role="main" class="main-container container js-quickedit-main-content" id="main-content">

Bill 37, Providing More Care, Protecting Seniors, and Building More Beds Act, 2021

Phillips, Rod Minister of Long-Term Care

Royal Assent received. Statutes of Ontario 2021,

chapter 39

Please select

View bill

Status

Debates

Acts affected

Royal Assent

As Amended by Standing Committee

Original

Bill 37 Royal Assent (PDF)

EXPLANATORY

NOTE

This Explanatory Note was written as a

reader’s aid to Bill 37 and does not form part of the law.

Bill 37 has been enacted as

Chapter 39 of the Statutes of Ontario, 2021.

SCHEDULE 1

FIXING LONG-TERM CARE ACT, 2021

The

Long-Term Care Homes Act, 2007 is repealed and

replaced.

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. New rights that

are provided for include the right of a resident right to have their lifestyle

and choices respected, and right to be provided with care and services based on

a palliative care philosophy. Targets are set for the hours of direct care to

be provided by personal support workers, nurses, and allied health care

professionals.

Part

III deals with quality. Every licensee of a long-term care home is required to

implement a continuous quality improvement initiative, and the Minister is

authorized to establish a Long-Term Care Quality Centre.

Part

IV provides for how admissions to a long-term care home are dealt with.

Part

V 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

VI deals with the operation of the homes. Among the changes here is the

emergency plan for a home is required to deal with epidemics and pandemics.

Part

VII deals with funding, including funding provided by the Minister for

long-term care homes, and charges that licensees may make to residents.

Part

VIII deals with the licensing of long-term care homes.

Part

IX provides for long-term care homes established and maintained by a

municipality or municipalities, or board of management that maintains a

municipal home, joint home or First Nations home.

Part

X deals with compliance and enforcement. New provisions dealing with the

suspension of licences and the powers of long-term care home supervisors are

included.

Part

XI deals with assorted administrative and miscellaneous areas.

Part

XII deals with transitional issues.

Part

XIII provides for amendments to the Act.

SCHEDULE 2

CONSEQUENTIAL AMENDMENTS

The

Schedule makes consequential amendments to various Acts to reflect the repeal

of the Long-Term Care Homes Act, 2007 and enactment

of the Fixing Long-Term Care Act, 2021 .

SCHEDULE 3

RETIREMENT HOMES ACT, 2010

The

Schedule makes several amendments to the Retirement Homes Act, 2010 . Here are some highlights:

1. The

Act is amended to require a licensee of a retirement home to make available to

any person on request information about accommodation and prices in print or

electronic form, or both.

2. Currently,

in certain circumstances, an inspector who conducts an investigation of a

retirement home under

section 77 of the Act is required to prepare a final

inspection report. An amendment to subsection 77 (14) of the Act requires the

inspector to ensure that the final inspection report does not contain personal

information or personal health information and only provides specified

information in respect of whether there has been a contravention of the Act.

3. The

Act is amended to give the Registrar the power to serve orders on a licensee in

prescribed extraordinary circumstances, if the Registrar believes on reasonable

grounds that the extraordinary circumstances have resulted or may result in harm

or a risk of harm to one or more residents.

4. Currently,

section 106 of the Act requires the Registrar to make available for public

inspection the information contained in registers established and maintained by

the Registrar. The Act is amended to allow the Registrar to withhold publishing

information in the circumstances set out in the section.

5. The

Schedule adds a new

section 108.1 to the Act allowing the Authority to require

a licensee to deliver a written communication, on behalf of the Authority, to a

resident or their substitute decision-maker.

6. The

Act is amended to allow the Authority to collect a resident or their substitute

decision-maker’s contact information from either of them or from a licensee,

for the purposes of administering the Act and regulations.

7. Other

technical and consequential amendments are made.

Bill 37 2021

Act to enact the Fixing Long-Term Care Act, 2021 and amend or repeal various

Acts

CONTENTS

Contents

of this Act

Commencement

Short

title

Schedule 1

Fixing

Long-term Care Act, 2021

Schedule 2

Consequential

Amendments

Schedule 3

Retirement

Homes Act, 2010

Her

Majesty, by and with the advice and consent of the Legislative Assembly of the

Province of Ontario, enacts as follows:

Contents

of this Act

1 This Act consists of this section, sections 2

and 3 and the Schedules to this Act.

Commencement

(1) Subject to subsections (2) and

(3), this Act comes into force on the day it receives Royal Assent.

(2) The

Schedules to this Act come into force as provided in each Schedule.

(3) If

a

Schedule to this Act provides that any provisions are to come into force on a

day to be named by proclamation of the Lieutenant Governor, a proclamation may

apply to one or more of those provisions, and proclamations may be issued at

different times with respect to any of those provisions.

Short

title

3 The

short title of this Act is the Providing More Care, Protecting Seniors, and Building More Beds

Act, 2021 .

SCHEDULE 1

FIXING LONG-TERM CARE ACT, 2021

CONTENTS

Preamble

PART I

FUNDAMENTAL PRINCIPLE AND

INTERPRETATION

Home:

the fundamental principle

Interpretation

PART II

RESIDENTS: RIGHTS, CARE AND SERVICES

Residents’ Bill of Rights

Residents’

Bill of Rights

Mission Statement

Mission

statement

Safe and Secure Home

to be safe, secure environment

Plan

of Care

Plan

of care

Consent

Care and Services

Direct

hours of care target — personal support workers, nurses

Direct

hours of care target — allied health care professionals

Measuring

progress

Nursing

and personal support services

Palliative

care

Restorative

care

Recreational

and social activities

Dietary

services and hydration

Medical

services

Information

and referral assistance

Religious

and spiritual practices

Accommodation

services

Volunteer

program

Staffing

and care standards

Standards

for programs and services

Infection

prevention and control program

Prevention of Abuse and Neglect

Duty

to protect

Policy

to promote zero tolerance

Reporting and Complaints

Complaints

procedure — licensee

Licensee

must investigate, respond and act

Reporting

certain matters to Director

Inspections

or inquiries where information received by Director

Whistle-blowing

protection

Complaint

to Ontario Labour Relations Board

Obstruction

— information to inspectors, Director

Minimizing of Restraining

Policy

to minimize restraining of residents, etc.

