Failure to Honor Resident Choice for Dining Location and Smoking Privileges
Penalty
Summary
The deficiency involves the facility’s failure to honor resident choice regarding dining location and smoking, as required under resident rights to self-determination. A resident reported that on a specific Saturday, residents were told they could not eat breakfast in the dining room because a CNA had called out, and all residents who normally ate in the dining room were required to eat in their rooms instead. Review of employee timecards for that date showed three CNAs were working the day shift. The DON stated the facility was supposed to have four CNAs but only had three, confirmed that residents had to eat in their rooms and not in the dining room, and acknowledged there was no reason this should have occurred and that residents should have been able to eat breakfast in the dining room. The deficiency also includes the facility’s revocation of a resident’s smoking privileges without staff directly observing a violation of the smoking policy. The resident, who had signed a Smoking Agreement and Procedures form stating that failure to comply with designated locations, times, and rules could result in termination of smoking privileges, reported that his smoking privileges were taken away and that he had been placed on 1:1 care because staff said he was smoking in the bathroom, which he denied. Progress notes documented that his roommate reported he had been smoking in the bathroom and that his smoking privileges were revoked, and later that the ombudsman was notified that the resident was non-compliant with the smoking policy based on the roommate’s report and his frequent exits from the center, and that he was on 1:1 supervision. The Administrator confirmed that smoking privileges were removed because the roommate said the resident was smoking in the bathroom, that staff never caught him but could smell him, that he liked to keep his smoking materials instead of handing them to staff, and that a new smoking agreement and procedure had been implemented after his admission.
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