F0610

D

Failure to Thoroughly Investigate Resident-to-Resident Abuse Allegation

Nampa, Idaho Survey Completed on 01-08-2026

Penalty

No penalty information released

Summary

The facility failed to ensure a thorough investigation was completed following an allegation of resident-to-resident abuse involving one cognitively intact resident with chronic respiratory failure and depression. According to the facility’s abuse policy, a follow-up report summarizing investigation findings and corrective actions must be submitted within five working days of an incident, including any new or revised information. In this case, a resident reported to the nurse’s station during the night that he "can't take it anymore" and that his roommate was "threatening to kick my ass." The resident was offered a temporary room change for the night, initially declined due to concern about losing his room, but later agreed after further discussion and slept peacefully in another room.

Progress notes documented that the resident reported there was no physical altercation, that both individuals remained on their own sides of the room during the verbal altercation, and that although the roommate stated, "once I get out of bed, I am going to kick your ass," the resident indicated he did not feel threatened and felt safe in the facility. During an interview, the Administrator stated he was notified of the situation by phone, was informed the residents were separated, and that he personally spoke with the resident and ruled out physical and psychosocial harm. When asked by surveyors why the incident was not reported and whether an investigation was conducted, the Administrator stated he ruled out harm and did not answer regarding an investigation, and the CRN acknowledged that the facility did not complete a thorough investigation, resulting in a failure to respond appropriately to the alleged abuse in accordance with facility policy.