Failure to Supervise Residents During Smoking Activities
Penalty
Summary
The facility failed to ensure that six residents who were identified as smokers received proper supervision and assistance devices as required to prevent accidents while smoking. Record reviews showed that these residents had various diagnoses, including asthma, COPD, stroke, lack of coordination, schizoaffective disorder, and cognitive impairments ranging from moderate to severe. Care plans and smoking assessments for most of these residents indicated a need for supervision during smoking, yet not all residents had completed smoking assessments or care plans addressing their smoking status. During an observation, all six residents were seen smoking in the designated area while the assigned CNA was present but not actively supervising them. Instead, the CNA was observed sitting and looking at her phone for at least five minutes, failing to monitor the residents as required. The CNA acknowledged in an interview that she was responsible for monitoring the residents, distributing cigarettes, lighting them, and applying smoking aprons when needed, but admitted she was distracted by her phone and not watching the residents as she should have been. Interviews with facility leadership, including the DON and Administrator, confirmed that staff are expected to supervise residents during smoking to prevent accidents and that staff should not be distracted by personal devices. The facility's smoking policy requires regular safe smoking assessments and mandates direct supervision for residents classified as unsafe smokers, specifying that supervisors must maintain direct view and be able to respond quickly in emergencies. Despite these policies, the observed lack of supervision constituted a failure to prevent accident hazards for these residents.