VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Chastain Home for Gentlewomen
370 Mountain Rd.
Halifax, VA 24558
(434) 476-6057

Current Inspector: Cynthia Jo Ball (540) 309-2968

Inspection Date: April 24, 2020

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 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. 22VAC40-80 THE LICENSING PROCESS. 22VAC40-80 COMPLAINT INVESTIGATION. 22VAC40-80 SANCTIONS.

Comments:

This inspection was conducted by licensing staff using an alternate remote protocol necessary due to a state of emergency health pandemic declared by the Governor of Virginia. A monitoring inspection was initiated on 4/24/2020 and concluded on 4/24/2020. The administrator was contacted by telephone to initiate the inspection. The administrator reported that the current census was 7. The inspector emailed the administrator a list of items required to complete the inspection. The inspector reviewed 2 resident records, 2 staff records, the facility health care oversight, fire and health department inspections, staff schedules and facility fire drills that were submitted by the facility to ensure documentation was complete. Information gathered during the inspection determined non-compliance with applicable standards or law, and violations were documented on the violation notice issued to the facility.

Violations:

Standard #:	22VAC40-73-250-D
Description:	Based on a review of staff records, the facility failed to ensure that staff received a screening for tuberculosis on or within 7 days prior to the first day of work. EVIDENCE: 1. The record for staff person 1, hired on 6/10/2019, did not have a completed screen for tuberculosis until 7/11/2019.
Plan of Correction:	The Chastain Home will ensure when hiring a new employee to adhere to the Standards for licensed Assisted Living 2 VAC 40-73-250 D. 1.a. The Administrator will maintain a log to document the tuberculosis screening of each new employee hired as a monitoring tool to ensure that the test is performed on or within 7 days prior to the first day of work.
Standard #:	22VAC40-73-680-A
Description:	Based on a review of resident records, the facility failed to ensure that staff who are licensed or registered to administer medications did so for residents who are dependent on medication administration as documented on their uniform assessment instrument (UAI). EVIDENCE: 1. The UAI dated 1/4/2020 in the record for resident 1 has documentation that the resident is dependent in medication administration and requires the assistance of a layperson. The UAI has "daughter" written in as the name of the helper. Per a phone interview with staff person 4 it was expressed that the resident 1's daughter places all of resident 1's medications for the month in a daily dosing medication container and the resident then takes them daily from this container. The facility does not employ a staff person who is licensed or registered to administer medications to assist resident 1 with medication administration as per the assessment on their UAI. 2. The UAI dated 1/24/2020 in the record for resident 2 has documentation that the resident is dependent in medication administration and requires the assistance of a layperson. The UAI has "son" written in as the name of the helper. Per a phone interview with staff person 4 it was expressed that resident 2's son places all of resident 2's medications for the month in a daily dosing medication container and the resident then takes them daily from this container. The facility does not employ a staff person who is licensed or registered to administer medications to assist resident 2 with medication administration as per the assessment on their UAI.
Plan of Correction:	On April 28, 2020, a UAI reassessment of resident #1 and resident #2 was performed. The reassessment concluded that both residents are able to self-administer their medications. 1. A local pharmacy has been identified who can provide medications in a pharmacy-issued compliant packet prepared by the pharmacist and delivered to the Home by a family member. These residents will self-administer their medications directly from the pharmacy-issued and labeled bubble pack. Completion Date: May 7, 2020. 2. The Home has been in contact with Rosa Wilson, RN, the RMA instructor through Danville Community College and Doss Estates. The Home is in the process of working with this instructor to set up a date for a Registered Medication Aide class. The instructor has indicated that she will be able to start the class in the next three weeks, if not sooner. The instructor will teach the instructional and the skills competency parts of the program. Due to the COVID-19 guidelines issued by the CDC and the state government regarding visitation restrictions in senior living facilities, we currently know of no assisted living facility who will allow students to come into their facilities to complete the required clinical portion of the training. In addition, testing is not currently being provided in Virginia. The RMA class will be set up for completion of the instructional and skills portion being completed as soon as possible, and the clinical portion completed as soon as a clinical site can be secured. The completion date will be dependent on COVID-19 guidance from the authorities. 3. The Home will hire a Registered Medication Aide by June 20, 2020, who will be able to administer medications once the Administrator receives her certification as an RMA and can oversee all RMA?s trained or hired in the future.