Smoking Policies: What are the Regulations for Nursing Homes and Assisted Living Facilities?
As the last of the Baby Boomer generation begins to reach retirement age, assisted living facilities and nursing homes in Wisconsin are receiving new resident applications every month. More and more people need to live where they can enjoy their golden years and get some help with daily tasks such as cooking, cleaning, getting dressed, etc. But most importantly, they want to socialize, take part in activities, and live life with dignity.
However, the management of these living centers also has the right to set policies and procedures for the care and safety of their residents. One of the concerns of most nursing facilities regards smoking.
People have the right to smoke, don’t they? On the other hand, smoking is terrible for the health of not only the residents who smoke but to everyone around them who is breathing in their secondhand smoke!
Wisconsin’s Nursing Homes and Assisted Living Smoking Policies
Wisconsin State laws and regulations seem to change all the time, trying to balance the rights of those who smoke with the rights of non-smokers. Additionally, the safety and health of all the residents in nursing homes and assisted living centers are the healthcare workers’ responsibility and staff.
How do these facilities decide what to do about the rights of residents who smoke yet still care for everyone’s health? And how can YOU make the decision easier for them? One of the best ways to help everyone’s future is to quit smoking right now!
Reasons To Stop Smoking
Do you smoke cigars or cigarettes every day? Is your family begging you to quit? Do your children or grandchildren say that you, your breath, or your house smells bad because of the lingering smoke odor?
You already know that smoking is harmful to your health. You are aware that smoking affects your heart and lungs, and causes coronary heart disease (which is when your arteries narrow, leading to a heart attack, a stroke, or death). It can cause congestive heart failure (fluid around your heart, making it difficult to pump blood) and high blood pressure.
Smoking increases your risk of lung cancer, and others: i.e., cancer of the mouth, throat, stomach, larynx, kidney, bladder, and the pancreas.
If preventing one of those diseases hasn’t already convinced you to stop, smoking can also give you chronic diseases such as emphysema or bronchitis, and reproductive damage like impotence, abnormal sperm cells, and early menopause, as well as causing miscarriages and congenital disabilities.
Ready To Quit Smoking Yet? Wait – There’s More!
If you aren’t worried about the long-term health effects on your body, maybe you’re a bit vain regarding your looks. Here’s what happens to the outside of your body when you smoke:
- Your face becomes prematurely wrinkled and sallow. You will look older than you indeed are.
- Your fingernails, fingers, and teeth turn yellow.
- You can lose some teeth and develop gum disease.
- You may lose your sense of taste or smell.
- Your voice will get deeper and sound gravelly and raspy.
- Your ability to take a deep breath will diminish, limiting your physical activities.
- Your immune system will become weakened, which means you leave yourself susceptible to colds, flu, and other common illnesses.
Two More Reasons to Quit Smoking
If you don’t worry about your insides, and you don’t worry about your outsides, here are two more reasons why you may want to quit smoking sooner rather than later:
- Smoking is expensive! Cigarettes in Wisconsin are the 10th most expensive in the US. The average cost of a pack is $7.67. If you smoke just one pack per day, you’ll spend $233 every month – that’s nearly $2,800 every year. By the way, if you’re a cigar smoker, your expenses may be higher depending on the brand of cigar you enjoy!
- Your future! With all the health problems you may experience from smoking, as you age, you’ll likely need to live in a nursing home or assisted living facility. However, although Wisconsin State law currently gives residents of nursing homes and assisted living facilities permission to smoke outdoors, they don’t have to accept you as a resident if you do! This means you or your family will have fewer choices of where you can live if you remain a smoker.
Do you really want to do that to the people you love? Or to yourself? Are you ready to quit yet? Keep reading, and you may finally be convinced.
Quality of Care Regulation in Facilities
Under the Quality of Care regulation (42 CFR 483.25), every facility and nursing home must provide, and each resident must receive the necessary services and care to allow residents to maintain their physical, mental, and psychosocial wellbeing.
The health facility must ensure that the environment remains free of hazards and foreseeable risks of harm. The staff and volunteers must take reasonable steps to ensure that a resident receives assistance devices (walkers, handrails, etc.) and constant supervision to keep them safe. The staff must anticipate and prevent accidents to the best of their ability.
Connected to these precautions and supervision is the Wisconsin Clean Indoor Air Act (Wis. stat. 101.123). This became effective in July 2010 and now prohibits smoking inside all nursing homes and in-patient healthcare facilities, including assisted living centers. However, smoking is not currently banned outdoors. This means if a current resident wants to smoke, they have the right to do so. A safe place must be provided to them.
