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Tribute at One Loudoun, LLC
20335 Savin Hill Drive
Ashburn, VA 20147
(571) 252-8292

Current Inspector: Amanda Velasco (703) 397-4587

Inspection Date: Sept. 5, 2019 and Sept. 12, 2019

Complaint Related: Yes

Areas Reviewed:

Technical Assistance:
Licensing Inspector (LI) reviewed Standard 700-1 regarding oxygen therapy and the requirements for a valid physician's order for oxygen therapy,

On 9/5/19 and 9/12/10 Licensing Inspector (LI) conducted unannounced focused monitoring visit to ensure correction of violation cited during 7/2/19, 7/3/19 complaint study. Reviewed staff work schedules. All previous violations were found to have been corrected.

Licensing Inspector (LI) conducted unannounced complaint investigation on 9/5/19 and 9/12/19 regarding medication administration and documentation. LI reviewed resident record, medication administration records, interviewed staff, and inspection the medication cart. LI spoke with Executive Director.

Complaint regarding Standard 650-A is deemed valid as a preponderance of evidence gathered during the investigation supported the allegations. An exit interview was held and violations were discussed.

Areas of non-compliance are identified on the violation notice. Please complete the "plan of correction" and "date to be corrected" for each violation cited on the violation notice and return to the licensing office within 10 calendar days.

Please specify how the deficient practice will be or has been corrected. Just writing the word "corrected" is not acceptable. The plan of correction must contain: 1) steps to correct the non-compliance with the standard(s), 2) measures to prevent the non-compliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventative measure(s).

Thank you for your cooperation and if you have any questions please call 703-479-5247 or contact me via email at

Standard #: 22VAC40-73-650-A
Complaint related: No
Description: Based upon a review of records and interview with staff, the facility failed to ensure that no medication shall be started, changed, or discontinued by the facility without a valid order from a physician or other prescriber. Medications include prescription, over-the-counter, and sample medications.

Evidence: Resident #1 had a January 13, 2019 physician's order to take Furosemide 40mg, 1 tablet everyday. According to the Medication Administration Record (MAR), that order was discontinued on August 22, 2019. A valid physician's order discontinuing the January 13, 2019 order was not found in the resident's records.

Plan of Correction: Furosemide 40mg was placed back on electronic MAR after confirming with the prescribing MD that the medication is indeed to be given on a routine and PRN basis. The prescription orders for routine and PRN received via fax on 9/18/19 was faxed to the dispensing pharmacy. Mandatory Registered Medication Aide and Nurse meeting held on 9/20/19 for the purpose of educating surrounding medication orders, prescriptions, medication administration, and regulation. Opportunity provided to team to ask questions. This violation was used as an example as a learning opportunity. In going forward, all LPNs and RMAs are to compare new prescriptions to the current eMAR and engage the dispensing pharmacy/pharmacist for questions and or concerns. The dispensing pharmacy is advised to contact the prescriber and or nurse/medication aide for any questions or concerns surrounding medication orders. The experience team is aware that all medications such as prescription, over-the-counter, and sample medications can not be started, changed, or discontinued by the facility without a valid doctor order.

This information is provided by the Virginia Department of Social Services, which neither endorses any facility nor guarantees that the information is complete. It should not be used as the sole source in evaluating and/or selecting a facility.

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