VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Westminster Canterbury on Chesapeake Bay
3100 Shore Drive
Virginia beach, VA 23451
(757) 496-1100

Current Inspector: Lanesha Allen (757) 715-1499

Inspection Date: Dec. 10, 2020 and Dec. 14, 2020

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS 22VAC40-73 RESIDENT CARE AND RELATED SERVICES 22VAC40-73 RESIDENT ACCOMODATIONS AND RELATED PROVISIONS

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 complaint investigation was initiated on 12-10-2020 and concluded on 12-14-2020. A complaint was received by the department regarding allegations in the areas of Personal Possessions. The Administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the Administrator a list of documentation required to complete the investigation. The evidence gathered during the investigation did not support the allegations of non-compliance with standards or law.

Violations:

Standard #:	22VAC40-73-390-A
Complaint related:	No
Description:	Based on record review and interview, the facility failed to ensure the resident written agreement/acknowledgment included the required information. Evidence: 1. Resident #1 admitted to the facility on 07-10-2018. Staff #1 provided a copy of resident #1?s ?Agreement to Transfer to Enhanced Services? [resident written agreement] dated 07-10-2018. The ?Agreement to Transfer to Enhanced Services? did not document the required sections of the agreement as outlined in subsections A.1. A through G and A.4. A through N of this standard. 2. Staff #1 could not provide documentation of the aforementioned information required for resident #1?s written agreement. 3. Staff #1 stated ?I provided what we had on file for [resident?s] resident agreement as of [resident?s] admission date.? Staff #1 acknowledged the facility did not have the required information documented on resident #1?s written agreement/acknowledgment.
Plan of Correction:	Facilities Resident Agreement form will be updated to comply with Standard Number 22VAC40-73(5)-390-A. All Residents will receive a copy of the updated Resident Agreement and the form will be used during each new admission moving forward in compliance with the standard.
Standard #:	22VAC40-73-550-G
Complaint related:	No
Description:	Based on record review and interview, the facility failed to ensure the rights and responsibilities of residents in assisted living facilities are reviewed annually with each resident. Evidence of this review should be the resident?s written acknowledgment of having been so informed. Evidence: 1. Resident #1 admitted to the Assisted Living area of the facility on 07-10-2018. Resident #1?s ?Admission Record? [face sheet] documented the resident is their own responsible party. 2. Staff #1 provided documentation of resident #1?s most current annual rights and responsibilities dated 08-19-2020; however, the document was not signed by the resident. The last annual rights and responsibilities review was signed and dated by resident #1 on 08-07-2019. 3. Staff #1 stated ?resident #1 did not attend the meeting? to review the annual rights and responsibilities and acknowledged this information was not reviewed with the resident.
Plan of Correction:	All residents and/ or responsible parties will receive a copy of the most up to date Rights and Responsibilities of Residents In Assisted Living Facilities In the January 2021 Resident Newsletter. A Receipt of Acknowledgement of Review will be filed In the Residents Chart. Review and Acknowledgement of Rights and Responsibilities of Residents In Assisted Living Facilities will be held annually during the Resident's Care Plan meeting with both the Resident and/or Responsible Party and filed in Residents Electronic Health Record. Resident rights will be reviewed during each Resident Council Meetings held monthly for those In attendance.