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F0600
G

Failure to Protect Resident from Physical Abuse by Roommate

Barre, Vermont Survey Completed on 09-23-2025

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

The facility failed to protect a resident from physical abuse by another resident, resulting in physical harm. One resident, diagnosed with frontotemporal neurocognitive disorder and moderate cognitive impairment, was assaulted by their roommate, who has a history of behavioral issues including agitation, restlessness, and previous incidents of physical aggression toward both staff and other residents. The roommate's care plan included interventions to observe for mood changes, identify triggers, and minimize escalation, but these measures were not effective in preventing the incident. On the day of the incident, the resident asked their roommate to turn off the TV, which led to verbal abuse and a physical assault. The assaulted resident sustained multiple injuries, including bruising and swelling to the face, an abrasion to the lower lip, and reported pain and fear following the event. Staff confirmed that the resident was not protected from abuse and had suffered injuries as a result of the assault.

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