Protection

from certain restraining

Restraining

by physical devices

PASDs

that limit or inhibit movement

Records

on restraining of residents

Prohibited

devices that limit movement

Common

law duty

Office of the Long-Term Care

Homes Resident and Family Adviser

Office

of the Long-Term Care Homes Resident and Family Adviser

Regulations

Regulations

PART III

QUALITY

Continuous

quality improvement

Resident

and Family/Caregiver Experience Survey

Long-Term

Care Quality Centre

Regulations

PART IV

ADMISSION OF RESIDENTS

Application

Part

Designation

of placement co-ordinators

Placement

co-ordinator to comply with Act, etc.

Requirements

for admission to home

Eligibility

for long-term care home admission

Authorization

for admission to a home

Elements

of consent

Substitute

decision-maker may apply for person

Transfer

of application

Controls

on licensee

Suspension

of admissions where risk of harm

Preference

for veterans

Immunity

— placement co-ordinator’s employees and agents

Hearing

— ineligibility

Appeal

to Divisional Court

Regulations

PART V

COUNCILS

Residents’ Council

Residents’

Council

Powers

of Residents’ Council

Residents’

Council assistant

Family

Council

Family

Council

Powers

of Family Council

Family

Council assistant

General

Licensee

to co-operate with and assist Councils

Licensee

duty to meet with Council

Attendance

at meetings — licensees, staff, etc.

interference by licensee

Immunity

— Council members, assistants

Duty

of licensee to consult Councils

Regulations

PART VI

OPERATION OF HOMES

Directors, Officers and Other Staff

Duties

of directors and officers of a corporation

Administrator

Director

of Nursing and Personal Care

Medical

Director

Staff

qualifications

Continuity

of care — limit on temporary, casual or agency staff

Screening

measures

Training

Orientation

for volunteers

Residents — Information, Agreements, etc.

Information

for residents, etc.

Posting

of information

Regulated

documents for resident

Voidable

agreements

Agreement

cannot prevent withdrawal of consent, etc.

Coercion

prohibited

General Management

Emergency

plans

Reports

Regulations

Regulations

PART VII

FUNDING

Funding

Resident

charges

Accounts

and records

Non-arm’s

length transactions, limitation

Regulations

PART VIII

LICENSING

Licence

required

Public

interest — need

Public

interest — who can be issued a licence

Limitations

on eligibility for licence

Issue

of licence

Undertaking

to issue licence

Conditions

of licence

Term

of licence

End

of term

Beds

allowed under licence

Transfers,

limitation

Public

consultation

Exercise

of security interests

Notice

Gaining

controlling interest

Management

contracts

Temporary

licences

Temporary

emergency licences

Amendments

with consent

Competitive

process

appeal

Review

by Minister

Regulations

PART IX

MUNICIPAL HOMES AND FIRST NATIONS HOMES

Interpretation

Interpretation

Southern

Homes

Southern

municipal homes

Joint

homes — south

Agreement

to help maintain home — south

Northern

Homes

Northern

municipal homes

Joint

homes — north

Agreement

to help maintain home — north

Territorial

district home under board of management

Operating

costs — apportionment by board of management

Capital

costs — apportionment by board of management

Regulations,

apportionments by boards of management

First Nations Homes

First

Nations homes

General

Approval

required

Application

Part VIII

Committee

of management, appointment

Trust

funds

Personal

information, disclosure to inspectors, etc.

Director

may make orders re renovations, etc.

Director

may take control with consent

Taking

control on certain grounds

Provisional

exercise of power without hearing

Powers

where control is taken

Regulations

PART X

COMPLIANCE AND ENFORCEMENT

Inspections

Appointment

of inspectors

Purpose

of inspection

Annual

inspection

Inspections

unannounced

Meeting

with councils

Powers

of entry

Powers

on inspection

Warrant

Inspection

report

Obstruction,

etc.

Enforcement

Actions

by inspector if non-compliance found

Compliance

orders

Order

that funding be returned or withheld

Order

requiring management

Notice

of administrative penalty

Suspension

or revocation

Supervisor,

rules relating to employees

Minister’s

suspension

Due

diligence, mistake do not prevent orders or penalties

More

than one order or notice

Enforcement

under other Acts

Order

or notice not a bar to conviction

Form

and service of orders and notices

Filing

with court

Offence

Reviews and Appeals

Review

of inspector’s order or notice

Appeal

from order, notice, decision

When

and how appeal to be made

automatic stay of order or decision

Parties

Hearing

Decision

of Appeal Board

Appeal

to court

Funding

not to be considered

Miscellaneous and Access to Information

Recognition

Publication

Reports,

etc., to be public

Copy

constitutes evidence

Compellability,

civil suit

Regulations

PART XI

ADMINISTRATION, MISCELLANEOUS

Directives

by Minister

Director

— appointment

Altering

or revoking orders

Personal

information, collection

Restriction

on terms

Affidavits

Service

Immunity

Penalties

Regulations

Public

consultation before making initial regulations

Amendments

General

provisions re regulations

PART XII

TRANSITIONAL

Transitional

— compliance

Transitional

— interim manager

Transition,

licences

Transition,

municipal homes

Further

transitional, Charitable Institutions Act

Further

transitional, Homes for the Aged and Rest Homes Act

PART XIII

AMENDMENTS TO THIS ACT

Amendments

to this Act

PART XIV

REPEAL

Repeal

PART XV

COMMENCEMENT AND

SHORT TITLE

Commencement

Short

title

Preamble

The people of Ontario and their Government:

Recognize

that long-term care services and care must respect resident diversity and

diversity in communities;

