VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Bickford of Suffolk
6860 Harbour View Boulevard
Suffolk, VA 23435
(757) 215-0058

Current Inspector: Margaret T Pittman (757) 641-0984

Inspection Date: Feb. 12, 2020

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMINISTRATION AND ADMINISTRATIVE SERVICES 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 ADDITIONAL REQUIREMENTS FOR FACILITIES THAT CARE FOR ADULTS WITH SERIOUS COGNITIVE IMPAIRMENTS Article 1 Subjectivity

Comments:

An unannounced focus complaint inspection was conducted on this date from 9:30 a.m until 3:05 p.m. in response to allegations of frequent falls. resident rooms not cleaned, total care residents ,and a manager speaking to subordinates disrespectfully in front of the residents . There were 57 residents in care. A residential level ambulatory resident with an admission exam indicating she was in good health did fall on 12-12-19. The incident had been reported to DSS as required. The resident went home with family. Another resident who shares a room with a spouse on 12-26-19 following a fall and went to ER and is currently in rehab . A report was also sent to DSS as required. The spouse remains in care and expressed no concerns about the care received. Seven resident rooms were checked, including one room that had two pets in the room . One room had some carpet stains, no other problem were observed. Interviewed the four residents identified as total care residents . All could articulate what their care needs were and none were totally dependent . All need cues, prompts and some assistance. Two of the residents had stokes that left them with some weakness but they were able to assist with their care. No one was an invalid or bedridden. All the residents were up and out of their rooms for meals and activities of choice . The family, staff, and residents interviewed did not substantiate the allegations about the manager's unprofessional conduct . Persons interviewed did comment about staff not being happy about work assignments or job expectations. The facility rewards staff outstanding work performance identified by families or peers with gifts cards and other incentives. The management staff was reminded to share with staff when reports are made to DSS and to keep communication open . Please complete the ?plan of correction? for each violation cited on the violation notice and return it to me within 10 calendar days from today on 3-5-20 You will need to specify how the violation will be or has been corrected. Just writing the word ?corrected? is not acceptable. Your plan of correction must include: 1. steps to correct the noncompliance 2. measures to prevent reoccurrences 3. Person(s) responsible for implementing and monitoring each step of the corrective measures and / or the preventative measures

Violations:

Standard #:	22VAC40-73-50-A
Complaint related:	No
Description:	Based on record review and interview the facility failed to ensure the assisted living facility prepared and provided a statement to the prospective resident and his legal representative, if any, that disclosed information about the facility. The statement shall be on a form developed by the department and shall disclose the following information, which shall be kept current: Qualifications of staff on each shift; Whether or not the facility has an onsite emergency electrical power source for the provision of electricity during an interruption of the normal electric power supply. If the facility does have an onsite emergency electrical power source, the statement must include: (i) the items for which the source will supply power and (ii) whether or not staff of the the facility have been trained to maintain and operate the power source. For the purposes of this subdivision, an onsite emergency electrical power supply shall include both permanent emergency electrical power sources and portable emergency electrical power sources, provided that such temporary electrical power supply source remains on the premises of the facility at all times. Written acknowledgement of the disclosure shall be evidenced by the signature or initials of the resident or his legal representative immediately following the onsite emergency electrical power source disclosure statement. Evidence 1. While reviewing resident records with staff #1 and #2 , the inspector found resident #1 admitted 1-23-20 had signed the 02/19 disclosure form .on 1-20-20. The form was not current as it did disclose the current staff qualifications on each shift or the information about the generator . 2. Staff #1 confirmed the 02 /19 disclosure form currently in use did not reflect the current staff qualifications, as no RN is employed by the facility and on each shift. Also the staff confirmed no information was disclosed about the generator.
Plan of Correction:	The insufficiency will be corrected as follows: - Disclosure form has been updated to the 10/19 version on the VDSS website to reflect updated staff qualifications of each shift and includes information about the Generator. The following measures will be taken to ensure problems do not occur again: - Director will check on the VDSS website every other month to ensure the branch has the proper, up to date, and required disclosure form. If any contents needs to be updated/changed, director will reach out to home office and ensure changes are made. Persons responsible to implement and monitor corrective measure to ensure compliance: - Director
Standard #:	22VAC40-73-870-A
Complaint related:	Yes
Description:	Based on observation and interview the facility failed to ensure the interior of all the building was maintained in good repair and kept clean Evidence 1. During a tour of the facility with staff #2 ,the inspector observed holes in the wall behind resident #2 's recliner and detached and frayed wallpaper along the bottom of the door frame of the bathroom and multiple carpet stains in resident #4's room 2. Staff acknowledged the holes in wall behind the resident chair , the carpet stains and the detached and frayed paper along the door frame.
Plan of Correction:	The insufficiency will be corrected as follows: - Resident #2 hole behind recliner chair will be corrected with adding plexiglass by 3/04/2020. - Resident #4 carpet has been shampooed and stains were removed on 2/25/2020. The following measures will be taken to ensure problems do not occur again: - Director will randomly perform oversight 6 room checks for the next 6 weeks. - Weekly room checks by maintenance will be performed to check for maintenance work and cleanliness. Persons responsible to implement and monitor corrective measure to ensure compliance: - Director/Maintenance Coordinator/Housekeeper Target Completion Date: 3/04/20, Ongoing