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 #:	22VAC40-73-320-A
Description:	Based upon a review of records, the facility failed to ensure that within the 30 days preceding admission, a person shall have a physical examination by an independent physician. The report of such examination shall be on file at the assisted living facility and shall contain the following: height, weight, and blood pressure. Evidence: For Residents #3, #4, and #5, neither height nor weight were included on the report of physical examination form submitted to the facility.
Plan of Correction:	1. The history and physical of Resident's #3, #4, and #5 cannot be updated with current information. Weight and blood pressure of these residents have been updated monthly and are up-to-date in resident's records. 2. Practice Administrator or designee will ensure that 100% of medical providers who complete assisted living/memory care resident admission paperwork receive education specifying that the history and physical must be completed in full and shall contain height, weight, and blood pressure. Education completed by 8/30/2021. 3. Memory Care Manager or designee will ensure that 100% of the healthcare sales team receives education regarding required components on the history and physical. Education completed by 8/30/2021. 4. Healthcare counselor or designee will audit 100% of new resident admission paperwork to ensure that the history and physical is completed in full, including height, weight, and blood pressure; ongoing for 3 months. Completion by 10/30/2021. 5. Date to be corrected 10/30/2021.