Health inspection·November 25, 2024

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, clinical record review, and facility documents review, the facility failed to ensure one of three Residents (Resident 1) was treated with dignity and respect when Certified Nursing Assistant (CNA) 1 raised her voice and cussed at Resident 1. This failure resulted in Resident 1 feeling scared. Findings: Resident 1 was admitted to the facility on [DATE]. During a review Resident 1 ' s Quarterly Minimum Data Set (MDS-an assessment tool), dated 10/20/24, described Resident 1 as having clear speech, able to make herself understood and as able to understand others. Resident 1 ' s BIMS (a brief screening that aids in detecting cognitive impairment) score was 15 which indicated she was cognitively intact. The MDS described Resident 1 as having no signs or symptoms of delirium or behavioral symptoms. During a review of Resident 1 ' s Progress Notes, dated 11/18/24 at 10:39 a.m., it Was reported to the DON [Director of Nursing] at 0815 11/18/24, by the resident that on 11/16/24 during lunchtime when the dining room only had a handful of residents that the resident (Resident 1) and C.N.A. (CNA 1) got into a verbal altercation. Resident was talking to another resident and was encouraging her to eat, when the C.N.A. told her to mind her own business and that the resident was fine. [Resident 1] continued to encourage resident in Spanish. [Resident 1] and another resident were at a different table discussing the other resident's upcoming Surgery when the CNA turned around and started to curse at her, [Resident 1] then told her that she was talking to the other resident to give her reassurance for her upcoming surgery, and she wasn't saying anything. CNA was feeding another resident at a different table when event happened. Per resident they argued back in forth for a few minutes when another staff member came in and the CNA left the room. During an interview on 11/25/24 at 9:52 a.m. with Resident 2, she stated the incident it was so upsetting and didn ' t want to be interviewed regarding what she witnessed or heard. Resident 2 stated she gave her statement to [DON]. During a review of the facility ' s interview with Resident 2, dated 11/21/24, regarding the incident on 11/18/24 during the lunch meal. Resident 2 stated, I was having a conversation with [Resident 1] regarding my upcoming surgery. [Resident 1] was trying to reassure me, and I was worried about managing my pain after surgery. We did notice a resident spilling food on herself, and I mentioned that she was dropping food on herself. [Resident 1] went and was trying to help the other resident and came back to our table and started to talk to me. [CNA 1] did start cussing at [Resdient1] and did Page 1 of 2 056098 056098 11/25/2024 Cottonwood Healthcare Center 625 Cottonwood Street Woodland, CA 95695

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few use the F word, but I don't remember how she used it. I do remember that she did tell [Resident 1] if you don't like it here you can leave. The nurse then came in and [Resident 1] and I continued our discussion. During a review of the facility ' s interview with Resident 3, dated 11/18/24, regarding the incident on 11/16/24 during the lunch meal. Resident 3 stated, I was in the back dining room being assisted with lunch by [CNA 1] when she stopped feeding me and started to yell out to [Resident 1] telling her to shut her fucking mouth and to quit talking shit. [Resident 1] continued to antagonize and yell and curse at [CNA 1] . During an interview on 11/25/24 at 9:44 a.m. with Resident 3, she stated she was in the dining room eating her lunch, she was being fed by CNA 1. Res 1 started talking bad about the place (facility). CNA 1 starting cussing at Resident 1. Resident 3 was asked how this made her feel when CNA 1 stopped feeding her and started having words with other the resident. Resident 3 stated she was thinking just feed me and don ' t worry about Resident 1 was saying. During a telephone interview on 12/2/24 at 3:21 p.m. with Resident 1, she stated they were in the dining room and CNA 1 was feeding one of the residents their lunch. Resident 1 and another resident were sitting there talking about how the resident was going to have surgery. Resident 1 said she and the other resident (Resident 2) were talking about her aftercare and all that and how she was scared because she felt like she was not going to be taken care of properly. We were talking about different issues that happened here throughout the facility, it was mostly about her aftercare. Then all of a sudden, CNA (1) turns around in her seat and says, Are you going to be talking fucking shit all day? or something like that. Resident 1 said she said something like, Excuse me, are you talking to me? CNA (1) says, Yeah. CNA 1 said to me, you've been fucking talking shit about this fucking place and about how this fucking place is garbage and this and that and how administration is garbage. And I said, Wait a minute. Well, first of all, you are interfering in a conversation that is none of your business. I told the CNA that her name was not brought into this. I told her to get your facts straight and that we were talking about general stuff that happens around different facilities and that people don't get taken care of. I told her to mind her own business. She (CNA 1) started going off and she said nobody even fucking wants you here. She said you got such a fucking foul mouth, but she was the one cussing at me. She just kept going on and on and then I told her I didn ' t want to talk to her and for her to mind her own business. She was like, no, and started going off and we started going at it and then a nurse and another CNA rushed in. Resident 1 was asked how this made her feel when CNA 1 started yelling and cussing at her. Resident 1 stated, Like she was going to get up and come over .and I was just scared if she was going to do that or not .because of the way she cussed me out, you know. I was scared. I'm in a wheelchair and she is tall. During a review of the facility ' s policy and procedure (P&P) titled, Resident Rights revised 8/2022 indicated, Facility staff shall treat all residents with kindness, respect, and dignity. 056098 Page 2 of 2