Respect

the requirements of the French Language Services Act

in the planning, design, delivery and evaluation of long-term care services for

Ontario’s French-speaking communities;

Recognize

the role of Indigenous peoples in the planning, design, delivery, and

evaluation of culturally safe long-term care services and care in their communities;

Acknowledge

that long-term care residents have diverse and complex physical and mental

health needs that require individual, proactive, efficient, and effective

supports;

Are

committed to resident-directed, safe, quality care that responds to a resident’s

physical, psychological, emotional, social, spiritual and cultural goals and

needs and is respectful of every resident’s individual identity and history;

Are

committed to providing and promoting high quality accommodation in a safe,

comfortable, home-like environment where every long-term care resident has an

ability to enjoy life, and pursue the relationships, activities and interests

that are meaningful to them;

Acknowledge

that a resident’s health and quality of life depend on integration and collaboration

between an ecosystem of people, including fellow residents, family members,

caregivers, long-term care home staff, volunteers, service providers, community

and government;

Recognize

the importance of caregivers in supporting a resident’s physical, mental,

social and emotional well-being and quality of life;

Are

committed to having a diverse, qualified, and empowered workforce that is

respected and supported by effective leadership to meet the individual and

diverse needs of residents;

Share

a vision for a province where excellent long-term care services and care are

available to all Ontarians who require it and where residents and their

families have trust and confidence in their long-term care home;

Affirm

their belief that long-term care homes must be governed and operated in a way

that reflects the interest of the public, and promote effective and efficient

delivery of high-quality care and services to all residents;

Are

committed to improving public accountability and transparency, through robust

and regular inspections and progressive enforcement actions;

Affirm

our responsibility to take action where standards or requirements under this

Act are not being met, or where the care, safety, security and rights of

residents might be or are compromised;

Recognize

the importance of fostering an environment that supports continuous quality

improvement and innovation;

Recognize

the value of transparency from government, long-term care home licensees, staff

and service providers with residents and their families;

Acknowledge

that relevant information and data about long-term care homes should be

accessible to the public in a timely manner;

Recognize

the principle that access to long-term care homes is based on prospective

residents’ assessed needs;

Are

committed to the promotion of the delivery of long-term care home services by

not-for-profit and mission-driven organizations; and

Are

committed to all long-term care homes operating as mission-driven organizations

that have resident-directed, safe, quality care as the primary goal.

PART I

FUNDAMENTAL PRINCIPLE AND

INTERPRETATION

Home:

the fundamental principle

1 The fundamental principle to be applied in the

interpretation of this Act and anything required or permitted under this Act is

that a long-term care home is primarily the home of its residents and is to be

operated so that it is a place where they may live with dignity and in

security, safety and comfort and have their physical, psychological, social,

spiritual and cultural needs adequately met.

Interpretation

(1) In this Act,

“abuse”,

in relation to a resident, means physical, sexual, emotional, verbal or

financial abuse, as defined in the regulations in each case; (“mauvais

traitements”)

“Administrator”,

in relation to a long-term care home, means the Administrator for the home

required under

section 76; (“administrateur du foyer”)

“Agency”

means the corporation continued by

section 3 of the Connecting

Care Act, 2019 ; (“Agence”)

“Appeal

Board” means the Health Services Appeal and Review Board under the Ministry of Health and Long-Term Care Appeal and Review Boards

Act, 1998 ; (“Commission d’appel”)

“care”

includes treatment and interventions; (“soins”)

“Director”

means the person appointed under

section 185 as the Director and, where more

than one person has been appointed, means the person who is the Director for

the purposes of the provision in which the term appears; (“directeur”)

“Director

of Nursing and Personal Care”, in relation to a long-term care home, means the

Director of Nursing and Personal Care for the home required under

section 77;

(“directeur des soins infirmiers et des soins personnels”)

“fundamental

principle” means the fundamental principle set out in

section 1; (“principe

fondamental”)

“incapable”

means unable to understand the information that is relevant to making a

decision concerning the subject matter or unable to appreciate the reasonably

foreseeable consequences of a decision or a lack of decision; (“incapable”)

“intervention”

means an action, procedure or activity designed to achieve an outcome to a

condition or a diagnosis; (“intervention”)

“licensee”

means the holder of a licence issued under this Act, and includes the

municipality or municipalities or board of management that maintains a

municipal home, joint home or First Nations home approved under

Part IX;

(“titulaire de permis”)

“local

health integration network” means a local health integration network as defined

section 2 of the Local Health System Integration Act,

2006 ; (“réseau local d’intégration des services de santé”)

“long-term

care home” means a place that is licensed as a long-term care home under this

Act, and includes a municipal home, joint home or First Nations home approved

under

Part IX; (“foyer de soins de longue durée”)

“Minister”

means the Minister of Long-Term Care, or, if the responsibility for the

administration of this Act has been assigned to another Minister under the Executive Council Act , that Minister; (“ministre”)

“Ministry”

means the Ministry over which the Minister presides; (“ministère”)

“physician”

means a member of the College of Physicians and Surgeons of Ontario;

(“médecin”)

“registered

nurse” means a member of the College of Nurses of Ontario who holds a

certificate of registration as a registered nurse under the Nursing Act, 1991 ; (“infirmière autorisée” or “infirmier

autorisé”)

“registered

nurse in the extended class” means a registered nurse who holds an extended

certificate of registration under the Nursing Act, 1991 ;

(“infirmière autorisée ou infirmier autorisé de la catégorie supérieure”)

“registered

practical nurse” means a member of the College of Nurses of Ontario who holds a

certificate of registration as a registered practical nurse under the Nursing Act, 1991 ; (“infirmière auxiliaire autorisée” or

“infirmier auxiliaire autorisé”)

“requirement

under this Act” means a requirement contained in this Act, in the regulations,

or in an order or agreement made under this Act, and includes a condition of a

licence under

Part VIII or an approval under

Part IX, a condition to which

funding is subject under

section 93 and, subject to subsection 184 (7), an

operational or policy directive issued by the Minister under

section 184;

