Failure to Honor Resident Choice in Smoking Policy
Penalty
Summary
The facility failed to honor residents' rights to self-determination and choice by implementing a policy that prohibited the use of tobacco cigarettes and only allowed vaping or e-cigarettes. This policy change affected all residents who smoked, as they were no longer permitted to smoke tobacco cigarettes in the designated smoking area. Observations and interviews confirmed that multiple residents, including those who were cognitively intact or moderately impaired and had a documented history of tobacco use, were required to use vaping devices despite their expressed preference for tobacco cigarettes. Residents reported dissatisfaction with vaping, with some stating it made them sick or that they did not like it, and indicated they were not given the option to continue smoking tobacco cigarettes as they had previously. The facility's records, including care plans and safe smoking evaluations, showed that residents had previously been assessed for safe tobacco use and had interventions in place such as supervision and the use of smoking aprons. Despite these measures, the facility's new policy was implemented due to concerns about residents' ability to safely handle lit cigarettes and challenges with staff supervision during smoking times. Residents were informed of the policy change through meetings, but those who did not wish to switch to vaping were only offered smoking cessation support or the option to transfer to another facility that allowed tobacco cigarettes.