Rockwall Nursing Care Center

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

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

was placed on 1:1 monitoring until she was seen and cleared by psych services. She stated the incident occurred on Saturday and she spoke with both residents the following Monday. She stated when she spoke with the residents, Resident #1 denied being hit and Resident #2 denied hitting her. She stated Resident #2 was autistic and processed feelings differently. She stated Resident #2 was fairly new at the facility and the resident's family member provided tips on what knowledge she had acquired over the years caring for the resident. She stated Resident #2 saw a counselor and psych services in the facility. The Social Worker stated after the incident, safe surveys were completed with other residents and trauma informed assessments completed for both parties involved. She stated she followed up with the residents daily for 3 days to monitor for any other concerns or behaviors. During a telephone interview on 09/26/2025 at 3:09 PM, RN B stated CNA C notified her Resident #2 hit Resident #1. She stated when she asked Resident #2 what happened, she just said she was sorry. RN B stated she separated the residents and Resident #2 was placed on 1:1 monitoring until psych cleared her. She stated Resident #2 had not hit another resident. The

interview revealed RN B was knowledgeable about the types of abuse and to report any abuse to the administrator who was the abuse coordinator.During an interview on 09/26/2025 at 4:10 PM, the Administrator stated he was told CNA C was in the tv room when the incident occurred. He stated CNA C reported she was cleaning up fluids or a spill on the floor and heard a commotion. When CNA C stood up, a resident pointed and said she hit her, indicating Resident #2 had hit Resident #1. CNA C reported Resident #1 had a red face. The Administrator stated he arrived at the facility 45 minutes after the incident was reported to him. He stated Resident #1 and Resident #2 did not recall the incident happening. He stated Resident #2 did not recall hitting anyone. He stated Resident #2 curses and uses profane language. He stated he did not believe the residents knew what they were doing based on their cognitive ability. The Administrator stated in-service training was provided to staff on abuse, neglect, and de-escalation. He stated the staff had a heightened awareness of Resident #2 and monitored to ensure Resident #1 and Resident #2 were not in each other's personal space or sat at the same table for meals. He stated trauma assessments showed there were no adverse effects, and staff had not witnessed a change in the residents' daily routines. He stated both residents had a psych visit and the facility's consulting service would continue to provide guidelines and activities to redirect Resident #2. He stated Resident #2 had not hit another resident. Record review of the facility's policy Abuse/Neglect - Resident to Resident reflected The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation as defined in this subpart.Residents should not be subjected to abuse by anyone including, but not limited to, facility staff, other residents.family members, or legal guardians, friends, or other individuals. The facility will provide and ensure the promotion and protection of resident rights. 1. Abuse. Abuse is the willful infliction of injury.with resulting physical harm, pain or mental anguish.Willful, as used in this definition of abuse, means

the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm.

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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

11/25/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Rockwall Nursing Care Center

206 Storrs Rockwall, TX 75087

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

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

she just said she was sorry. RN B stated she separated the residents and Resident #2 was placed on 1:1 monitoring until psych cleared her. She stated Resident #2 had not hit another resident. The interview revealed RN B was knowledgeable about the types of abuse and to report abuse to the abuse coordinator, who was the administrator. During an interview on 09/26/2025 at 4:10 PM, the Administrator stated he was told CNA C was in the tv room where the incident occurred. He stated CNA C reported she was cleaning up fluids or a spill on the floor and heard a commotion. When CNA C stood up, a resident pointed and said she hit her, indicating Resident #2 had hit Resident #1. CNA C reported Resident #1 had a red face. The Administrator stated he arrived at the facility 45 minutes after the incident was reported to him. He stated Resident #1 and Resident #2 did not recall the incident happening. He stated Resident #2 did not recall hitting anyone. He stated Resident #2 curses and uses profane language. He stated he did not believe the residents knew what they were doing based on their cognitive ability. The Administrator stated in-service training was provided to staff on abuse, neglect, and de-escalation. He stated the staff had a heightened awareness of Resident #2 and now ensured Resident #1 and Resident #2 were not in each other's personal space or sat at the same table for meals. He stated based on the trauma assessments, there were no adverse effects and no change in the residents' daily routines. He stated both residents had a psych visit and the facility's consulting service would continue to provide guidelines and activities to redirect Resident #2. He stated Resident #2 had not hit another resident. Record review of the facility's policy Abuse/Neglect - Resident to Resident reflected The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation as defined in this subpart.Residents should not be subjected to abuse by anyone including, but not limited to, facility staff, other residents.family members, or legal guardians, friends, or other individuals. The facility will provide and ensure the promotion and protection of resident rights.New employee orientation will consist of educational resources to identify abuse, neglect, exploitation, and misappropriation of resident property. Ongoing in-services will be conducted to educated staff regarding.how to reported suspected abuse, neglect. Interventions for aggressive behavior of residents, and dementia management and resident abuse prevention.The facility will be responsible to identify, correct, and intervene in situations of possible abuse/neglect. This facility established an environment that is as homelike as possible and includes a culture and environment that treats each resident with respect and dignity.

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