Failure to Ensure Safe Smoking Practices and Supervision
Penalty
Summary
The facility failed to ensure a safe environment related to smoking for a resident with diagnoses including polyneuropathy, glaucoma, diabetes mellitus type 2, and nicotine dependence, who was cognitively intact and used a motorized wheelchair. Multiple observations showed the resident leaving the building independently to smoke, smoking on facility grounds, extinguishing cigarettes on his wheelchair, and storing cigarettes and a lighter unsecured in his room. The resident also disposed of cigarette butts in his room trash can and kept smoked butts in his hand. Despite a physician's order requiring education on smoking risks and secure storage of smoking materials, these measures were not consistently implemented. A review of records revealed that a safe smoking assessment was not completed or signed by the resident until after several of these incidents. The care plan indicated the resident was to use nicotine safely in designated areas and was encouraged to store smoking materials securely, but the resident declined these interventions. Staff interviews confirmed uncertainty about the resident's compliance with smoking policies, supervision needs, and disposal of cigarette butts. The facility's policy required assessment and supervision for residents who smoke, as well as secure storage and designated smoking areas, but these procedures were not followed for this resident.