(“exigence que prévoit la présente loi”)

“resident”

means a person admitted to and living in a long-term care home; (“résident”)

“Residents’

Bill of Rights” means the list of rights of residents set out in

section 3;

(“déclaration des droits des résidents”)

“rights

adviser” means a person designated by or in accordance with the regulations as

a rights adviser; (“conseiller en matière de droits”)

“spouse”

means,

(

a) a

spouse as defined in

section 1 of the Family Law Act ,

(

b) either

of two persons who live together in a conjugal relationship outside marriage;

(“conjoint”)

“staff”,

in relation to a long-term care home, means persons who work at the home,

(

a) as

employees of the licensee,

(

b) pursuant

to a contract or agreement with the licensee, or

(

c) pursuant

to a contract or agreement between the licensee and an employment agency or

other third party; (“personnel”)

“substitute

decision-maker” means a person who is authorized under the Health Care Consent Act, 1996 or the Substitute Decisions Act, 1992 to give or refuse consent

or make a decision, on behalf of another person; (“mandataire spécial”)

“volunteer”

means a person who is part of the organized volunteer program of the long-term

care home under

section 20 and who does not receive a wage or salary for the

services or work provided for that program. (“bénévole”)

Meaning

of “explain”

(2) A

rights adviser or other person whom this Act requires to explain a matter

directly to a resident or an applicant for admission to a long-term care home

satisfies that requirement by explaining the matter to the best of their

ability and in a manner that addresses the special needs of the person

receiving the explanation, whether that person understands it or not.

PART II

RESIDENTS: RIGHTS, CARE AND SERVICES

Residents’

Bill of Rights

Residents’

Bill of Rights

(1) Every licensee of a long-term

care home shall ensure that the following rights of residents are fully

respected and promoted:

Right

to be treated with respect

1. Every

resident has the right to be treated with courtesy and respect and in a way

that fully recognizes the resident’s inherent dignity, worth and individuality,

regardless of their race, ancestry, place of origin, colour, ethnic origin,

citizenship, creed, sex, sexual orientation, gender identity, gender

expression, age, marital status, family status or disability.

2. Every

resident has the right to have their lifestyle and choices respected.

3. Every

resident has the right to have their participation in decision-making

respected.

Right

to freedom from abuse and neglect

4. Every

resident has the right to freedom from abuse.

5. Every

resident has the right to freedom from neglect by the licensee and staff.

Right

to an Optimal Quality of Life

6. Every

resident has the right to communicate in confidence, receive visitors of their

choice and consult in private with any person without interference.

7. Every

resident has the right to form friendships and relationships and to participate

in the life of the long-term care home.

8. Every

resident has the right to share a room with another resident according to their

mutual wishes, if appropriate accommodation is available.

9. Every

resident has the right to meet privately with their spouse or another person in

a room that assures privacy.

10. Every

resident has the right to pursue social, cultural, religious, spiritual and

other interests, to develop their potential and to be given reasonable

assistance by the licensee to pursue these interests and to develop their

potential.

11. Every

resident has the right to live in a safe and clean environment.

12. Every

resident has the right to be given access to protected outdoor areas in order

to enjoy outdoor activity unless the physical setting makes this impossible.

13. Every

resident has the right to keep and display personal possessions, pictures and

furnishings in their room subject to safety requirements and the rights of

other residents.

14. Every

resident has the right to manage their own financial affairs unless the

resident lacks the legal capacity to do so.

15. Every

resident has the right to exercise the rights of a citizen .

Right

to quality care and self-determination

16. Every

resident has the right to proper accommodation, nutrition, care and services

consistent with their needs.

17. Every

resident has the right to be told both who is responsible for and who is

providing the resident’s direct care.

18. Every

resident has the right to be afforded privacy in treatment and in caring for

their personal needs.

19. Every

resident has the right to,

i. participate

fully in the development, implementation, review and revision of their plan of

care,

ii. give

or refuse consent to any treatment, care or services for which their consent is

required by law and to be informed of the consequences of giving or refusing

consent,

iii. participate

fully in making any decision concerning any aspect of their care, including any

decision concerning their admission, discharge or transfer to or from a

long-term care home and to obtain an independent opinion with regard to any of

those matters, and

iv. have

their personal health information within the meaning of the Personal Health Information Protection Act, 2004 kept

confidential in accordance with that Act, and to have access to their records

of personal health information, including their plan of care, in accordance

with that Act.

20. Every

resident has a right to ongoing and safe support from their caregivers to

support their physical, mental, social and emotional wellbeing and their

quality of life and to assistance in contacting a caregiver or other person to

support their needs.

21. Every

resident has the right to have any friend, family member, caregiver or other

person of importance to the resident attend any meeting with the licensee or

the staff of the home.

22. Every

resident has the right to designate a person to receive information concerning

any transfer or any hospitalization of the resident and to have that person

receive that information immediately.

23. Every

resident has the right to receive care and assistance towards independence

based on a restorative care philosophy to maximize independence to the greatest

extent possible.

24. Every

resident has the right not to be restrained, except in the limited

circumstances provided for under this Act and subject to the requirements

provided for under this Act.

25. Every

resident has the right to be provided with care and services based on a

palliative care philosophy.

26. Every

resident who is dying or who is very ill has the right to have family and

friends present 24 hours per day.

Right

to be informed, participate, and make a complaint

27. Every

resident has the right to be informed in writing of any law, rule or policy

affecting services provided to the resident and of the procedures for

initiating complaints.

28. Every

resident has the right to participate in the Residents’ Council.

