March 23, 2007

To: All Nursing Home and Adult Care Home Providers

From: Jeff Horton, Chief Operating Officer

Resident Safety Regarding Smoking

There continue to be instances concerning resident smoking in nursing facilities and adult care facilities that result in fires. As a result of these fires, there have been resident deaths, several resident injuries and danger to other residents residing in the facilities. In addition, when fires occur, residents may have to be displaced from the facility they live in and moved to another facility, which can be disruptive and chaotic, especially for confused residents. The purpose of this memorandum is to alert and remind facilities of the need to provide adequate protections for residents who smoke.

Regulatory Requirements

There are a number of regulations in effect for nursing and adult care facilities that address resident safety and supervision, which would include when residents smoke.

For nursing facilities these regulations include:

For adult care homes these regulations include:

Additional Considerations

In addition to the above regulations, there are a number of factors facilities should consider regarding residents who desire to smoke. Listed below are some of these factors. Please note the below list is not all-inclusive as each situation is different and may vary according to resident and facility characteristics.

Therefore, according to NFPA-99 guidelines, smoking materials and any other source of ignition should be kept at least 15 ft. (4.3 m) away from an oxygen-enriched atmosphere such as a resident receiving oxygen via nasal canula, oxygen mask or other delivery device.

It should be noted it is not the policy of the State to discourage facilities from allowing residents to smoke. However, when residents do smoke, it is imperative that the facility consider the amount and level of supervision the resident may need for this activity and other considerations, such as a resident that smokes and who uses oxygen, that would warrant further precautionary measures be taken.

If there are further questions concerning this issue, please do not hesitate to contact (919) 855-4520 for questions related to nursing facilities and (919) 855-3784 for questions related to adult care facilities.

NC Fire Prevention Code - 2006 Edition

310.1 General. The smoking or carrying of a lighted pipe, cigar, cigarette or any other type of smoking paraphernalia or material is prohibited in the areas indicated in this section.

310.2 Prohibited areas. Smoking shall be prohibited where conditions are such as to make smoking a hazard, including areas of piers, wharves, warehouses, stores, industrial plants, institutions, schools, assembly occupancies and in spaces where combustible materials are stored or handled, except in approved designated smoking areas.

310.3 "No Smoking" signs. The code official is authorized to order the posting of “No Smoking” signs in a conspicuous location in each structure or location in which smoking is prohibited. The content, lettering, size, color and location of required “No Smoking” signs shall be approved.

310.4 Removal of signs prohibited. A posted “No Smoking” sign shall not be obscured, removed, defaced, mutilated or destroyed.

310.5 Compliance with "No Smoking" signs. Smoking shall not be permitted nor shall a person smoke, throw or deposit any lighted or smoldering substance in any place where “No Smoking” signs are posted.

310.6 Ash trays. Where smoking is permitted, suitable noncombustible ash trays or match receivers shall be provided on each table and at other appropriate locations.

310.7 Burning objects. Lighted matches, cigarettes, cigars or other burning object shall not be discarded in such a manner that could cause ignition of other combustible material.

310.8 Hazardous environmental conditions. When the code official determines that hazardous environmental conditions necessitate controlled use of smoking materials, the ignition or use of such materials in mountainous, brush-covered or forest-covered areas or other designated areas is prohibited except in approved designated smoking areas.