Health inspection·October 14, 2023

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Based on interview, resident record review, video and audio footage review, and facility policy review the facility failed to ensure a resident was not verbally abused by staff. This affected one resident (#65) of three residents reviewed for abuse. The facility census was 87. Findings included: Review of Resident #65's medical record revealed an admission date of 10/15/21 with diagnoses including chronic obstructive pulmonary disease, morbid obesity due to excess calories, essential hypertension, hyperlipidemia, and hemiplegia and hemiparesis following a cerebral infarction affecting the left non-dominant side. Review of Resident #65's annual Minimum Data Set (MDS) 3.0 assessment, dated 09/01/23, revealed the resident was cognitively impaired. The resident was totally dependent on two people for bed mobility, transfers, and toileting. The assessment revealed the resident did not exhibit physical behaviors, verbal behaviors, or other symptoms not directed towards others. Review of Resident #65's plan of care, dated 03/14/23, revealed she had a history or diagnosis of depression and or anxiety, crying and tearfulness. She had decreased socialization/withdrawal from activities and recurrent statements, repetitive physical movements, and a sad/anxious appearance. One of the goals was she would exhibit the ability to express anxiety in a calm manner and would not harm self or others. Further review of Resident #65's plan of care, dated 07/13/22, revealed she experienced an alteration in mood and/or behavior as evidenced by feeling down, depressed, and hopeless, feeling tired or having little energy, showing little interest/pleasure in doing things, yelling and screaming, and cursing at others. One of the goals was she would exhibit appropriate interpersonal communication. Review of the Daily Assignments Day Thursday 09/21/23 revealed State Tested Nursing Assistant (STNA) #104 was signed to rooms 504 to 512 from 6:00 P.M. to 6:00 A.M. Resident #65 did not reside in one of the rooms but did reside on the 500 hall. Interview on 10/13/23 at 3:20 P.M. with the director of nursing (DON) revealed STNA #111 was originally assigned to care for Resident #65, but he called off and STNA #104 was then assigned to care for the entire 500 hall which included Resident #65 on 09/21/23. Review of STNA #104's time punch card revealed she clocked in on 09/21/23 at 6:22 P.M. and clocked out on 09/22/23 at 6:04 A.M. Page 1 of 3 365929 365929 10/14/2023 Crown Pointe Care Center 1850 Crown Park Court Columbus, OH 43235

F 0600 Level of Harm - Minimal harm or potential for actual harm Interview on 10/13/23 at 8:33 A.M. with Resident #65 revealed about a month ago, her daughter walked in when an STNA was not speaking kindly to her. Resident #65 revealed the STNA was saying bad things to her. Resident #65 felt what the STNA was saying was abusive and disrespectful. Resident #65 could not remember the STNAs name but knew she no longer worked in the facility. Resident #65 denied any negative long-term psychosocial effects from the incident. Residents Affected - Few Telephone interview on 10/13/23 at 10:50 A.M. with STNA #104 revealed she was terminated from employment around the first of October (2023) due to an incident with the daughter of Resident #65. STNA #104 revealed she at no time was verbally abusive to any of the residents. She reported Resident #65 had put her light on for incontinence care, and she had already changed her three times. STNA #104 had asked Resident #65 to give her a minute and then she would be back. Resident #65's daughter overheard her telling Resident #65 to wait and became very upset. STNA #104 revealed she and Resident #65's daughter had words in the hallway, and they were each speaking inappropriately. STNA #104 revealed she never verbally abused Resident #65 but was verbally abusive to Resident #65's daughter. Interview on 10/13/23 at 11:31 A.M. with the Administrator revealed during the verbal abuse investigation with STNA #104, it was discovered that she did not treat a family member of a resident with dignity and respect. He reported due to this behavior, STNA #104 was terminated. He denied any findings regarding residents not being treated with dignity/respect or residents being verbally, mentally, or physically abused. Telephone interview on 10/13/23 at 11:40 A.M. with Registered Nurse (RN) #106 revealed she was the nurse on duty the night of the alleged verbal abuse of Resident #65. She revealed she did not witness/hear any verbal abuse. RN #106 reported she was in the hallway and did not hear the exchange between STNA #104, Resident #65 or Resident #65's daughter. RN #106 revealed STNA #104 did report to her she used the F word in a conversation she had with Resident #65's daughter. She reported Resident #65's daughter came out of the room to her and wanted STNA #104 off the floor and wanted to speak to the charge nurse. Telephone interview on 10/13/23 at 12:11 P.M. with Licensed Social Worker (LSW) #112, who was Resident #65's guardian and worked for the County Guardianship Service Board, revealed she had sent the facility Administrator video and audio footage which she had received from Resident #65's daughter regarding the alleged verbal abuse on 09/21/23. LSW #112 then forwarded the video and audio footage to this surveyor. Review of the video and audio footage on 10/13/23 at 12:18 P.M., which was provided by a LSW #112, revealed on 09/21/23 a 47 second recording of STNA #104 using the curse word f*ck while providing care and services to Resident #65. Resident #65's daughter was not in the room but outside the room when the curse work f*ck was verbalized. At the end of the recording, STNA #104 admitted and apologized to Resident #65's daughter for her verbal abuse toward Resident #65. Interview on 10/13/23 at 12:45 P.M. with Licensed Practical Nurse (LPN) #110 revealed she had spoken with Resident #65's daughter over the phone the evening of 09/21/23 when the alleged verbal abuse occurred. She revealed Resident #65's daughter was upset about how STNA #104 spoke to her mother and also that her mother was constipated. LPN #110 revealed the daughter did not want STNA #104 to care for her mother. LPN #110 watched the video and audio footage recorded by Resident #65's daughter and verified in the video and audio footage Resident #65's daughter told STNA #104 she was verbally abusing her mother and STNA #104 replied I know, and I apologize. LPN #110 reported she had seen only approximately the first 20 seconds of the video and audio footage and didn't realize STNA #104 had 365929 Page 2 of 3 365929 10/14/2023 Crown Pointe Care Center 1850 Crown Park Court Columbus, OH 43235

F 0600 replied I know, and I apologize when confronted by Resident #65's daughter about verbal abuse. Level of Harm - Minimal harm or potential for actual harm Interview on 10/13/23 at 12:56 P.M. with the Administrator revealed the investigation was found inconclusive for verbal abuse because watching the video and audio footage confirmed there was a verbal altercation, but he did not know the context of the video. The Administrator revealed part of the investigation was to discover what happened prior to the video and audio footage and he made multiple phone calls to Resident #65's daughter, LSW #112 and STNA #104 but no one would return his calls. The Administrator revealed that due to the lack of information about what occurred prior to the video and audio footage, the verbal abuse allegation was found inconclusive. Residents Affected - Few Telephone interview on 10/13/23 at 2:29 P.M. with the Resident #65's daughter revealed she did record the incident of verbal abuse of her mother by STNA #104 on 09/21/23 and she had forwarded the video and audio footage to guardian, LSW #112. Review of facility policy titled, Abuse, Neglect, Exploitation, and Misappropriation of Resident Property, dated 11/21/16, revealed the definition of abuse was the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. It includes verbal abuse, sexual abuse, physical abuse and mental abuse, including abuse facilitated or enabled through the use of technology, such as through the use of photographs and recording devised to demean or humiliate a resident. Further review under the subsection of prevention and identification include the supervision of staff to identify inappropriate behaviors, such as using derogatory language, rough handling, ignoring residents while giving care, and directing residents who need toileting assistance to urinate or defecate in their beds. This deficiency represents non-compliance investigated under Complaint Number OH00146683. 365929 Page 3 of 3