29. Every

resident has the right to raise concerns or recommend changes in policies and

services on behalf of themself or others to the following persons and

organizations without interference and without fear of coercion, discrimination

or reprisal, whether directed at the resident or anyone else:

i. the

Residents’ Council.

ii. the

Family Council.

iii. the

licensee, and, if the licensee is a corporation, the directors and officers of

the corporation, and, in the case of a home approved under

Part IX, a member of

the committee of management for the home under

section 135 or of the board of

management for the home under

section 128 or 132.

iv. staff

members.

v. government

officials.

vi. any

other person inside or outside the long-term care home.

Further

guide to

interpretation

(2) Without

restricting the generality of the fundamental principle, the following are to

be interpreted so as to advance the objective that a resident’s rights set out

in subsection (1) are respected:

1. This

Act and the regulations.

2. Any

agreement entered into between a licensee and the Crown or an agent of the

Crown.

3. Any

agreement entered into between a licensee and a resident or the resident’s

substitute decision-maker.

Enforcement

by the resident

(3) A

resident may enforce the Residents’ Bill of Rights against the licensee as

though the resident and the licensee had entered into a contract under which

the licensee had agreed to fully respect and promote all of the rights set out

in the Residents’ Bill of Rights.

Regulations

(4) The

Lieutenant Governor in Council may make regulations governing how rights set

out in the Residents’ Bill of Rights shall be respected and promoted by the

licensee.

Mission

Statement

Mission

statement

(1) Every licensee shall ensure

that,

(

a) there

is a mission statement for each of the licensee’s long-term care homes that

sets out the principles, purpose and philosophy of care of the home;

(

b) the

principles, purpose and philosophy of care set out in the mission statement are

driven by the primary goal of providing quality care that is resident-directed

and safe; and

(

c) the

principles, purpose and philosophy of care set out in the mission statement are

put into practice in the day-to-day operation of the long-term care home.

Basic

consistency

(2) The

licensee shall ensure that the mission statement is consistent with the

fundamental principle and the Residents’ Bill of Rights.

Collaboration

(3) The

licensee shall ensure that the mission statement is developed, and revised as

necessary, in collaboration with the Residents’ Council and the Family Council,

if any, and shall invite the staff of the long-term care home and volunteers to

participate.

Updating

(4) At

least once every five years after a mission statement is developed, the

licensee shall consult with the Residents’ Council and the Family Council, if

any, as to whether revisions are required, and shall invite the staff of the

long-term care home and volunteers to participate.

Safe

and Secure Home

to be safe, secure environment

5 Every licensee of a long-term care home shall

ensure that the home is a safe and secure environment for its residents.

Plan of Care

Plan

of care

(1) Every licensee of a long-term

care home shall ensure that there is a written plan of care for each resident

that sets out,

(

a) the

planned care for the resident;

(

b) the

goals the care is intended to achieve;

(

c) clear

directions to staff and others who provide direct care to the resident; and

(

d) any

other requirements provided for in the regulations.

Based

on assessment of resident

(2) The

licensee shall ensure that the care set out in the plan of care is based on an

assessment of the resident and on the needs and preferences of that resident.

Plan

to cover all aspects of care

(3) The

licensee shall ensure that the plan of care covers all aspects of care,

including medical, nursing, personal support, mental health, nutritional,

dietary, recreational, social, palliative, restorative, religious and spiritual

care.

Integration

of assessments, care

(4) The

licensee shall ensure that the staff and others involved in the different

aspects of care of the resident collaborate with each other,

(

a) in

the assessment of the resident so that their assessments are integrated and are

consistent with and complement each other; and

(

b) in

the development and implementation of the plan of care so that the different

aspects of care are integrated and are consistent with and complement each

other.

Involvement

of resident, etc.

(5) The

licensee shall ensure that the resident, the resident’s substitute

decision-maker, if any, and any other persons designated by the resident or

substitute decision-maker are given an opportunity to participate fully in the

development and implementation of the resident’s plan of care.

Development

of initial plan of care

(6) When

a resident is admitted to a long-term care home, the licensee shall, within the

times provided for in the regulations, ensure that the resident is assessed and

an initial plan of care developed based on that assessment and on the

assessment, reassessments and information provided by the placement

co-ordinator under

section 51.

Duty

of licensee to comply with plan

(7) The

licensee shall ensure that the care set out in the plan of care is provided to

the resident as specified in the plan.

Staff

and others to be kept aware

(8) The

licensee shall ensure that the staff and others who provide direct care to a

resident are kept aware of the contents of the resident’s plan of care and have

convenient and immediate access to it.

Documentation

(9) The

licensee shall ensure that the following are documented:

1. The

provision of the care set out in the plan of care.

2. The

outcomes of the care set out in the plan of care.

3. The

effectiveness of the plan of care.

When

reassessment, revision is required

(10) The

licensee shall ensure that the resident is reassessed and the plan of care

reviewed and revised at least every six months and at any other time when,

(

a) a

goal in the plan is met;

(

b) the

resident’s care needs change or care set out in the plan is no longer

necessary; or

(

c) care

set out in the plan has not been effective.

Reassessment,

revision

(11) When

a resident is reassessed and the plan of care reviewed and revised,

(a) subsections

(4) and (5) apply, with necessary modifications, with respect to the

reassessment and revision; and

(

b) if

the plan of care is being revised because care set out in the plan has not been

effective, the licensee shall ensure that different approaches are considered

in the revision of the plan of care.

Explanation

of plan

(12) The

licensee shall ensure that the resident, the resident’s substitute

decision-maker, if any, and any other persons designated by the resident or

substitute decision-maker are given an explanation of the plan of care.

Limitation

on disclosure

(13) Subsection

(12) does not require the disclosure of information if access to a record of

the information could be refused under the Personal Health

Information Protection Act, 2004 .

Access

to plan

(14) Nothing

in this

section limits a right of access to a plan of care under the Personal Health Information Protection Act, 2004 .

Consent

7 Nothing in this Act authorizes a licensee to

assess a resident’s requirements without the resident’s consent or to provide

care or services to a resident without the resident’s consent.

