Failure to Prevent Unsupervised Smoking and Smoking Hazards
Penalty
Summary
The facility failed to ensure adequate supervision and a hazard-free environment for residents who smoke, as evidenced by repeated incidents involving a resident smoking inside the building against facility policy. Multiple observations noted a cigarette smoke odor in a resident hall, and interviews with residents and staff confirmed that a resident had been smoking in his room without supervision. The resident admitted to smoking in his room, and another resident expressed frustration over the violation of smoking rules. Staff interviews confirmed that residents are not permitted to smoke inside the facility and should not possess cigarettes or lighters, with smoking materials to be distributed only during supervised, designated smoking times in the outdoor smoking area. Record review revealed that the resident involved had diagnoses including tobacco use, nicotine dependence, COPD, polyneuropathy, and an unspecified mental disorder, with no cognitive impairment noted on the most recent assessment. The resident's smoking safety assessment indicated prior burn marks on skin, clothing, or furniture, and required supervision per facility policy. Nurses' progress notes documented multiple instances of the resident smoking inside the facility and possessing smoking items, including taking cigarette butts from outside ashtrays. The facility's smoking policy explicitly prohibits smoking inside and requires all smoking materials to be kept at the nurse's station and distributed only at designated times.