registration Procedures 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 22VAC40-80 THE LICENSE.

Technical Assistance:

Standard 320.A.7 regarding known allergies and description of reactions on the physical examination was discussed and is required.

Comments:

An unannounced renewal study was conducted from 8:30 a.m. - 5:00 p.m. on 11/14/2019 and 8:45 a.m. - 5:00 p.m. on 11/15/2019. At the time of entrance 122 residents were in care. The sample size consisted of ten resident records and two discharged resident records, and five staff records. Four residents, one family member and staff were interviewed. Resident, staff and pet records and other documentation reviewed. Criminal Background Checks of all staff hired since previous inspection conducted on 11/01/2018 were reviewed. Residents were observed eating breakfast and lunch and engaging in activities including exercise, daily chronicles, community chat and trivia in assisted living area and daily chronicles, music and art therapy in safe, secure unit. Medication administration was observed with two staff and medication carts observed for PRN medications. Building and Grounds observed. Violations and risk ratings reviewed and exit interview held. Areas of non-compliance are identified on the violation notice. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return to the licensing office within 10 calendar days. Please specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. The plan of correction must contain: 1) steps to correct the non-compliance with the standard(s), 2) measures to prevent the non-compliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s). Thank you for your cooperation and if you have any questions please call (703) 895-5627 or contact me via e-mail at jeannette.zaykowski@dss.virginia.gov.

Violations:

Standard #:	22VAC40-73-640-A
Description:	Based on record review, observation and interview, facility failed to ensure that the facility shall implement a written plan for medication management and the plan shall address procedures for administering medication and shall include: methods to prevent the use of outdated or contaminated medications; methods to ensure that each resident's prescription medications are filled and refilled in a timely manner to avoid missed dosages; and methods for verifying that medication orders have been accurately transcribed. Evidence: During observation of medication administration on 11/14/2019 and record review, Resident #3?s Alphagan P Solution 0.1% was observed on the medication cart and was not dated when opened; Resident #1?s Anastrozole 1 MG and Resident #3?s Vitamin D3 1000 Unit were not available; Resident #1?s Fluticasone Propionate Suspension 50 MCG/ACT was ordered by the physician and was documented on the MAR for 1 spray each nostril and the medication was observed on the cart with a pharmacy label for 2 sprays in each nostril and without a changed order sticker added on the label; and Resident #3?s Alphagan P Solution 0.1% was ordered by the physician to instill in left eye twice a day and to instill in both eyes twice a day, the pharmacy label was documented to instill in right eye, and the MAR was documented to instill in both eyes.
Plan of Correction:	Resident #3 Aphalgan P Solution 0.1% was labeled and dated during inspection. Resident #3 and Resident #1?s Vitamin D and Anastrozole 1 MG were moved from nursing office to the medication cart during inspection. The label for resident #1?s nasal spray was corrected during inspection. The label for resident #3?s eyedrops was corrected during inspection. Medication technicians have received an in-service on auditing Medication carts for correct labeling and missing medications. Medication carts were audited on 11/15/19 by the Health and Wellness Director/Nurse Designee to verify proper labeling of current resident medications. Health and Wellness Director or designee will audit 100% of medication carts monthly to ensure continued compliance.