Care and Services

Direct

hours of care target — personal support workers, nurses

(1) This

section establishes a

target for the average number of hours of direct care to residents to be

provided by individuals who are hired by or otherwise work for licensees in a

long-term care home as personal support workers, registered nurses, or

registered practical nurses.

Target

(2) The

target is for an average of four hours of direct care to be provided per

resident per day.

Target

date

(3) The

target set in subsection (2) must be achieved no later than March 31, 2025, and

once achieved, shall continue at that level, subject to subsection (5).

Periodic

increase towards target

(4) The

following periodic increases towards the target must also be achieved:

1. An

average of three hours of direct care to be provided per resident per day no

later than March 31, 2022.

2. An

average of three hours and 15 minutes of direct care to be provided per resident

per day no later than March 31, 2023.

3. An

average of three hours and 42 minutes of direct care to be provided per

resident per day no later than March 31, 2024.

Additional

targets

(5) To

further the purposes of this section, additional targets that are higher than

those set out in subsections (2) and (4) may be established by regulation, and

such a regulation, if made, may also set dates by which the higher targets must

be achieved.

Required

to comply

(6) Despite

subsection (5), the regulation may not remove or amend the requirement to

comply with the targets and achievement dates established under subsections

(2), (3) and (4).

How

average calculated

(7) The

average is to be determined by taking the total number of hours of direct care

actually worked by registered nurses, registered practical nurses and personal

support workers in all long-term care homes, and dividing that number by the

total number of resident days in all long-term care homes for the applicable

calculation period provided for in the regulations.

Direct

hours of care target — allied health care professionals

(1) This

section establishes a

target for the average number of hours of direct care to residents to be

provided by allied health care professionals.

Target

(2) The

target is for an average of 36 minutes of direct care to be provided per

resident per day.

When

to be achieved

(3) The

target set in subsection (2) must be achieved no later than March 31, 2023,

and, once achieved, shall continue at that level, subject to subsection (5).

Increase

towards target

(4) An

increase towards a target of an average of 33 minutes of direct care to be

provided per resident per day must also be achieved no later than March 31,

Additional

targets

(5) To

further the purposes of this section, additional targets that are higher than

those set out in subsections (2) and (4) may be established by regulation, and

such a regulation, if made, may also set a date by which the excess target time

must be achieved.

Required

to comply

(6) Despite

section (5), the regulation may not remove or amend the requirement to comply

with the targets and achievement dates established under subsections (2), (3)

and (4).

How

average calculated

(7) The

average is to be determined by taking the total number of hours of direct care

actually worked by allied health care professionals in all long-term care

homes, and dividing that number by the total number of resident days in all

long-term care homes for the applicable calculation period provided for in the

regulations.

Measuring

progress

(1) The Minister shall assess, and

publicly report, before the achievement date of the next target in subsection 8

(4), the progress that is being made or that has been made towards achieving

the targets set out in sections 8 and 9 on an annual basis.

Assessment

(2) For

the purposes of subsection (1), the Minister shall assess whether there are

barriers or risks to achieving the targets and shall consider mitigations to

the barriers and risks.

Dates

(3) For

the purposes of subsection (1), the Minister shall annually assess the progress

that is being made or has been made towards achieving the targets no later than

six months after the end of every fiscal year of the Government of Ontario.

Failure

to achieve a target

(4) If

a target set out in this Part or under the regulations is not achieved, the

Minister shall,

(

a) identify

the reasons for the failure to achieve the targets, including any barriers and

risks; and

(

b) develop

and include a plan that specifies the measures that were implemented to achieve

the target and the reasons for the failure to do so, and that contains proposed

strategies to assist in achieving the target, or proposed steps to be taken to

assist in achieving the target.

How

subs. (4) requirements met

(5) The

requirements under subsection (4) may be satisfied concurrently with the

reporting requirements under subsections (1) and (3), or may be completed after

the public reporting in subsection (1), but in any event, must be completed and

made publicly available no later than six months after the end of the fiscal

year of the Government of Ontario.

Consultation

(6) For

the purposes of subsection (4), the Minister may consult with individuals or

organizations that may have an interest in the target.

Nursing

and personal support services

(1) Every licensee of a long-term

care home shall ensure that there is,

(

a) an

organized program of nursing services for the home to meet the assessed needs

of the residents; and

(

b) an

organized program of personal support services for the home to meet the

assessed needs of the residents.

Personal

support services

(2) In

clause (1) (b),

“personal

support services” means services to assist with the activities of daily living,

including personal hygiene services, and includes supervision in carrying out

those activities.

24-hour

nursing care

(3) Every

licensee of a long-term care home shall ensure that at least one registered

nurse who is both an employee of the licensee and a member of the regular

nursing staff of the home is on duty and present in the home at all times,

except as provided for in the regulations.

Same,

Administrator and Director of Nursing and Personal Care

(4) During

the hours that an Administrator or Director of Nursing and Personal Care works

in that capacity, they shall not be considered to be a registered nurse on duty

and present in the long-term care home for the purposes of subsection (3),

except as provided for in the regulations.

Palliative

care

(1) Every licensee of a long-term

care home shall ensure that, subject to

section 7, residents are provided with

care or services that integrate a palliative care philosophy.

Matters

in regulations

(2) Without

restricting the generality of subsection (1), every licensee shall comply with

the regulations respecting palliative care and the palliative care philosophy.

Restorative

care

(1) Every licensee of a long-term

care home shall ensure that there is an organized interdisciplinary program

with a restorative care philosophy that,

(

a) promotes

and maximizes independence; and

(

b) where

relevant to the resident’s assessed care needs, includes, but is not limited

to, care or services that address psychosocial needs and physiotherapy and

other therapy services, any of which may be either arranged or provided by the

licensee.

Certain

cases

(2) Without

restricting the generality of subsection (1), the program shall include

services for residents with cognitive impairments and residents who are unable

to leave their rooms.

