The Living Centre

During an interview on 2/24/26 at 1:18 p.m., staff member G stated he did not know of any resident in the facility who used tobacco products.

Staff member G stated the facility was a tobacco-free facility, and he had never seen resident #35 with tobacco products.During an interview on 2/25/26 at 10:01 a.m., staff member F stated resident #35 uses [NAME] pouches and was not sure of their ingredients.

Staff member F looked up resident #35's physicians' orders, which showed that resident #35 had an order for nicotine replacement pouches and not tobacco pouches.

During an interview on 2/25/26 at 3:49 p.m., staff member B stated she was not sure whether resident #35 was using tobacco pouches or nicotine replacement pouches.

Staff member B looked up the [NAME] pouches on the internet and verified that the pouches were a tobacco product containing nicotine.

Staff member B stated the care plan, and his [resident #35] physician orders should reflect the tobacco product, and they did not.

Staff member B stated resident #35 was on hospice for a short time, and hospice must have allowed him the tobacco pouches as he was using ZYN nicotine replacement pouches prior.

Staff member B stated she would update the physician order and the care plan to reflect the [NAME] (tobacco) pouches instead of nicotine replacement products.

Review of resident #35's comprehensive care plan with a revision date of 1/17/25, showed: Focus: I have used chewing tobacco for many years and often crave it.Goal: I want to stop chewing tobacco and remain comfortable without cravings associated with tobacco cessation during this assessment period.Interventions: I am aware that this is a tobacco-free environment. I have agreed to use nicotine pouches to curb my nicotine cravings. My physician has given an order to allow me to use nicotine replacement products, such as pouches, as needed when I am craving tobacco.

Sometimes offering gum or hard candy will help me overcome my cravings for nicotine.Review of a facility document titled Care Plans, Comprehensive Person-Centered with a revision date of January 2026, showed: .1.

The interdisciplinary team (IDT), in conjunction with the resident and his/her family or legal representative, develops and implements a comprehensive, person-centered care plan for each resident.3.

The care plan interventions are derived from a thorough analysis of the information gathered as part of the comprehensive assessment.

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.

LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

275125 02/26/2026

The Living Centre 57 Main St Stevensville, MT 59870