IDPH has cited and fined Fondulac Rehabilitation & Health Care Center nursing home in East Peoria after a resident there caught fire in a smoking accident.
People unfamiliar with the nursing home industry may be surprised to hear that nursing home residents are permitted to smoke – they are in a health care institution after all. However, nursing homes are the homes of residents, and they are adults who are permitted to smoke if they so choose. However, the right to smoke is not unrestricted. Smoking is permitted only within designated areas of the nursing home home and under terms that are set by the nursing home.
There are a couple of dangers associated with smoking for nursing home residents that are not large issues with the general population, but are certainly important with nursing home residents. The first of these is smoking near concentrated oxygen equipment, as the oxygen equipment can cause a flash fire. The second of these is fires resulting from the mishandling of smoking materials, such as when a resident is not able to handle a lighter safely or drops lit cigarettes onto the themselves or their clothing. This can happen when the resident has some type of movement or musculoskeletal disorder. The dangers of all these are worse when the resident suffers from cognitive or memory impairments or from poor safety awareness.
Like any risk to the health and well-being of a nursing home resident, the risks associated with smoking should be addressed in the resident care plan. There are six basic steps in the care planning process: (1) an assessment of the risks to the resident, (2) the development of a care pan to address those risks, (3) communication of the care plan to the staff charged with carrying it out, (4) implementation of the care plan, (5) evaluation of the effectiveness of the care plan, and (6) and revision of the care plan if it proves to be ineffective in practice or if the care needs of the resident changes. Care plans should be be reviewed at least quarterly and changes made as needed.
The resident at issue here suffered from emphysema for which he was prescribed supplemental oxygen. When he was last assessed, he had the physical ability to smoke and did not have cognitive impairments which kept him from smoking. However, that assessment was not current, and there had not been an assessment of his smoking risk in the current quarter. The failure of assess was important here because there had been declines in both his cognitive abilities and in his ability to use a lighter safely.
On the morning of this nursing home smoking accident, the resident stopped by the nurse’s station to get a fresh tank of oxygen and then went to the smoking patio with a another resident. The other resident told the state investigator that they knew the code to exit the building onto the smoking patio and that they routinely smoked without staff present, despite facility policies requiring staff supervision of smoking.
The resident was unable to light his lighter himself, so the other resident went to start the lighter for him. Unfortunately, his supplemental oxygen was on and this started a flash fire, setting the residents beard and face on fire. The other resident grabbed the tubing and threw it to the ground and stomped out the fire, but it was too late.
The resident suffered superficial and deep partial thickness burns to his face, lips, and eye. Soot was found in his nasopharynx and oropharynx. He had to be intubated and placed on a ventilator and was placed under the care of a wound care physician.
There were at least failures that resulted in the injuries to this resident. The first is that the smoking risk assessments were not kept current, and the declines in the is resident’s cognitive state and ability to safely handle smoking materials was not addressed in his care plan as a result. Second the facility policies regarding supervision of smoking activities was not followed. There was no staff present. Staff would have known to make sure that the supplemental oxygen was turned off before attempting to light the resident’s cigarette. Other residents may not know that, and responsibility for that cannot be handed off from the staff to someone else. Clearly, the facility policies were no being followed as a matter of routine, much to the detriment of this resident.
One of our core beliefs is that nursing homes are built to fail due to the business model they follow and that unnecessary accidental injuries and wrongful deaths of nursing home residents are the inevitable result. Order our FREE report, Built to Fail, to learn more about why. Our experienced Chicago nursing home lawyers are ready to help you understand what happened, why, and what your rights are. Contact us to get the help you need.
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