Recreational

and social activities

(1) Every licensee of a long-term

care home shall ensure that there is an organized program of recreational and

social activities for the home to meet the interests of the residents.

Certain

cases

(2) Without

restricting the generality of subsection (1), the program shall include

services for residents with cognitive impairments, and residents who are unable

to leave their rooms.

Dietary

services and hydration

(1) Every licensee of a long-term

care home shall ensure that there is,

(

a) an

organized program of nutritional care and dietary services for the home to meet

the daily nutrition needs of the residents; and

(

b) an

organized program of hydration for the home to meet the hydration needs of

residents.

Same

(2) Without

restricting the generality of subsection (1), every licensee shall ensure that

residents are provided with food and fluids that are safe, adequate in

quantity, nutritious and varied.

Medical

services

16 Every licensee of a long-term care home shall

ensure that there is an organized program of medical services for the home.

Information

and referral assistance

(1) Every licensee of a long-term

care home shall ensure that residents are provided with information and

assistance in obtaining goods, services and equipment that are relevant to the

residents’ health care needs but are not provided by the licensee.

Clarification

of extent of assistance

(2) The

information and assistance required under subsection (1) does not include

financial assistance.

Religious

and spiritual practices

18 Every licensee of a long-term care home shall

ensure that there is an organized program for the home to ensure that residents

are given reasonable opportunity to practise their religious and spiritual

beliefs, and to observe the requirements of those beliefs.

Accommodation

services

(1) Every licensee of a long-term

care home shall ensure that,

(

a) there

is an organized program of housekeeping for the home;

(

b) there

is an organized program of laundry services for the home to meet the linen and

personal clothing needs of the residents; and

(

c) there

is an organized program of maintenance services for the home.

Specific

duties re cleanliness and repair

(2) Every

licensee of a long-term care home shall ensure that,

(

a) the

home, furnishings and equipment are kept clean and sanitary;

(

b) each

resident’s linen and personal clothing is collected, sorted, cleaned and

delivered; and

(

c) the

home, furnishings and equipment are maintained in a safe condition and in a good

state of repair.

Volunteer

program

(1) Every licensee of a long-term

care home shall ensure that there is an organized volunteer program for the

home that encourages and supports the participation of volunteers in the lives

and activities of residents.

be included in program

(2) The

volunteer program must include measures to encourage and support the

participation of volunteers as may be further provided for in the regulations.

Staffing

and care standards

21 Every licensee of a long-term care home shall

ensure that the home meets the staffing and care standards provided for in the

regulations.

Standards

for programs and services

(1) Every licensee shall ensure that

the programs required under sections 11 to 20, the services provided under those

programs and anything else required under those sections comply with any

standards or requirements, including outcome measures, provided for in the

regulations.

Matters

included

(2) Without

restricting the generality of subsection (1), every licensee shall comply with

the regulations made under paragraph 14 of subsection 193 (2).

Infection

prevention and control program

(1) Every licensee of a long-term

care home shall ensure that there is an infection prevention and control

program for the home.

Requirements

of program

(2) The

infection prevention and control program must include,

(

a) evidence-based

policies and procedures;

(

b) an

educational component in respect of infection prevention and control for staff,

residents, volunteers and caregivers;

(

c) daily

monitoring to detect the presence of infection in residents of the long-term

care home;

(

d) measures

to prevent the transmission of infections;

(

e) a

hand hygiene program; and

(

f) any

additional matters provided for in the regulations.

Standards

and requirements

(3) The

licensee shall ensure that the infection prevention and control program and

what is provided for under that program, including the matters required under

subsection (2), comply with any standards and requirements, including required

outcomes and accountability measures, provided for in the regulations.

Infection

prevention and control lead

(4) Except

as provided for in the regulations, every licensee of a long-term care home

shall ensure that the home has an infection prevention and control lead whose

primary responsibility is the home’s infection prevention and control program.

Qualifications

(5) Every

licensee of a long-term care home shall ensure that the infection prevention

and control lead possesses the qualifications provided for in the regulations.

Prevention of Abuse and Neglect

Duty

to protect

(1) Every licensee of a long-term

care home shall protect residents from abuse by anyone and shall ensure that

residents are not neglected by the licensee or staff.

absent from the home

(2) The

duties in subsection (1) do not apply where the resident is absent from the

home, unless the resident continues to receive care or services from the

licensee, staff or volunteers of the home.

Offence

(3) Every

licensee who contravenes subsection (1) is guilty of an offence.

Policy

to promote zero tolerance

(1) Without in any way restricting

the generality of the duty provided for in

section 24, every licensee shall

ensure that there is in place a written policy to promote zero tolerance of

abuse and neglect of residents, and shall ensure that the policy is complied

with.

Contents

(2) At

a minimum, the policy to promote zero tolerance of abuse and neglect of

residents,

(

a) shall

provide that abuse and neglect are not to be tolerated;

(

b) shall

clearly set out what constitutes abuse and neglect;

(

c) shall

provide for a program, that complies with the regulations, for preventing abuse

and neglect;

(

d) shall

contain an explanation of the duty under

section 28 to make mandatory reports;

(

e) shall

contain procedures for investigating and responding to alleged, suspected or

witnessed abuse and neglect of residents;

(

f) shall

set out the consequences for those who abuse or neglect residents;

(

g) shall

comply with any requirements respecting the matters provided for in clauses (

a) through (

f) that are provided for in the regulations; and

(

h) shall

deal with any additional matters as may be provided for in the regulations.

Communication

of policy

(3) Every

licensee shall ensure that the policy to promote zero tolerance of abuse and

neglect of residents is communicated to all staff, residents and residents’

substitute decision-makers.

