F 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Note: The nursing home is
disputing this citation.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate
catheter care, and appropriate care to prevent urinary tract infections.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record review and interviews, the facility failed to ensure incontinent care was provided at least once every
shift. This affected five (Resident #1, #2, #3, #4, and #17) out of nine residents reviewed for incontinence
care. The facility census was 78.Findings include: 1. Review of the medical record revealed Resident #1
was admitted on [DATE] with diagnoses that included acute and chronic respiratory failure, cerebral
infarction, hemiplegia and hemiparesis, aphasia, anxiety disorder, and benign prostatic hyperplasia. Review
of Resident #1's care plan dated 05/08/24 revealed Resident #1 had alteration in elimination and required
assistance with toileting. Interventions included to provide incontinence care as needed. Review of
Resident #1's bowel and bladder assessment dated [DATE] revealed Resident #1 was always incontinent of
bowel and bladder. Review of the quarterly Minimum Data Set (MDS) dated [DATE] revealed Resident #1
had severe cognitive impairment and was dependent on staff for toileting. The MDS revealed Resident #1
was frequently incontinent of bowel and bladder. Review of the bowel and bladder elimination
documentation by Certified Nursing Assistants (CNA) revealed Resident #1 had incontinent care provided
one out of two shifts on 01/25/26, 01/30/26, 02/02/26, 02/05/26, 02/07/26, 02/08/26, 02/09/26, 02/12/26,
02/13/26, 02/16/26, and 02/17/26. Resident #1 did not have incontinent care provided on 01/29/26 and
02/11/26. 2. Review of the medical record revealed Resident #2 was admitted on [DATE] with diagnoses
that included Parkinson's disease, multi-system degeneration of the autonomic nervous system, chronic
kidney disease, dementia, and benign prostatic hyperplasia. Review of Resident #2's care plan dated
08/05/25 revealed Resident #2 had alteration in elimination and was completely incontinent of bowel and
bladder. Interventions included to provide incontinence care as needed. Review of the quarterly MDS dated
[DATE] revealed Resident #2 had severe cognitive impairment and was dependent on staff for toileting. The
MDS revealed Resident #2 was frequently incontinent of bowel and bladder.Review of Resident #2's bowel
and bladder assessment dated [DATE] revealed Resident #2 was always incontinent of bowel and bladder.
Review of the bowel and bladder elimination documentation by CNA's revealed Resident #2 had incontinent
care provided one out of two shifts on 01/25/26, 01/29/26, 02/02/26, 02/05/26, 02/7/26, 02/08/26, 02/09/26,
02/13/26, 02/16/26, and 02/17/26. Resident #2 did not have incontinent care provided on 02/11/26.3.
Review of the medical record revealed Resident #3 was admitted on [DATE] with diagnoses that included
Type II Diabetes, dementia, and hypertension.Review of Resident #3's care plan dated 04/27/21 revealed
Resident #3 had alteration in elimination and was dependent on staff for incontinence care. Interventions
included to provide incontinence care as needed.Review of Resident #3's bowel and bladder assessment
dated [DATE] revealed Resident #3 was always incontinent of bowel and bladder.Review of the quarterly
MDS dated [DATE] revealed Resident #3 had moderate cognitive impairment and required
substantial/maximal assistance with toileting. Resident #3 was occasionally incontinent of bowel and
bladder. Review of the bowel and bladder elimination
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 2
Event ID:
365929
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
365929
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/20/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Crown Pointe Care Center
1850 Crown Park Court
Columbus, OH 43235
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Note: The nursing home is
disputing this citation.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
documentation by CNA's revealed Resident #3 had incontinent care provided one out of two shifts on
01/23/26, 01/24/26, 01/25/26 01/29/26, 01/31/26, 02/06/26, 02/07/26, 02/08/26, 02/11/26, 02/12/26,
02/13/26, 02/17/26. Resident #3 did not have incontinent care provided on 02/05/26. 4. Review of the
medical record revealed Resident #4 was admitted on [DATE] with diagnoses that included dementia,
osteoarthritis, and chronic pain syndrome. Review of Resident #4's care plan dated 02/05/24 revealed
Resident #4 may require assistance with care. Interventions included Resident #4 required assistance with
toileting. Review of Resident #4's bowel and bladder assessment dated [DATE] revealed Resident #4 was
frequently incontinent of bowel and bladder. Review of the annual MDS dated [DATE] revealed Resident #4
had moderate cognitive impairment and required partial/moderate assistance with toileting. The MDS also
revealed Resident #4 was frequently incontinent of bowel and bladder.Review of the bowel and bladder
elimination documentation by CNA's revealed Resident #4 had incontinent care provided one out of two
shifts on 02/07/26, 02/08/26, 02/11/26, 02/12/26, and 02/13/26. 5. Review of the medical record revealed
Resident #17 was admitted on [DATE] with diagnoses that included Type II Diabetes, acute kidney failure
and anorexia.Review of Resident #17's care plan dated 04/15/24 revealed Resident #17 had alteration in
elimination and was frequently incontinent of bowel and bladder. Interventions included to provide
incontinence care as needed.Review of the quarterly MDS dated [DATE] revealed Resident #17 was
cognitively intact and was dependent on staff for toileting. The MDS revealed Resident #17 was frequently
incontinent of bowel and bladder. Review of Resident #17's bowel and bladder assessment dated [DATE]
revealed Resident #17 was always incontinent of bowel and bladder. Review of the bowel and bladder
elimination documentation by CNA's revealed Resident #17 did not have incontinent care provided on
01/26/26 and 02/19/26. Resident #17 had incontinent care provided one shift on 01/26/26, 01/28/26,
01/30/26, 02/01/26, 02/05/26, 02/09/26, and 02/15/26. During an interview on 01/20/26 at 8:12 A.M. a
Resident that requested to be anonymous stated that there was not enough staff. The resident stated staff
did not check residents frequently for incontinence. The resident stated she complained once and the staff
refused to provide any care and incontinence care was not provided for 17 hours.During an interview with
the Director of Nursing (DON) on 02/20/26 at 1:47 P.M. the DON verified the CNA documentation revealed
incontinent care was not being provided every shift for Resident #1, #2, #3, #4, and #17. The DON stated
staff were being educated about charting, but The DON could not verify that incontinent care had been
provided. During an interview with Resident #4's family on 01/20/26 at 2:16 P.M. the family stated they
found Resident #4 frequently incontinent and had asked that Resident #4 be checked and changed every
two hours, but it was not being done. This deficiency represents non-compliance investigated under
Complaint Number 2717356.
Event ID:
Facility ID:
365929
If continuation sheet
Page 2 of 2