38:2 Bill 140, Long-Term Care Homes Act, 2007

Smitherman, Hon George Minister of Health and Long-Term Care

Viewing: Royal Assent (current version) pdf

Explanatory Note

Extracted from Chapter 8, Statutes of Ontario 2007.

This Explanatory Note was written as a reader’s aid to Bill 140 and does not form part of the law.  Bill 140 has been enacted as Chapter 8 of the Statutes of Ontario, 2007.

The Bill establishes a new system of governance for long-term care homes in Ontario.  It replaces the Nursing Homes Act, the Charitable Institutions Act and the Homes for the Aged and Rest Homes Act.

Part I sets out the fundamental principle that is to be applied in the interpretation of the legislation, and provides for how terms in the legislation are to be interpreted.

Part II deals with the rights of residents of long-term care homes and the care and services they are entitled to. This includes a bill of rights of residents and a requirement that every long-term care home have a mission statement.  The plan of care that must be developed for every resident is provided for.  Licensees must ensure that certain programs and services are provided.  These include programs and services related to the following:

    1.   Nursing and personal support services.

    2.   Restorative care.

    3.   Recreational and social activities.

    4.   Dietary services and hydration.

    5.   Medical services.

    6.   Information and referral assistance.

    7.   Religious and spiritual practices.

    8.   Accommodation services.

    9.   A volunteer program.

10.   Staffing and care standards.

The licensee of a long-term care home is required to protect residents from abuse and ensure that they are not neglected by the licensee or the licensee’s staff. The licensee must establish a policy to promote zero tolerance of abuse and neglect and ensure that it is complied with.

A regime for making reports and complaints is established, together with whistle-blowing protections.  Inspections and inquiries that must be made by inspectors in response to reports and complaints are provided for.

This Part contains provisions aimed at minimizing the restraining of residents, and establishing safeguards for when restraining is allowed. Residents may not be restrained for the convenience of staff or as a disciplinary measure. Such matters as transfer to a secure unit and the use of personal assistance services devices that restrict movement are dealt with.

This Part also provides for the establishment for an Office of the Long-Term Care Homes Resident and Family Adviser to assist and provide information to residents, families and others and to perform other functions.

Part III provides for how admissions to a long-term care home are dealt with.  Placement co-ordinators determine a person’s eligibility to be admitted to a long-term care home, and authorize a person’s admission to a specific home.  The placement co-ordinator can only act after certain assessments of the person, dealing with such matters as health, personal care requirements and behaviour, have been made.  Other aspects of the admissions process are provided for, including preference for veterans in certain cases.  Rights of appeal are also provided for.

Part IV deals with the Residents’ Council and Family Council of a long-term care home.  Every home must have a Residents’ Council and may have a Family Council.  The powers of these councils, such as assisting residents and advising licensees, are provided for.

Part V deals with the operation of the homes.  A wide range of matters are provided for, including:

    1.   Key staff, such as the Administrator of the home, the Director of Nursing and Personal Care, and the Medical Director. 

    2.   Staff qualifications.

    3.   Providing for continuity of care by limiting the use of temporary, casual and “agency” staff by licensees.

    4.   Screening measures for staff, including criminal reference checks.

    5.   Training of staff.

    6.   Orientation for volunteers.

    7.   Information that must be provided to residents.

    8.   Posting of information.

    9.   The regulation of certain documents.

10.   Continuous quality improvement and satisfaction surveys.

11.   Infection prevention and control and emergency plans.

12.   Reporting requirements.

Part VI deals with funding, including funding provided by the Minister for long-term care homes, and charges that licensees may make to residents. Limitations and restrictions are also imposed on non-arm’s length transactions.

Part VII deals with the licensing of long-term care homes. It is prohibited to operate residential premises where nursing care is provided except in accordance with the legislation.  (Hospitals and certain other places are exempted.)

Licences are issued by the Director based on what the Minister considers to be the public interest. Criteria are set for who is eligible to be issued a licence. The process for the issue of a licence is provided for. Licences are issued for a fixed term of up to 25 years, with a three-year notice before the end of the term as to whether a new licence will be issued.  Restrictions are placed on the transfer of licences.  Rules are established for public consultations before licences are issued, transferred, etc.  Rules are established governing the procedure for when a licensee wishes to have someone else manage the home under a “management contract”. Other related matters are also dealt with, including the exercise of security interests, changes in corporate licensees, temporary licences, temporary emergency licences and short term authorizations for additional beds.

Part VIII provides for long-term care homes established and maintained by municipalities. Most upper and single-tier municipalities in southern Ontario are required to establish homes. Large upper or single-tier municipalities in Northern Ontario are permitted to establish homes.  Provision is also made for the establishment of homes by the municipalities in a territorial district. The Minister’s approval is required for the establishment of a municipal home.  An approval has no term and cannot be revoked, but there is provision for the Director to make orders requiring renovations, etc., or to take over a home in certain cases. The Part also provides for the approval of First Nations homes.

Part IX deals with compliance and enforcement. It includes provisions for inspections of long-term care homes, and actions that may be taken when a licensee does not comply with a requirement under the legislation. Inspections are required at least once a year, and normally must be unannounced.  Inspectors are given an assortment of powers in carrying out their duties.  Actions that may be taken against licensees that are not in compliance with a requirement under the legislation are provided for. Examples of actions that can be taken are work orders and withholding of funding. The power to revoke a licence is also provided for.  Licensees against whom action has been taken have a right of appeal.

Part X deals with assorted administrative and miscellaneous areas and transitional matters.  This includes transitional provisions relating to existing nursing homes and approved charitable homes for the aged. 

Part XI provides for repeals and consequential amendments.

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