§483.10(f) Self-determination. The resident has the right to and the facility must promote and facilitate resident self-determination through support of resident choice, including but not limited to the rights specified in paragraphs (f)(1) through (11) of this section.
§483.10(f)(1) The resident has a right to choose activities, schedules (including sleeping and waking times), health care and providers of health care services consistent with his or her interests, assessments, and plan of care and other applicable provisions of this part.
§483.10(f)(2) The resident has a right to make choices about aspects of his or her life in the facility that are significant to the resident.
§483.10(f)(3) The resident has a right to interact with members of the community and participate in community activities both inside and outside the facility.
§483.10(f)(8) The resident has a right to participate in other activities, including social, religious, and community activities that do not interfere with the rights of other residents in the facility.
|
Observations:
Based on review of select facility policy and procedures, observations, and resident and staff interviews, it was determined that the facility failed to ensure that residents could make choices about aspects of their lives that were significant to them, such as smoking, for one of 32 residents reviewed (Resident 315).
Findings include:
The facility policy entitled, "Smoking Policy Skilled Nursing Facility," last reviewed without changes on January 25, 2024, revealed the facility is a smoke free building. The policy of the facility was to ensure that smoking was only permitted in a designated area and was done in a safe manner. New residents will be informed that the facility is smoke free; and they are welcome to reside here but may not smoke.
The procedure indicated that the skilled nursing center has a designated smoking area on the porch outside the main lobby for visitors to smoke. Staff are permitted to smoke during break times in areas indicated by signs as a "designated smoking area" to include the smoke shack off the skilled nursing facility and the designated smoking areas at the apartments, or in their vehicle.
Interview with Resident 315 on January 30, 2024, at 1:15 PM revealed that she does smoke but that the facility indicated they are a non-smoking facility, so she is not able to smoke here. She indicated that it was driving her nuts.
Further interview of Resident 315 on January 31, 2024, at 10:30 AM after she requested to see the surveyor, revealed that she wanted to know what the facility smoking policy was and what the "rules" were related to smoking because she was hearing two different stories. She indicated that she was told on admission that the facility was non-smoking but that a nurse last night told her that staff and visitors smoke at the facility. She also indicated that she is manic depressive (a mental health disorder that causes extreme mood swings from emotionally high to emotionally low) and with her pain slowly getting under control, and that fact that she is "not allowed to smoke she can feel herself slipping into a low spot."
The Nursing Home Administrator and Director of Nursing were made aware of Resident 315's concerns related to smoking during a meeting on January 31, 2024, at 2:15 PM. They confirmed that staff and visitors could smoke at the facility in designated areas but that residents are not allowed to smoke. They also confirmed that residents are made aware of this on admission.
The facility failed to ensure that a resident of the facility that desired to smoke, could smoke on premises in the facility designated smoking areas that are available to visitors and staff.
28 Pa. Code 201.29(j) Resident rights
| | Plan of Correction - To be completed: 03/25/2024
This plan of correction is prepared and executed because it is required by the provisions of the state and federal regulations and not because The Williamsport Home agrees with the allegations and citations listed on the statement of deficiencies. The Williamsport Home maintains that the alleged deficiencies do not, individually, and collectively, jeopardize the health and safety of the residents, nor are they of such character as to limit our capacity to render adequate care as prescribed by regulation. This plan of correction shall operate as The Williamsport Home's written credible allegation of compliance. By submitting this plan of correction, The Williamsport Home does not admit to the accuracy of the deficiencies. This plan of correction is not meant to establish any standard of care, contract, obligation, or position, and The Williamsport Home reserves all rights to raise all possible contentions and defenses in any civil or criminal claim, action or proceeding.
1. A grievance form was completed with resident 315 on 2/1/2024. Nursing Home Administrator spoke with residents and again offered a nicotine patch. Upon her choice to not utilize a patch alternative placement in a facility permitting resident smoking was offered. The resident had a successfully planned discharge home on 2/12/24.
2. No other current residents in the facility have showed interest in smoking. The facility has reviewed the admission process and has reimplemented the resident handbook, which provides the residents with our smoking policy at the time of admission. Current residents in the facility will be provided the re-implemented resident handbook.
3. Education will be completed with Admissions Director and Admissions and Discharge Nurse by the Director of Nursing or designee regarding the requirement to provide and review the resident handbook at the time of admission. Staff will be educated upon hire on the smoking policy and annually. Re-education to all staff will be conducted to inform them of the employee policy for smoking.
4. The Nursing Home Administrator or designee will review for acknowledgement that the resident handbook was provided and reviewed at the time of admission x 3 and monthly x 2. Audit results will be reviewed by the Quality Assurance Performance Improvement Committee to determine resolution or need for continuation of audit process.
|
|