VIRGINIA DEPARTMENT OF SOCIAL SERVICES

Ashby Ponds, Inc.
21160 Maple Branch Terrace
Ashburn, VA 20147
(571) 291-6210

Current Inspector: Sarah Pearson (540) 680-9469

Inspection Date:

Complaint Related: No

Violations:

Standard #:	22VAC40-73-680-K
Description:	Based upon a review of records, the facility failed to ensure that the use of PRN medications is prohibited, unless one or more of the following conditions exist: Medication aides administer the PRN medication when the facility has obtained from the resident's physician or other prescriber a detailed medication order. The order shall include: directions as to what to do if symptoms persist. Evidence: Not all of the "as needed" PRN medications for Residents #2, #4, and #8 included what to do if symptoms persists on the physician's or other prescriber's order.
Plan of Correction:	1. As of 8/22/2019, PRN medication orders for residents #2, #4, and #8 were corrected to include what to do if symptoms persist. 2. A 100% audit for all PRN orders will be completed by September 11, 2019, to ensure physician?s or other prescriber?s order include what to do if symptoms persist. 3. Wellness Manager or designee will ensure completion of monthly audit of 10 residents for 3 months beginning 10/11/19 to ensure what to do if symptoms persist on the physician?s order or other prescriber?s order. 4. Date to be corrected 9/11/19.
Standard #:	22VAC40-73-930-D
Description:	Based upon a review of resident records and interviews with staff, the facility failed to ensure that for each resident with an inability to use the signaling device, in addition to any other services, the following shall be met: this inability shall be included in the resident's individualized service plan. Evidence: For Residents #4 and #6, who reside on the safe and secure unit, their inability to use the call bell system was not included on their Individualized Service Plan
Plan of Correction:	1. As of 8/22/2019, individualized service plans for residents #4 and #6 were updated to indicate their inability to use signaling device to call for assistance. 2. A 100% audit of the individualized service plans of residents who reside on the safe and secure unit will be done by September 11, 2019, to ensure it reflects their inability to use the signaling device. 3. Memory Care Manager or designee will assess resident?s ability to use a signaling device or any other services upon admission, annually during routine assessment, and/or during assessment of significant change in condition. Manager?s assessments will be documented in Individualized Service Plan. 4. Date to be corrected 9/11/19