Montana resident caught fire from cigarette and oxygen tank, CMS asserts

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A temporarily unsupervised Montana nursing home resident burned for an estimated 10 minutes after her cigarette ignited with her oxygen tank, causing second-degree burns and the resident's eventual death, state and federal officials say. The incident was the latest in the push-pull controversy over a resident's right to smoke and safety, and how to monitor them.

Big Sky Healthcare Community in Helena received an Immediate Jeopardy citation from the Montana Department of Public Health and Human Services after an investigation of the May 1 emergency. It also said the facility did not report the incident and that staff members were unclear on the facility's smoking policies.

In a statement provided to the Helena's Independent Record newspaper, Big Sky Healthcare said it “strives to provider the highest quality of care to our residents” and noted that it had recently done well on a survey.

"Big Sky Healthcare Community promptly and directly addressed the state citation through our Quality Assurance and Performance Improvement process, which includes, but is not limited to, immediate resolution of the concern, evaluation of the root cause of the concern and ongoing monitoring to assure the issue is resolved. This established process was implemented in the case of this citation," the statement said. "Big Sky Healthcare Community, however, does not agree with the findings and is contesting the citation through the State's required process."

The resident in question had been caught smoking multiple times by staff before catching fire, according to Helena newspaper. She arrived at the facility in December and died May 24. Other residents told surveyors that those smoking were often left unsupervised, and one unnamed staff member reported that he or she thought cigarettes and lighters could be kept by the resident in his or her room.

Long-term care experts have complained about mixed messages from state and federal agencies about smoking policies, noting that it's unclear whether a resident can be denied admission due to a smoking habit.