Resident Smoked Indoors in Violation of Facility Policy
Penalty
Summary
A deficiency occurred when a resident with a diagnosis including bipolar disorder with manic delusions was observed smoking a cigarette inside the facility lobby, in violation of the facility's smoking policy that prohibits smoking indoors at any time. The resident had been assessed as cognitively intact, able to self-propel in a wheelchair, and was care planned as a safe, independent smoker who could keep smoking materials in a lock box in her room. Staff interviews confirmed that the resident had previously understood and agreed to the smoking policy, and there were no prior incidents of indoor smoking reported for this resident. On the day of the incident, the resident was seen lighting and smoking a cigarette in the lobby area, away from other residents with oxygen. Staff intervened by escorting the resident outside and attempting to retrieve her smoking materials, which led to the resident becoming combative and the police being called. The resident was subsequently sent to the emergency room for evaluation due to escalating behaviors and later returned to the facility under one-to-one supervision. The facility's policy allowed certain residents, grandfathered in from a previous administration, to retain smoking materials in their rooms if assessed as safe smokers, which applied to this resident prior to the incident.