F 0600 The DON said CNA #2 told her Resident #1 was combative, hitting her, and called her (CNA #2) a racial slur.

The DON said CNA #2 said she only tapped the back (top side) of Resident #1's left hand, and that she Level of Harm - Actual harm (CNA #2) had told him/her If you are going to hit me, I am going to hit, you back. The DON said the facility substantiated the allegation of abuse and that CNA #2 was terminated. Residents Affected - Few

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 3 of 5 225474 Department of Health & Human Services Printed: 08/26/2025 Form Approved OMB Centers for Medicare & Medicaid Services No. 0938-0391

STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A. Building 225474 B. Wing 05/21/2025

NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE

Regalcare at Taunton 68 Dean Street - Rear Taunton, MA 02780

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 0607 During an interview on 05/22/25 at 12:29 P.M., (which included review of her written statement) CNA #1 said around 5:00 A.M., her and CNA #2 were providing care to Resident #1. CNA #1 said Resident #1 became Level of Harm - Minimal harm or combative, hit CNA #2 several times and called her (CNA #2) a racial slur. CNA #1 said CNA #2 became potential for actual harm frustrated and told Resident #1, If you hit me again, I will hit, you back.

Residents Affected - Few CNA #1 said CNA #2 then forcefully grabbed Resident by his/her left wrist, slapped the top of his/her left hand twice and Resident #1 yelled out Ow. CNA #1 said she became anxious about what she saw and that

she did not report the incident to the Nurse on duty.

CNA #1 said she went home after the end of her shift (7:00 A.M.) but knew that she was supposed to report what she had observed. CNA #1 said she went back to the Facility around 9:00 A.M. and told Nurse #1 that CNA #2 had slapped Resident #1's left hand while she (CNA #1) and CNA #2 were providing care to him/her.

During an interview on 05/21/25 at 2:44 P.M., the Director of Nursing (DON) said that on 03/30/25 around 9:19 A.M. Nurse #1 notified her that CNA #1 reported that she had witnessed CNA #2 slap Resident #1's hand. The DON said she started her investigation, told Nurse #1 to notify the Police, and she notified the scheduler to remove CNA #2 from the schedule pending investigation.

The DON said CNA #1 did not immediately report the incident to Nurse #1 per Facility Policy. The DON said her expectation is that all staff immediately report any concern for potential abuse, and that they should notify

the Administrator or DON.

FORM CMS-2567 (02/99) Event ID: Facility ID: If continuation sheet Previous Versions Obsolete Page 5 of 5 225474