Failure to Enforce No-Smoking Policy for Resident
Penalty
Summary
The facility failed to ensure safe smoking practices for Resident R50, who has a history of nicotine dependence and other significant health issues, including respiratory failure and chronic obstructive pulmonary disease. Despite the facility's policy prohibiting smoking and the presence of a care plan addressing Resident R50's smoking habits, the resident was caught smoking in their bathroom. The clinical record lacked documentation of a smoking assessment, confiscation of cigarettes and lighters, a signed smoking policy agreement, and a signed admission agreement. Interviews with staff revealed that the Nursing Home Administrator had confiscated cigarettes and lighters from Resident R50 on multiple occasions, and staff had reported smelling smoke in the resident's bathroom. However, there was no evidence of consistent enforcement of the no-smoking policy or adequate supervision to prevent the resident from smoking. The Social Worker confirmed that the no-smoking policy is included in the Resident Handbook, but it appears to be enforced on a case-by-case basis, leading to inconsistencies in policy application.
Plan Of Correction
For residents R50 and all residents who will be admitted to the facility, a notice of non-smoking will be included in the admission packet and alternatives offered as the building is a non-smoking building. Admissions for the last 30 days were reviewed to ensure that they were notified of us being a nonsmoking facility by the administrator/designee. Staff will be educated on non-smoking policy and reporting of smoking material in resident rooms by the Director of Nursing/designee. No other residents have been reported to have smoking materials in their rooms at this time. An audit will be completed by social service/designee and will occur 3 times a week for 4 weeks, 2 times a week for 3 weeks, then weekly for 3 months to ensure that residents have signed the non-smoking policy and that residents with nicotine dependence do not have smoking materials in their possession. Social Service will ask to be able to speak at Resident Council, to provide additional education regarding the facility non-smoking policy. The audit will be monitored by the Administrator and the results of the audit will be presented at the monthly Quality Assurance meeting and recommendations will be implemented.