Smoking Complaint – Assisted Living

This page  provides information about making a complaint regarding others smoking in assisted living residences – how to make a complaint, and what the law and the BC Human Rights Code says about smoking.

About Assisted Living Residences

Assisted living is a form of housing that combines private units in apartment-style residences with the provision of hospitality and one or two personal assistance services, such as regular assistance with activities of daily living (personal care, help with medications), or psychosocial supports (referred to as “prescribed services”).  Assisted living is meant for seniors and others who are able to direct their own care, can no longer live safely on their own and require some services, but do not require 24-hour care.  It is often seen as falling between home support and residential care on the spectrum of seniors’ care services.

Assisted living residences can be owned and operated by health authorities, non-profit groups or private companies.  Individual facilities may contain only subsidized units, only non-subsidized units or both.  Health authorities administer subsidized assisted living services.  Private companies and some non-profit groups provide non-subsidized assisted living services.

Publicly subsidized and private-pay assisted living residences that meet the definition of an assisted living residence under Community Care and Assisted Living Act (the act), are required to be registered with the provincial Assisted Living Registrar.

Information about Complaints

Assisted Living residences are required by the Ministry and the Assisted Living Registry to inform residents, staff and visitors about how to make a complaint, including:

  • how to make an internal complaint at the residence;
  • how to make a complaint to the Assisted Living Registry  (health & safety complaints);
  • how to make a complaint to the Health Authority’s Patient Care Quality Office (complaints about care); and,
  • ensuring the complaint process and contact information for the Assisted Living Registry and the Health Authority Patient Care Quality Office is readily accessible.

Health and Safety Complaints

The Assisted Living Registry (ALR) staff investigate complaints related to the health and safety of persons living in assisted living residences. Please note that this is limited to concerns and complaints about health and safety in assisted living residences.  Most other issues in non-subsidized facilities can be dealt with only by the facility operator or contracted service provider- they are treated to some extent like consumer or contract problems.

Registry staff investigate allegations about circumstances where:

  • a residence may be being operated in a way that puts the health and/or safety of residents at risk; or
  • an operator may be housing a resident who is unable to make the decisions needed to function safely in the semi-independent supportive environment of an assisted living residence.

Anyone with a concern about the health or safety of an assisted living resident can make a complaint to the registry, including: a resident, a family member, a friend of a resident, residence staff, health authority staff or a member of the public.  Complaints can be made by phone, email, fax or in writing to the registry staff.

Health and Safety Complaint Reports

The Assisted Living Registrar posts substantiated complaint information reports, following an investigation, that provide a “high level summary” of information on assisted living residences and may result in loss of registration if not remedied. These reports include the type of concern or complaint reported to the Registry, without identifying the complainant.

Smoking by other Residents

A common complaint by residents in assisted living is about smoking by other residents, staff or visitors.  Second-hand smoke seeping into your unit from neighboring units through walls, crawl spaces and light fixtures constitutes not just a significant nuisance, but also a health risk – second-hand smoke is a deadly toxin.

In BC, smoking in private and public spaces is extensively regulated.  Legislation, regulation, and regulatory policies relating to smoking in assisted living have several aspects:

  • residents’ health and safety;
  • legal protections against second-hand smoke exposure;
  • occupational health and safety laws; and,
  • human rights law.

The Assisted Living Registry (formerly known as the Office of the Assisted Living Registrar) has published standards that include the statement:

“Registrants must respect the personal decision of residents and accommodate a resident’s right to take risks, as long as the risks do not place other residents or staff in jeopardy…” (Policy 4, Section 5.1.2)

As an example of complying with this standard while mitigating risk, it refers to the operator negotiating “appropriate locations for residents to smoke.”

The combined effect of the legislation, regulations, and human rights case law appears to be[1] the following:

  1. Residents may smoke outdoors in an area that is located at least the minimum distance permitted by law from a doorway, window, or air intake of the building (3 metres unless a greater distance is prescribed by local bylaws).
  2.  An operator may, but is not required, to designate a room or rooms in an assisted living facility for “tobacco use” by residents, which must meet all applicable requirements for ventilation and protection against the escape of tobacco smoke (tightly sealed and ventilated to outdoors, or  ‘negative air pressure’ ventilation) into the rest of the facility.   Residents in assisted living are legally permitted to smoke indoors in such a designated “smoking room,” but not otherwise.
  3. If the operator does not designate any “smoking room,” residents are not legally permitted to smoke indoors, even in their own units.
  4. An operator may be on unsafe ground in completely prohibiting residents from smoking anywhere on the premises, as this arguably would amount to discrimination against heavily addicted smokers under BC’s Human Rights Code on the basis of physical disability in the provision of accommodation or services.  At the same time, however, the operator and residents must comply with all applicable laws and regulations concerning protection of others from exposure to  second-hand smoke.

Principles of Operation – ALR

The following principles guide the conduct and operations of the Assisted Living Registry:

  • protect the health and safety of residents
  • ensure fairness, transparency and accountability in administrative practices
  • value the perspectives of stakeholders — i.e., community advocates, operators, health authorities and other government agencies
  • partner with stakeholders to update the health and safety standards
  • investigate complaints using an incremental, remedial approach

[1] BC Law Institute – Consultation Paper on Assisted Living in BC