Failure to Prevent Smoking Hazards and Incomplete Supervision
Penalty
Summary
The facility failed to ensure that the environment was free from accident hazards and did not provide adequate supervision to prevent accidents for two residents who smoked or vaped. One resident, who was cognitively intact and had diagnoses including hypertension, COPD, depression, and anxiety, was observed carrying cigarettes and a lighter away from the designated smoking area to her room. Her clinical record did not contain a physician's order for smoking, a completed smoking safety risk assessment, or a smoking care plan, despite documentation that she smoked daily and used smoking materials. The assessment section regarding the storage of smoking materials was incomplete, and there was no evidence that all smoking materials were being locked in the designated area as required by policy. Another resident, with a history of stroke, COPD, and requiring significant assistance with personal care, was found to have a vaping device in her possession in her room. Her clinical record included an order permitting smoking for psychosocial and medical necessity, but lacked a smoking care plan. The smoking safety risk assessment for this resident was incomplete and incorrectly indicated she did not use electronic smoking devices. Interviews revealed that she had not attended supervised smoking breaks for two months, was not listed as a dependent or independent smoker, and that all smoking materials for skilled nursing residents were supposed to be kept at the front desk. Facility policy required all residents to turn in smoking materials to staff, but this was not followed for these two residents.