Failure to Provide Required Smoking Safety Equipment and Supervision
Penalty
Summary
A deficiency occurred when a resident was allowed to smoke in the facility's designated smoking area without being offered or wearing a smoking apron, as required by her care plan and the facility's smoking policy. During observation, the resident, who has diagnoses of congestive heart failure, polyneuropathy, and muscle weakness, was seen dropping ashes on her shirt and between her legs in her wheelchair while smoking two cigarettes. The activities assistants supervising the smoking break were present but did not offer the resident a smoking apron, and the resident brushed ashes off her body with her hand while still holding a lit cigarette. The resident's records indicated she was cognitively intact and required supervision and the use of a smoking apron for safety during smoking activities. The Smoking Observation/Assessment specifically noted that a smoking apron should be offered and that supervision was required to help prevent burns. Despite these documented requirements, staff failed to provide the necessary adaptive equipment and did not ensure that ashes were properly disposed of in the ashtray, as outlined in the facility's policy. Interviews with staff, including the activities assistants, Activities Director, ADON, and DON, confirmed that the expectation was for the resident to be offered a smoking apron and to be supervised to ensure safe smoking practices. Staff acknowledged that the resident's safety was put at risk due to the failure to follow the facility's smoking policy, which mandates direct supervision and the use of safety equipment for residents with smoking privileges who require monitoring.