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F0689
E

Failure to Secure Smoking Materials and Complete Required Smoking Safety Assessments

Chesapeake, Virginia Survey Completed on 09-19-2025

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 secure smoking materials and conduct required smoking safety assessments for residents who smoke, as outlined in its own smoking policy. The policy required that residents be evaluated for smoking safety on admission, quarterly, and upon significant change, and that smoking materials be secured by staff rather than kept in residents' possession. However, one resident with a history of multiple sclerosis and muscle weakness was allowed to keep cigarettes and a lighter in their room and on their person, despite documentation that the resident was a daily smoker and had previously been found smoking in bed. Staff interviews confirmed that independent smokers were permitted to maintain control of their smoking materials, contrary to the facility's policy. Another resident with a diagnosis of nicotine dependence was identified as a smoker in the care plan, but there was no evidence that a smoking safety evaluation had ever been completed for this resident. Staff interviews revealed that this resident also kept their smoking supplies with them, and the lack of assessment was attributed to administrative changes and oversight. The Director of Nursing and former interim administrator both stated that smoking assessments were expected to be completed on admission, quarterly, and as needed, but acknowledged that these were not consistently performed. A third resident with nicotine dependence and respiratory conditions had a history of moderately impaired cognition and was documented as unable to safely handle smoking materials. While a smoking safety evaluation was completed on admission and again over a year later, there was no documentation of quarterly assessments as required. The failure to conduct regular assessments and secure smoking materials as per policy was attributed to changes in administration and a shift in practice to honor resident independence, resulting in lapses in monitoring and documentation.

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