Failure to Complete Smoking Assessment for Resident
Penalty
Summary
The facility failed to ensure that a smoking assessment was completed for a resident who smoked, as required by facility policy. The resident, who had a history of cerebral infarction, traumatic brain injury, difficulty walking, anxiety disorder, urinary incontinence, parkinsonism, cognitive communication deficit, and nicotine dependence, was moderately cognitively impaired and dependent on staff for toileting and transfers. Despite these conditions, there was no evidence that a Smoking Safety Screen was completed upon admission or during subsequent assessments until several months later. The deficiency was identified when the Administrator, while reviewing camera footage for an unrelated investigation, observed the resident smoking outside. This led to the discovery that the resident's smoking status had not been identified or assessed during the admission process or quarterly assessments, contrary to facility policy. The policy required all residents to be asked about tobacco use at admission and during each MDS assessment, with further assessment for those who smoked to determine supervision needs. This lapse was noted as a continued non-compliance from previous surveys.