Failure to Prevent In‑Room Smoking Exposing Roommate to Smoke
Penalty
Summary
The deficiency involves the facility’s failure to maintain a safe, comfortable, and smoke‑free environment for a resident sharing a room with a known smoker. One resident with medical diagnoses including anxiety disorder, bipolar disorder, paraplegia affecting the right side, cerebral infarction, and asthma, and who was documented as cognitively intact, reported that his roommate was constantly smoking in their room. The roommate had medical diagnoses including nicotine dependence, cognitive communication issues, dementia, major depressive disorder, memory deficit following cerebral infarction, and chronic osteomyelitis, and was also documented as cognitively intact. Despite a facility policy that the interior of the facility remain smoke‑free and that smoking occur only in designated areas, the smoking roommate admitted to smoking in the shared room and stated he did so because he did not feel like going outside and did not care about the rules. The smoker’s record showed a long-standing pattern of smoking in his room, with social service notes documenting multiple dates over several months when he was observed smoking in his room. His care plan identified a behavior of smoking cigarettes in his room, and a Smoking Risk Review concluded he may not be capable of handling or carrying smoking materials and required supervision when smoking. A smoking contract specified that he would not smoke anywhere else in the building, would surrender all smoking materials, and would not possess smoking materials in his room or clothing, with stated consequences for violating the policy. Nonetheless, staff, including an LPN, confirmed that the resident continued to smoke in his room while he was roommates with the resident who had asthma, and that the asthmatic resident complained about the smoking because he did not want his asthma to flare up. These actions and inactions resulted in the resident with asthma being exposed to cigarette smoke in his room, contrary to the facility’s smoking safety policy and the resident’s right to a safe, clean, and comfortable environment.
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