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Resident Smoking

SuperUser Account posted on May 07, 2015 12:42 Article Rating All news

Resident Smoking

by Betty Frandsen | Mar 18, 2015

Dear Betty,

Although our facility is designated as “smoke free,” we were cited at a high level for unsafe smoking on our recent survey. A resident deemed independent was smoking outside without supervision or a smoking apron in an area not approved for smoking. The citation said our assessment of this resident was not current, the care plan was inadequate regarding smoking for five residents, and we were not able to show that new admissions understood that we are a smoke free facility. Please share our story and tell others what the Department of Health expects. Thank you.

Smoke Free and Still Cited

Dear Smoke Free,

Thank you for your comments. Smoking presents a potential serious problem in nursing facilities, even when designated as a “smoke free” setting.  Residents with “grandfathered” permission continue smoking despite the decision not to allow smoking for individuals admitted after a selected date. Many residents have smoked for most of their lifetime, and now experience declining physical or mental status that makes smoking inadvisable. The United States Fire Administration determined that the older adult population represents the highest fire risk group in the United States, with a risk more than twice the national average, and that increases to three times the average in persons 75 and older, and four times the average for individuals 85 and older.  Residents who smoke and do not adhere to safety policies present a significant risk. As providers of quality care, we are obligated to establish and enforce safe smoking rules and practices.

CMS released an alert on November 10, 2011, titledSmoking Safety in Long Term Care Facilities,which includes the following summarized recommendations:

 

For more information on this topic, you can obtain the full CMS memo fromwww.aanac.org  by visiting “What’s New,”Smoking Safety in Long Term care Facilities Alert, 11/11. Also, review F323 Accidents and Supervision in the State Operations Manual, Appendix PP.           ~ Betty

Betty Frandsen RN, NHA, MHA, C-NE has worked in long term care for over 30 years, including 14 years as aDirector of Nursing, and as an Administrator in both Pennsylvania and New York. She served as Vice President of Education and Regulatory Affairs for AANAC, and is a past president of NADONA/LTC. 

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