Failure to Supervise Resident Smoking and Secure Smoking Materials
Penalty
Summary
The facility failed to follow its policy and procedure regarding resident smoking for one resident by not ensuring supervision while the resident was smoking in the designated smoking patio and by not securing the resident's smoking materials in a locked box or drawer. During an observation, the resident was seen smoking a cigarette on the smoking patio without staff supervision, despite the facility's policy requiring supervision for all residents during smoking, regardless of their alertness or orientation. Additionally, a lighter was found on the resident's bed, indicating that smoking materials were not properly secured as required by facility policy. The resident involved had a history of encephalopathy, respiratory failure, and asthma, and required substantial to maximal assistance with several activities of daily living. Facility records, including the resident's Safe Smoking Assessment and Interdisciplinary Team Conference notes, documented the need for supervision and secure storage of smoking materials. Interviews with facility staff confirmed that supervision and secure storage were expected practices, but these were not followed in this instance, potentially compromising the safety of the resident and others.