Failure to Enforce Smoking Safety Policy and Supervision
Penalty
Summary
A deficiency occurred when a resident, who was assessed as a safe smoker and was cognitively intact, was found to have cigarettes and a lighter in her personal possession in her room, contrary to facility policy. The resident, who had diagnoses including chronic obstructive pulmonary disease, atrial fibrillation, and neuropathies, was fully ambulatory and required supervision to no assistance with activities of daily living. Her care plan specified that she should not keep cigarettes or a lighter in her room and that these items should be stored safely, with smoking to be supervised as needed. Despite these care plan interventions and the facility's smoking policy, which prohibits residents from keeping smoking articles in their rooms and requires all smoking to be supervised with items stored in a lock box, the resident stated she was allowed to keep her cigarettes and lighter because she was a safe smoker. She also reported that she did not have to follow the policy due to her status. Staff interviews revealed confusion and inconsistency regarding the enforcement of the smoking policy, with the DON stating the resident was allowed to smoke unsupervised, while the Corporate RVP confirmed that all residents should be supervised and not keep smoking articles in their rooms. Further review of facility documentation showed that the required documentation sheet for tracking cigarettes and lighters had not been filled out for the past 30 days, and some staff were unaware of the documentation process. The facility's smoking policy and in-service records clearly outlined the procedures for supervised smoking and the handling of smoking materials, but these were not consistently followed, leading to the deficiency.