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F0550
D

Resident Not Treated with Dignity During Staff Interaction

Harwich, Massachusetts Survey Completed on 08-28-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

A deficiency occurred when a certified nurse aide (CNA) failed to treat a resident with dignity and respect. The incident involved a resident with severe cognitive impairment, dementia, and psychotic disorder with delusions, who was dependent on staff for self-care. The CNA engaged in teasing behavior by repeatedly pretending to sit on the resident's lap while the resident was seated on an unoccupied bed in another resident's room. Despite the resident's verbal protests, the CNA continued the behavior multiple times. This interaction was witnessed by another CNA, who confirmed that the resident yelled each time the CNA attempted to sit on their lap and that the behavior was repeated three times. A family member, upon hearing the resident yelling, entered the room and observed the CNA sitting on the resident's lap, which caused the resident to become upset and seek comfort from the family member. The family member described the CNA's behavior as bizarre and inappropriate. The facility's internal investigation corroborated that the CNA's actions were intended as a joke but were not appropriate, especially given the resident's cognitive status and distress during the incident.

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