Based on observation, interview and record review, the facility failed to provide appropriate treatment and services to prevent catheter-associated injury or urinary tract infections for 2 of 5 residents (Residents 1 and 2) with an indwelling urinary catheter (tube for drainage of urine). The facility failure to provide adequate & timely assessment, close monitoring and timely reporting of condition changes, and interventions, such as checking for proper placement of a urinary catheter and/or consideration of all possible causes for reduced/obstructed urine flow through the catheter, contributed to harm for Resident 1 who developed an acute life threatening medical condition related to catheter placement/migration. …
F690 citations in Washington
Incontinence and catheter care · Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Washington cites F690 less often than its own record predicts
0.75 times the national share — cited less often here than elsewhere.
Of every deficiency written in Washington in 2025, this is the portion that was F690.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Washington surveyors wrote
F690 findings written in Washington, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interview and record review the facility failed to provide care for an indwelling urinary catheter (a flexible tube placed inside the bladder to drain urine continuously into an external bag), according to physician orders and plan of care, for 1 of 5 sample residents (Resident 1) reviewed for catheter care. Resident 1, who had a know history of catheter related infections, experienced harm from staff failing to flush their catheter leading to a hospitalization for bacteremia (when bacteria enters the blood stream). This failure placed facility residents at risk of infection, poor clinical outcomes and a decreased quality of life.Findings included. …
Based on observation, interview and record review, the facility failed to ensure assessment and monitoring of resident bladder programs for 1 of 3 residents (Resident 15) reviewed for bowel and bladder programs. This failure placed residents at risk for infection, bladder injury and adverse events. Findings included . Resident 15 admitted on [DATE] with diagnoses that included spinal injury with resulting bladder dysfunction. The resident was alert and oriented and able to self-advocate regarding their care. Review of Resident 15's treatment order dated 06/26/2026 documented Resident to self cath (catheterize) to drain the bladder, every hour as needed. …
The short window
Recent years
| Year | Share of Washington citations | vs expected |
|---|---|---|
| 2023 | 1.19% | 0.73× |
| 2024 | 1.25% | 0.83× |
| 2025 | 1.01% | 0.75× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Washington surveyors cite →
Deficiency Index is independent and is not affiliated with, endorsed by, or approved by CMS, Medicare, or any government agency. About this data · Report a correction