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F0656
D

Failure to Implement Smoking Safety Intervention per Care Plan

Butler, Pennsylvania Survey Completed on 07-25-2025

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Summary

The facility failed to implement the comprehensive care plan for a resident who required safety interventions while smoking. According to the resident's care plan and quarterly smoking assessment, the resident, who had diagnoses including high blood pressure, hemiplegia, and muscle weakness, was required to wear a smoking apron during smoking activities. However, during an observation, the resident was seen smoking in the designated area without the required smoking apron, despite this intervention being clearly documented in the care plan. Further investigation revealed that the staff member supervising the smoking session, a receptionist, was not aware that the resident was supposed to wear a smoking apron. The receptionist confirmed during an interview that they had never been informed of this requirement and acknowledged that the resident was not wearing the apron as indicated in the care plan. This failure to communicate and implement the care plan intervention resulted in noncompliance with facility policy and state regulations regarding resident care policies and nursing services.

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