Based on interviews and record review the facility failed to develop and implement a policy related to screening of potential employees to include a national background checks for all employees. Findings include: Per interview on 11/12/24 at 1:25 PM, the DON [Director of Nursing] confirmed that the facility substantiated that LNA #1 sexually assaulted Resident #1 on 11/6/24. Per record review of LNA #1's human resource file there was no national background check completed for LNA #1. Per interview with the Human Resources Director and the Administrator on 11/12/24 at 11:30 AM, it was confirmed that the facility did not do a national background check for LNA #1. …
F607 citations in Vermont
Abuse-prevention policies · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Vermont cites F607 more often than its own record predicts
1.46 times the share F607 takes of citations nationally.
Of every deficiency written in Vermont in 2025, this is the portion that was F607.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Vermont surveyors wrote
F607 findings written in Vermont, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
Based on interview and record review the facility failed to ensure that their policies related to screening for abuse via background checks had been implemented for 2 of 5 employees (LNAs #1 and #2). Findings include:Per record review of the facility policy titled Background Screening Investigations no date, it states Our facility Conducts employment background screening checks, reference checks and criminal conviction investigation checks on all applicants for positions with direct access to residents ( direct access employees).Background and criminal checks are initiated within two days of an offer of employment or contract agreement, and completed prior to employment.Per record review, LNA (Licensed Nursing Assistant) #1 was hired on 7/8/25 and LNA #2 was hired on 8/29/25. …
Based on facility policy review and staff interview, the facility failed to develop written policies and procedures that include all the required regulatory topics related to screening, training, prevention, and identification. Findings include: Per review of facility policy titled, Preventing, Reporting, and Investigating Resident Abuse, Mistreatment, Exploitation and Neglect, published on 3/14/24, the following required components are missing: Screening, -screening potential employees for a history of abuse, neglect, exploitation, or misappropriation of resident property in order to prohibit abuse, neglect, and exploitation of resident property; and -screening prospective residents to determine whether the facility has the capability and capacity to provide the necessary care and… …
The short window
Recent years
| Year | Share of Vermont citations | vs expected |
|---|---|---|
| 2024 | 2.22% | 2.95× |
| 2025 | 0.96% | 1.46× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Vermont surveyors cite →
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