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F0926
D

Failure to Enforce Smoking Material Storage Policy

Waco, Texas Survey Completed on 06-15-2025

Penalty

Fine: $10,765
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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 follow its established smoking policy for one resident who was identified as a smoker. According to the facility's policy, residents' smoking materials, including lighters and cigarettes, are to be kept at the nurse's station and not in residents' rooms. However, during an observation and interview, the resident was found to have both a lighter and a pack of cigarettes stored in her bedside drawer. The resident confirmed that she kept these items in her room and was able to light her own cigarettes, although staff accompanied her during designated smoke breaks. Staff interviews revealed inconsistent practices regarding the storage of smoking materials, with one LVN stating that smoking materials should be kept at the nurse's station but admitting uncertainty about the location of the resident's lighter. The DON also confirmed that smoking materials should not be kept in residents' rooms. The resident involved was cognitively intact, as indicated by a BIMS score of 15, and had multiple medical diagnoses including cancer, high blood pressure, kidney failure, malnutrition, depression, white matter disease, and vitamin D deficiency. The resident's care plan had not been started at the time of review, and although a safe smoking assessment indicated she could smoke without supervision, the facility did not ensure compliance with its policy regarding the storage of smoking materials. This lapse was identified through observations, interviews, and record reviews conducted by surveyors.

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