The CEO of Nova Scotia's biggest health district says she's concerned patients at the East Coast Forensic Hospital in Dartmouth will soon have a smoking area, but Chris Power says one will be created.

A smoking area is one of 18 changes the Dexter government says it will make, after the release of a report on Tuesday. It's supposed to reduce requests for one-hour passes from the hospital.

Andre Denny, a psychiatric patient, was on a one-hour pass when he was charged with murder in the death of Raymond Taavel five months ago.

Power, with the Capital Health District Authority, said it's a recommendation health officials aren't behind.

"It is one of the only recommendations in the report that we don’t support, but we recognize that if the minister directs us to do that then certainly we will do that. This is one area of concern for us, we are a health care facility; we're a hospital. We don't allow any smoking in any of our other hospitals for all the reasons that we've been through over the number of years," she said.

"This will be something that may have an impact on our staff as well as other patients and we'll need to be very thoughtful about how we make this recommendation come to pass."

The government ordered a review of policies at the hospital after Denny was charged.

Under new recommendations released Tuesday no unescorted leaves will be granted for the first 45 days after a patient arrives. A smoking area will be established on the grounds to discourage requests for one-hour leaves.

The joint review lists better tracking and more frequent assessments of forensic psychiatric patients among the 18 recommendations.

The facility has 84 beds. About 45 are occupied by people courts have found "not criminally responsible" for their actions because of a mental disorder.