VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Morningside of Bellgrade
2800 Polo Parkway
Midlothian, VA 23113
(804) 379-2800

Current Inspector: Tamara Watkins (804) 662-7422

Inspection Date: Aug. 12, 2021 , Aug. 13, 2021 , Aug. 16, 2021 , Aug. 17, 2021 and Aug. 20, 2021

Complaint Related: Yes

Comments:

A non-mandated complaint inspection was initiated on August 12, 2021 and concluded on August 20, 2021. A complaint was received by the department regarding allegations in the areas of resident care and related services and resident rights. The Executive Director was contacted by telephone to conduct the investigation. The licensing inspector emailed the Executive Director a list of documentation required to complete the investigation. The licensing inspector conducted an on-site observation at the facility on August 20, 2021. 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.

Violations:

Standard #:	22VAC40-73-130-A
Complaint related:	Yes
Description:	Based on record review and interviews with staff, all staff who are mandated reporters under ? 63.2-1606 of the Code of Virginia shall report suspected abuse, neglect, or exploitation of residents in accordance with that section. Evidence: 1. Resident #3 nurses notes dated 04-11-2021 documented by Staff #3 stated, ?Resident approached staff this AM with an complaint that she had asked nurse who worked on 3-11 shift on 4-10-2021 to give her the medications, she stated that a medicine (liquid) was given to her in a small med cup that she stated she did not need at this time. She also stated when she refused to take med, the nurse threw the medication onto the floor and appeared to be ver angry with her, concerns were addressed to ARCD (Assisted Resident Care Director) on 4/12/2021.? 2. Staff #2 could not produce documentation that the suspected abuse was reported as required by 63.2-1606 of the Code of Virginia.
Plan of Correction:	Steps to correct the noncompliance with the standards 22VAC40-73-(2)70-A (1.) Mandated reporting responsibilities of employees to be reviewed with employees by 9/17/2021. Measures/systematic changes put in place to ensure that the deficient practice does not reoccur: (1.) Staff will be in-serviced on regulations in regards to self-reports to DSS when occurrence of incident that negatively affects or threatens the life, health of safety or welfare of any resident.(2.) Staff in-serviced on notifying Director of Resident Care/Executive Director when incident that negatively affects or threatens the life, health of safety or welfare of any resident occur including at night and/or weekends. Person(s) responsible for implementing each step and/or Monitoring of corrective action to ensure the deficient practice will not reoccur: The Executive Director and/ or Director of Resident Care are responsible for monitoring and educating staff on following protocol for the self-report of incidents that adversely affect residents.
Standard #:	22VAC40-73-650-B
Complaint related:	No
Description:	Based on record review and discussion, the facility failed to ensure physician?s orders identified the diagnosis, condition, or specific indications for administering each drug. Evidence: 1. Resident #3?s physician?s orders dated 5-22-2021 had no diagnosis, condition, or specific indications for administering the following drugs: a. Carvedilol F/C 6.25 mg b. Citalopram HBR F/C 20 mg c. Hydralazine HCL 100 mg d. Isosorbide MN ER 30 mg e. Lokelma Outer 10 GM Powder f. Melatonin 5 mg g. Pregabalin 75 mg h. Sodium Bicarbonate 10 GR 650 mg i. Vitamin D2 5000 U j. Breo Ellipta 30 dose 100-25 mcg 2. Staff #2 confirmed during discussion the aforementioned diagnosis, condition, or specific indications for administering each drug were not documented.
Plan of Correction:	Steps to correct the noncompliance with the standards 22VAC40-73-(2)70-A (1.) Resident?s physician has been contacted and physician orders will be updated to include diagnosis, condition, or specific indications for administering all medications. Measures/systematic changes put in place to ensure that the deficient practice does not reoccur: (1.) All physician orders will be reviewed monthly by Director of Resident Care or Assistant Director of Resident Care to be sure they include diagnosis, condition, or specific indications for administering all medications. Person(s) responsible for implementing each step and/or Monitoring of corrective action to ensure the deficient practice will not reoccur: (1.) The Director of Resident Care is responsible for monitoring physician orders.
Standard #:	63.2-1808-A
Complaint related:	Yes
Description:	Based on record review and interviews with staff and residents, the facility failed to ensure that each person who becomes a resident of the assisted living facility: Is treated with courtesy, respect, and consideration as a person of worth, sensitivity, and dignity. Evidence: 1. A complaint was received by the Central Licensing Office on July 14, 2021 alleging Staff #1 ?has shown numerous residents disrespect ? [Staff #1] took the med in cup threw med to floor? [Resident #1] complained [Staff #1] came in laid her meds on counter where [Resident #1] couldn?t get at the time because of a broken right arm?[Resident #2] stated [Staff #1] verbally abused [Resident #2] as well?? 2. During resident interviews onsite on 8-20-2021, two residents confirmed that Staff #1 had been disrespectful, with one resident stating Staff #1 said to them, ?What do you want? I?m busy? and another resident stating Staff #1 said, ?Your meds are here? placing them on the counter and walking away despite resident?s limitations to reach the medications. 3. During staff interviews on 8-17-21, two staff confirmed that they had witnessed Staff #1 speaking disrespectfully to residents regarding the residents mentioned in the complaint, with one staff stating, ?I witnessed a tone with specific residents and residents complaining and crying about how [Staff #1] talked to them.? 4. Staff #2 confirmed during discussion the aforementioned information and that residents were not treated with courtesy, respect, and consideration as a person of worth, sensitivity, and dignity.
Plan of Correction:	Steps to correct the noncompliance with the standards 22VAC40-73-(2)70-A (1.) Staff member is no longer employed by community. (2.) Resident Rights and reporting responsibilities of employees to be reviewed with employees by 9/17/2021. Measures/systematic changes put in place to ensure that the deficient practice does not reoccur: (1.) Staff will be in-serviced on Resident?s Rights to be treated with courtesy, respect, and consideration as a person of worth, sensitivity, and dignity.2.) Staff will be in-serviced on notifying Director of Resident Care/Executive Director when incident that negatively affects or threatens the life, health of safety or welfare of any resident occur including at night and/or weekends. Person(s) responsible for implementing each step and/or Monitoring of corrective action to ensure the deficient practice will not reoccur: The Executive Director and/ or Director of Resident Care are responsible for monitoring and educating staff on Resident Rights.