Smoking Policies Under Facility Care
Unfortunately, injuries from smoking can occur even when a resident is adequately supervised. Injuries may happen with a disabled or physically impaired resident or when a non-disabled resident is lighting a cigarette and accidentally drops it or the lit match. Clothes may catch on fire, and the smoker or a bystander can get injured. Sometimes these accidents result in severe burns.
Because of the potential for these kinds of accidents, nursing homes and healthcare centers have various smoking policies to address safety concerns. Wisconsin state law allows nursing homes and assisted living centers two choices:
- The facility can allow smoking only outdoors in specific, designated areas.
- The facility can identify the entire campus as non-smoking and ban tobacco use altogether.
The new policies must be clearly explained to current staff and residents, to any new or potential residents, and staff both orally and in writing.
Once a location has determined that it will be a non-smoking facility, if a potential resident admits to being a smoker during the interview process, the facility can refuse them.
New residents must agree to abide by the non-smoking policy, and if they are caught smoking, the center may ask the resident to leave. If a potential resident doesn’t feel that they can follow these smoking regulations, the facility can suggest they find another place to live. Having an explicit smoking policy helps the nursing home settle or deter any situation that may come about.
Rules for Smoking in Facilities
As mentioned above, a healthcare facility has the right to ban smoking altogether. However, there are a few reasonable restrictions and limitations related to their current residents. For example: although new residents may be prohibited from smoking, the nursing home or assisted living center must allow a current resident to continue to smoke in a designated area outside the building. The current residents do not lose their right to smoke because of a change in policy and the need for someone to assist them.
However, the facility has the right to restrict residents’ smoking to certain times of the day, outdoor locations, type of assistance offered, frequency, what they’ll do in inclement weather, etc.
Especially if the smoking area is away from the building, the nursing home or living center must continue to keep the health and safety of the residents their first responsibility.
Designated Smoking Areas
For the residents’ safety and ease of staff assistance, designated outdoor smoking areas should be easily accessible and located near the facility building. This area also needs to protect other residents and staff from secondhand smoke as well. The healthcare facility is required to provide noncombustible ashtrays and garbage cans, and oxygen tanks must never be anywhere near the smoking area – even if the smoker is the one who needs the oxygen.
With all these regulations and guidelines, you can see why a nursing home or assisted living facility would instead make their location smoke-free!
How Facilities Revise Their Policies on Smoking
A healthcare facility that allows smoking can change their policy at any time to become a non-smoking facility. These changes must be announced to residents and staff verbally and through written and posted notifications. The federal government regulation – 483.10(g)16 – states that the nursing home or care facility must receive written confirmation from each resident, their legal representative, or a family member, acknowledging their receipt of the new rules and what changes will occur regarding residents who smoke. These facilities will also often notify the residents’ families, the community, visitors, and sources of referrals regarding their smoking policy change.
The Rights of Current Residents
Guidance from Wis. Admin Code 42 CFR 483.10(f)2 states that when/if a healthcare facility or nursing home decides to change its smoking policy to prohibit smoking by staff or residents, it still needs to allow their current residents to smoke. The facility must also offer a location that maintains the quality of life for its residents who smoke.
However, residents admitted after the policy change date are restricted from smoking and must follow the new policy. Current residents are considered “grandfathered in” and can continue to smoke – albeit outdoors – because they moved into the location when smoking was allowed. This means that any assisted living facility or nursing home which currently has residents who smoke must continue providing an outdoor area for them to do so in safety and comfort – even after they become a non-smoking facility.
Help to Quit Smoking
For residents who wish to quit smoking, the healthcare facility is responsible for helping them. The assistance must include medically-related social services to maintain the wellbeing of every resident. The benefits available through Medicaid are over the counter nicotine chewing gum and patches, as well as other prescribed medications, group classes, and therapy.
Assisted living facilities and nursing homes are responsible for meeting the emotional and physical needs of all their residents. (Guidance for 42 CFR 483.40(d).) They must also accommodate each person’s choices and desires for how they want to spend their day, whether inside or outside of the building.
Villa St Francis
Villa St. Francis is a smoke-free assisted living facility. At Villa St Francis, our community is built on a foundation of caring and dignity. We respect every person’s fundamental dignity, where all feel welcome, supported, and cared for. We offer a wide variety of activities to provide educational, social, and physical opportunities to enhance our residents’ lives. We want our residents to be as happy and healthy as possible and work to help everyone become smoke-free.
Today, make a promise to yourself to quit smoking. Your family, friends, wallet, and your healthy future will thank you for it!
Are you interested in learning more about Villa St. Francis? Give us a call, and we’re happy to give you a tour and answer all your questions.