Failure to Honor Resident Smoking Rights
Penalty
Summary
Squirrel Hill Wellness and Rehabilitation Center was found to be non-compliant with resident rights as outlined in 42 CFR Part 483, Subpart B, and the 28 Pa. Code. The facility failed to honor the rights of residents to smoke, affecting four residents who were reviewed during the survey. The facility had a policy allowing supervised smoking in designated areas, but this was changed to a smoke-free policy, prohibiting smoking on the premises. The residents involved, who had a history of smoking and expressed a desire to continue, were informed of the new policy. Despite their wishes, the facility did not provide alternatives that were acceptable to the residents, such as transferring them to a facility that allows smoking. The residents, who were alert and able to make their needs known, declined the offer of nicotine patches and expressed their dissatisfaction with the inability to smoke or be transferred to a smoking facility. Interviews with the residents revealed their frustration and desire to either smoke or be moved to a facility that accommodates their smoking habits. The Director of Nursing confirmed the change in policy and acknowledged that the residents' rights to smoke were no longer honored. This change in policy and the facility's failure to accommodate the residents' rights led to the deficiency noted in the survey.
Plan Of Correction
A meeting regarding the facility's Non-Smoking Policy was conducted with residents #R11, R19, R28, and R53 (the "grandfathered residents"), each of whom had signed a smoking agreement prior to the non-smoking policy going into effect on February 5, 2025. The information discussed at that meeting included smoking times and rules for these grandfathered residents. The information was incorporated into the plan of care for these residents. The facility has determined that all residents have the potential to be affected. New residents are informed about the facility's Non-Smoking Policy prior to admission and are offered smoking cessation products. In-service education programs were conducted separately with licensed and non-licensed staff by the Director of Nursing Services (DON), or designee. In-service education regarding the Non-Smoking Policy included the grandfathered residents who are permitted to smoke. The Director of Nursing Services (DON), or designee, will conduct random observations to ensure that the smoking rights of the grandfathered residents are being met. Such observations will take place once per week for four weeks, then bi-weekly for one month, then monthly for one month. This plan of correction will be monitored at the monthly Quality Assurance meeting until such time consistent substantial compliance has been met.