Failure to Accommodate Resident's Smoking Needs
Penalty
Summary
The facility failed to accommodate the smoking needs and preferences of a resident who required a specialized chair for transport to the designated smoking area. The resident, who had a history of smoking and was not interested in a smoking cessation program, was unable to smoke due to the absence of the necessary equipment. This situation caused the resident significant anxiety and withdrawal symptoms, as she was unable to leave her room to smoke. The resident was admitted to the facility with a history of right cerebrovascular accident (CVA) with left side affected, hypertension, atrial fibrillation, and depression. Upon admission, it was noted that the resident had contractures and required a specialized chair for mobility. Despite this, the facility did not have the appropriate equipment available, and the resident's smoking evaluation was delayed. The resident expressed her distress and withdrawal symptoms to staff, but the issue remained unresolved for several days. Interviews with facility staff revealed a lack of awareness and communication regarding the resident's needs. The Nursing Home Administrator and other staff members were not informed of the requirement for a specialized chair, and the resident's smoking evaluation was not completed in a timely manner. The facility's failure to provide the necessary equipment and support resulted in the resident's inability to smoke, leading to unnecessary anxiety and distress.
Plan Of Correction
1: What corrective action(s) will be accomplished for those residents found to have been affected by the deficient practice; A. Resident #470 was assessed, and appropriate chair was provided, smoking assessment completed. B. Education was given to CNA O, SSD, LPN W, Admission Director, Unit manager LPN M. C. Director of Rehab is no longer at the facility. 2: How you will identify other residents having potential to be affected by the same deficient practice and what corrective action will be taken; A. Audit of all current residents who want to smoke and who currently smokes was completed to ensure they are able to smoke and abnormal findings were corrected. 3: What measures will be put into place or what systematic changes you will make to ensure that the deficient practice does not recur; A. Education to staff regarding the components of F558. B. Nursing management is to review new admission the following business day to ensure resident who wants to smoke has accommodation to do so. C. Nursing managers will review 24 hour report for any documentation or changes to resident smoking preferences. D. Education for smoking accommodation and F558 will be provided annually and upon new hire orientation. 4: How the corrective action(s) will be monitored to ensure the deficient practice will not recur, i.e., what quality assurance program will be put into place. The Director of nursing/Designee will audit the 24 hour report and review new smoking residents for accommodation and assessment weekly for four weeks then monthly for one quarter. The Nursing Home Administrator/Director of nursing/Designee will submit a report of findings to the Quality Assessment, Assurance and Compliance Committee monthly for one quarter.