Smoking at home: NC Nursing home residents regain right to smoke

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Smoking ban starts for homes – It will affect all nursing homes, long-term- and adult-care homes
October 01, 2007
James Romoser and Michael Hewlett
Starting today, thousands of North Carolinians will no longer be able to smoke inside their own homes.
A new state law is taking effect that bans smoking inside all nursing homes, adult-care homes and other residential centers that provide long-term care.
The impetus for the law was a fatal fire in March at a Mocksville adult-care home that was caused by a resident smoking in her room. State Rep. Julie Howard, R-Davie, sponsored the legislation, and it passed nearly unanimously in the General Assembly.
Before the law passed, many facilities had already banned indoor smoking voluntarily, so they will not be affected. And residents of long-term-care facilities were already prohibited from smoking in their rooms under previous state regulations.
But some facilities had indoor smoking lounges, which were said to be very popular among residents who smoked. Such lounges will no longer be allowed.
Owners of adult-care homes have been preparing for the change for weeks, said Lou Wilson, the executive director of the N.C. Association of Long Term Care Facilities. Facilities are required to post no-smoking signs, and when they admit new residents, they must collect a signature from the resident or the resident’s representative acknowledging the no-smoking policy.
Operators of the homes can be fined up to $200 for violating the law.
Wilson supported the new law when it was before the legislature, but she said last week that it has been difficult for some adult-care homes to adapt to the new requirements.
“It was tough for a month or two, but the majority of them have worked through it, so we’re going to give it a good shot, try to implement it, and if we have problems, we’ll take it back to the legislature next year,” Wilson said.
Wilson and others have expressed particular concern for the new law’s effect on the sizable population of mentally ill residents who live in adult-care homes, group homes or halfway houses.
People with mental-health problems are more likely to smoke than the overall population, and experts on mental illness say that smoking is one way that those patients can relieve stress.
Wilson said that there are about 6,000 residents with mental illnesses living in adult-care homes in North Carolina.
Some owners of long-term-care facilities have also said that the smoking ban will be counterproductive, because without the availability of smoking lounges, residents will be more likely to secretly smoke in their rooms. That could create the danger of more fires, not fewer, these owners say.
State officials said that the law’s effectiveness will depend on a facility’s ability to make sure that residents are abiding by it.
“Are you going to have folks that are going to try to sneak something? Probably. But if the staff are trained and handle it appropriately, hopefully the safety won’t be compromised,” said Jeff Horton, the chief operating officer of the state’s division of health service regulation.
Under the new law, residents will still be allowed to go outside, or onto a porch or balcony, to smoke. That’s a relief for some local residents in long-term care.
Outside the Winston-Salem Rehabilitation and Healthcare Center, Mike Meadows was playing dominoes last week with employees and other residents, many of whom were smoking. A partially enclosed area at the center is the only place where people can gather and smoke.
Meadows has smoked for 40 years, and even now, in a wheelchair, he smokes a pack a day. He said he can’t imagine not being able to smoke at the center.
Bo Johnson, the center’s interim executive director, said that residents who smoke have a hard time quitting because they’ve smoked for many years.
“It’s an ongoing struggle,” he said.
David Piner, the chief executive and president of Arbor Acres United Methodist Retirement Community Inc., agreed.
“I think it is incredibly difficult … for people who have smoked for decades,” he said. “It’s very hard for people who feel they are being stigmatized and being controlled.”

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Nursing home residents regain right to smoke

Sep 06, 2006

Residents of a Greensboro nursing home system are smoking again after regulators stamped out a campus tobacco ban.

The Moses Cone Memorial Health System recently outlawed smoking on its property to improve the quality of life for people at its facilities. But a state inspection in mid-August found that tobacco-free policy did not meet federal regulations.

Moses Cone wrongfully discharged three residents because of the new smoking ban, breaking federal rules that govern the industry, said Beverly Speroff, chief of the state’s Nursing Home Licensure and Certification Section.

Residents of the extended care center argued that the facility was their home and should be exempted from the smoking ban. Many disabled residents said it was difficult to leave the property to smoke.

“They had to grant us our rights,” said Ruby Watlington, a resident at the center.

Debbie Combs-Jones, the executive director for Moses Cone Health System, said no residents were forced to leave because of the smoking ban.

“It was their choice,” she said, adding that the three residents who left have been invited to return.

The smoking ban has been relaxed. Old residents have been grandfathered into the policy and can light up in a specific courtyard, but they must remain at least 10 feet away from the building. New residents are prohibited from lighting up.

Moses Cone could be fined for the problems. The state recommended a fine of $500 per day until the issue was resolved.

The ultimate decision rests with federal regulators.