Hebrew Home Of Greater Washington

F 0600 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

inappropriate tone, which was considered emotional abuse.behavior was inappropriate and threatening toward [Resident R17]. A review of the support planner's statement revealed, . [social worker] spoke at a passionate level that could be understood as yelling by [Resident R17] .I do not think he/she yelled at him/her, but I will say that he/she did reprimand him/her for making the statement.[SW] was a little too passionate.I could tell Resident R17 was not happy with the tone. I would describe it as being called into the principles [sic] office and being chastised for your behavior.o The facility's policy titled, Organizational Policy on Resident Abuse for HHGW dated 03/1998 with last revision and approval date of 01/2025 was reviewed without concerns. Within Section I. Policy Statement, it commands, Any associate, contracted provider, or volunteer, observing, knowing of, suspecting, or receiving any allegation of abuse, neglect or exploitation shall immediately report any of the above circumstances to their immediate supervisor, the Clinical Team Manager for the unit (Hebrew Home of Greater [NAME]), their shift supervisor, or Executive Director. Reporting must be immediate, without delay. Further, the policy defines abuse as, 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. 3. Psychological or verbal abuse: Mistreatment that affects a person's emotional or mental health or wellbeing, including but not limited to: intimidation, threats of punishment or harm, harassment, humiliation, insults, belittlement, or isolation. The use of oral, written or gestured language that disparages or demeans residents or their families, regardless of their age, ability to comprehend, or disability. Examples include, but are not limited to: threats of harm; saying things to frighten a resident.The facility implemented corrective action plans to include: The termination of SW24, education/in-servicing provided to all staff on abuse and communication which was reviewed without concerns, and education provided to outside coordination of care workers on abuse and reporting and accompanying policy requiring the same. The facility provided a copy of email correspondence between the Director of Social Work and the support planner from the community integration service company. The email was dated 7/3/25 and stated, in part, if you are vising any residents

in our facility and you see anything that could be misconstrued as hostile, negative, abusive, or unprofessional by our staff toward any resident, we ask that you inform someone of what you saw, no matter how miniscule or flagrant it may be. We at HHGW want to insure [sic] the best overall experience and safety to our residents. The email was acknowledged and signed by the support planner on 7/7/25.The facility verified the allegations of Quality of Care/Treatment and Administration/Personnel; however, this surveyor's investigation will substantiate a past noncompliance finding of the deficient practice of abuse (mental/verbal) as evidenced by a social worker demonstrating verbal and non-verbal aggressive behavior toward the resident which caused and had the potential to cause the resident to experience humiliation, intimidation, shame, agitation, and/or degradation and did not promote an environment to enhance the resident's dignity.

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Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/17/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Hebrew Home of Greater Washington

6121 Montrose Road Rockville, MD 20852

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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

all units, dining rooms, and bathrooms were searched withing the [NAME] building. The Missing Person Alert was also not activated for the same reason.The facility's elopement policy titled, Resident Elopment-Hebrew Home of Greater [NAME], dated 09/1998 with last revision and approval date of 5/2025 was reviewed without concerns. It defines elopement as, refers to when a resident leaves the premises or a safe area without authorization (i.e., an order for discharge or leave of absence) and/or any necessary supervision to do so. The facility implemented corrective action plans to include: Revision of the resident elopement policy and procedures, in-servicing staff on Missing Resident Response Protocol & Prevention,

an increase WanderGuard testing to three (3) times daily, an updated care plan for Resident R20, and updated treatment administration record to monitor Resident R20's behavior.The facility did not verify the allegation of Quality of Care/Treatment; however, this surveyor's investigation will substantiate a past noncompliance finding of

the deficient practice of residents receiving adequate supervision and assistance devices to prevent accidents as evidenced by Resident R20's elopement from the monitored area and the building of residence for approximately 2 hours.

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