Signature Healthcare Of Terre Haute

Based on interview and record review, the facility failed to promptly revise the comprehensive care plan to reflect changes in regard to a resident's access to smoking for 1 of 4 residents reviewed for resident rights (Resident B).

Findings include:Resident B's clinical record was reviewed on 11/5/25 at 10:44 a.m.

Diagnoses included nicotine dependence and major depressive disorder.

His smoking status on his profile page included current everyday smoker. A current health care plan, dated 5/19/22 and edited 10/9/25, indicated the resident chose to smoke and was a risk for injury related to smoking.

The resident had been evaluated and was deemed a safe smoker.

Interventions included, but was not limited to, the following: resident must be at dining room door to enter courtyard on time in order to participate in supervised smoking breaks; resident will be allowed two cigarettes, or 15 minutes per smoking pass; resident will smoke in designated area in courtyard of southwest of building; smoking/tobacco material will be made available to resident by facility staff at designated smoke breaks; staff members supervising smokers must light cigarettes for resident; and smoking assessment completed at this time and resident has been deemed as a safe smoker.

During an interview on 11/5/25 at 1:46 p.m., Resident B indicated he was no longer allowed to go out at smoke breaks. He indicated he had hit another resident in the nose and was told he could no longer participate in smoke breaks.

During an interview on 11/5/25 at 2:10 p.m., the Administrator indicated Resident B lost his smoking privileges after hitting another resident.

She had spoken to him multiple times regarding his behaviors during smoke breaks.

They had reviewed the Smoking Agreement with the resident multiple times due to his crowding behaviors, and on 8/31/25, he became physical and he lost his privilege to smoke.

His care plan was not updated or the indication on his profile of him being an everyday smoker.

This should have been done following the revocation of his smoking privileges.No specific facility policy regarding care planning provided.

The facility followed CMS guidelines.This citation was in regard to intake 2655657.3.1-35(b)

Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided.

For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.

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