Municipal Bylaws

LONG-TERM CARE FACILITIES

Overview

The Ministry of Health and Long-Term Care (MOHLTC) describes long-term care (LTC) facilities as places that provide accommodation for people who are in need of 24-hour nursing care and supervision within a secure setting.

Long-term care facilities are owned and operated by various organizations:

• Nursing homes are normally operated by private corporations

• Municipal homes for the aged are owned by municipal councils

• Charitable homes are usually owned and operated by non-profit corporations, such as faith, community, ethnic or cultural groups

  **NOTE - Many municipalities are required to build a home for the aged in their area, either on their own or in partnership with a neighbouring municipality.

Government Regulations

There are three pieces of provincial legislation that govern long-term care facilities, including:

• Homes for the Aged and Rest Homes Act

• Nursing Home Act

• Charitable Institutions Act

The MOHLTC sets standards for care and inspects long-term care facilities annually. All facilities must post and follow a Residents’ Bill of Rights, which spells out in detail residents' rights and the responsibilities of the facility to fully respect, promote and support these rights, as well as residents' autonomy and decision-making.

Tobacco Control Act and Regulation of Long-Term Care Facilities

The Tobacco Control Act 1994 regulates any facilities that are covered by the above three acts by restricting smoking to designated smoking rooms (DSR) "if the area is identified as an area where smoking is permitted" (TCA. 1994, c. 10, s. 9.) and the prescribed criteria are met.

However, if there is a conflict with other legislation, namely a municipal by-law, the regulation more restrictive of tobacco use applies (TCA. 1994, c. 10, s 12.) In the case of municipalities that have 100% smoke-free workplace bylaws, smoking in DSRs is not permitted.

• There are currently 252 municipalities* that have smoke-free workplace and/or public place bylaws, which may or may not regulate LTC facilities in their bylaws. Click here to view a summary table of the municipalities that specifically address LTC facilities:

  • Of the 252 municipalities, there are 84 municipalities that specifically mention "long-term care facilities", "nursing homes", "homes for the aged", "homes for special care", and /or "charitable homes for the aged" and have exempted these facilities in their bylaws, thereby making the TCA the regulating act and allowing for smoking in DSRs.

  • The remaining municipalities, which do not specifically mention LTC within their bylaws, may or may not have 100% smoke-free facilities. Most defer to the TCA and allow for DSRs.

    Note: Greater Sudbury has a sunset provision, which will prohibit smoking in DSRs within LTC facilities by 05/31/04. Wellington County and Hamilton-Wentworth will prohibit smoking in DSRs by 2008.

  Smoking Policy - Office of the Fire Marshal

  There have been two Coroner’s Inquest reports issued as a result of the accidental smoking-related deaths of two residents of long-term care facilities in 2000 and 2001.

  • Cecil Clarence Randle, November 2000

  • John Wilson Inquest, May 2003

    The recommendations made in the Randle inquest gave rise to the Office of the Ontario Fire Marshal’s Smoking Policy in Long-Term Care Facilities, which lists and expands upon basic procedures required for safe smoking practices within long-term care facilities and the responsibilities of the owner/operator, staff, residents and visitors in carrying out these practices.

    With respect to DSRs, the policy recommends that residents should be supervised (by staff or by visitors - when written permission is given) while in smoking areas and be provided with clothing protection suitable for preventing the ignition of clothing by smoking materials.

  LTC Facility Workers

  In August 2001, The Workplace Safety and Insurance Board (WSIB) made the decision to compensate a Health Care Aide working in a provincially funded nursing home in Peterborough for health effects suffered as a result of being required to enter the DSR in this facility to supervise residents during smoking breaks. Contact the OCAT office for more information on this case.

  Rest or Retirement Homes

  The municipalities of Elliot Lake, Kingston, and Greater Napanee make specific mention of "retirement" and "rest homes" in their workplace bylaws and provide exemptions for these facilities. However, it is important to note that although they cater to a similar population, they are not regulated by the TCA.