Failure to Complete Smoking Assessments and Contracts for Residents
Penalty
Summary
The facility failed to complete required smoking assessments and contracts for two residents who were identified as smokers. One resident, who had been smoking since admission approximately two weeks prior, was observed with cigarettes and a lighter at the bedside. The resident confirmed that staff occasionally accompanied them to the designated outdoor smoking area. Review of the medical record showed no evidence of a smoking assessment or a signed smoking contract upon admission or after the facility became aware of the resident's smoking. The Director of Nursing Services (DNS) confirmed that the assessment was not completed until after the surveyor's inquiry. Another resident, also identified as a smoker, was found with multiple boxes of cigarettes in their room, including one in their shirt pocket and two on the windowsill. The resident was reported by an LPN to go out alone to smoke. Review of this resident's clinical record, who was admitted several months prior, also lacked evidence of a completed smoking assessment. The DNS confirmed that no assessment had been completed for this resident, and acknowledged that the assessment determines whether residents may keep smoking materials at bedside or require them to be secured. The facility's policy requires a smoking assessment upon admission or when a resident begins smoking, and quarterly thereafter.