Reporting and Complaints

Complaints

procedure — licensee

(1) Every licensee of a long-term

care home shall,

(

a) ensure

that there are written procedures that comply with the regulations for

initiating complaints to the licensee and for how the licensee deals with

complaints;

(

b) ensure

that the written procedures include information about how to make a complaint

to the patient ombudsman under the Excellent Care for All

Act, 2010

and to the Ministry; and

(

c) immediately

forward to the Director any written complaint that it receives concerning the

care of a resident or the operation of a long-term care home in the manner set

out in the regulations, where the complaint has been submitted in the format

provided for in the regulations and complies with any other requirements that

may be provided for in the regulations.

Other

documentation

(2) A

licensee who is required to forward a complaint under clause (1) (

c) shall also

provide the Director with any documentation provided for in the regulations, in

a manner that complies with the regulations.

Licensee

must investigate, respond and act

(1) Every licensee of a long-term

care home shall ensure that,

(

a) every

alleged, suspected or witnessed incident of the following that the licensee

knows of, or that is reported to the licensee, is immediately investigated:

(

i) abuse

of a resident by anyone,

(ii) neglect

of a resident by the licensee or staff, or

(iii) anything

else provided for in the regulations;

(

b) appropriate

action is taken in response to every such incident; and

(

c) any

requirements that are provided for in the regulations for investigating and

responding as required under clauses (

a) and (

b) are complied with.

Reports

of investigation

(2) A

licensee shall report to the Director the results of every investigation

undertaken under clause (1) (a), and every action taken under clause (1) (b).

Manner

of reporting

(3) A

licensee who reports under subsection (2) shall do so as is provided for in the

regulations, and include all material that is provided for in the regulations.

Reporting

certain matters to Director

(1) A person who has reasonable

grounds to suspect that any of the following has occurred or may occur shall

immediately report the suspicion and the information upon which it is based to

the Director:

1. Improper

or incompetent treatment or care of a resident that resulted in harm or a risk

of harm to the resident.

2. Abuse

of a resident by anyone or neglect of a resident by the licensee or staff that

resulted in harm or a risk of harm to the resident.

3. Unlawful

conduct that resulted in harm or a risk of harm to a resident.

4. Misuse

or misappropriation of a resident’s money.

5. Misuse

or misappropriation of funding provided to a licensee under this Act, the Local Health System Integration Act, 2006 or the Connecting Care Act, 2019 .

False

information

(2) Every

person is guilty of an offence who includes in a report to the Director under

subsection (1) information the person knows to be false.

Exceptions

for residents

(3) A

resident may make a report under subsection (1), but is not required to, and

subsection (2) does not apply to residents who are incapable.

Duty

on practitioners and others

(4) Even

if the information on which a report may be based is confidential or

privileged, subsection (1) also applies to a person mentioned in paragraph 1 or

2, and no action or other proceeding for making the report shall be commenced

against a person who acts in accordance with subsection (1) unless that person

acts maliciously or without reasonable grounds for the suspicion:

1. A

physician or any other person who is a member of a College as defined in

subsection 1 (1) of the Regulated Health Professions Act,

1991 .

2. A

member of the Ontario College of Social Workers and Social Service Workers.

Offence

of failure to report

(5) The

following persons are guilty of an offence if they fail to make a report

required by subsection (1):

1. The

licensee of the long-term care home or a person who manages a long-term care

home pursuant to a contract described in

section 113.

2. If

the licensee or person who manages the home is a corporation, an officer or

director of the corporation.

3. In

the case of a home approved under

Part IX, a member of the committee of

management for the home under

section 135 or of the board of management for the

home under

section 128 or 132.

4. A

staff member.

5. Any

person who provides professional services to a resident in the areas of health,

social work or social services work.

6. Any

person who provides professional services to a licensee in the areas of health,

social work or social services work.

Offences

re suppressing reports

(6) Every

person mentioned in paragraph 1, 2, 3 or 4 of subsection (5) is guilty of an

offence if the person,

(

a) coerces

or intimidates a person not to make a report required by this section;

(

b) discourages

a person from making a report required by this section; or

(

c) authorizes,

permits or concurs in a contravention of the duty to make a report required by

this section.

Solicitor-client

privilege

(7) Nothing

in this

section abrogates any privilege that may exist between a solicitor and

the solicitor’s client.

Inspections

or inquiries where information received by Director

(1) The Director shall have an

inspector conduct an inspection or make inquiries for the purpose of ensuring

compliance with the requirements under this Act if the Director receives

information from any source indicating that any of the following may have

occurred:

1. Improper

or incompetent treatment or care of a resident that resulted in harm or a risk

of harm to the resident.

2. Abuse

of a resident by anyone or neglect of a resident by the licensee or staff that

resulted in harm or a risk of harm to the resident.

3. Unlawful

conduct that resulted in harm or a risk of harm to a resident.

4. A

violation of

section 30.

5. Misuse

or misappropriation of a resident’s money.

6. Misuse

or misappropriation of funding provided to a licensee under this Act, the Local Health System Integration Act, 2006 or the Connecting Care Act, 2019 .

7. A

failure to comply with a requirement under this Act that resulted in harm or

risk of harm to a resident.

8. Any

other matter provided for in the regulations.

Immediate

visit to home

(2) The

inspector acting under subsection (1) shall immediately visit the long-term

care home concerned if the information indicates that any of the following may

have occurred:

1. Anything

described in paragraph 1, 2 or 3 of subsection (1) that resulted in serious

harm or a significant risk of serious harm to a resident.

2. Any

other matter provided for in the regulations.

Other

matters

(3) If

the Director receives information, not provided for in subsection (1), that

raises concerns about the operation of a long-term care home, the Director

shall have an inspector conduct an inspection or make inquiries into the matter

for the purpose of ensuring compliance with the requirements under this Act, if

the Director has reasonable grounds to believe that there may be a risk of harm

to a resident.

Powers

of inspector

(4) For

greater clarity, an inspector acting under this

section may exercise any power

of an inspector under

section 150, and has the power of an inspector to obtain

a warrant under

section 151.

Other

inquiries

(5) If

the Director receives information from any source about the operation of a

long-term care home, and is not required to have an inspector conduct an

inspection or make inquiries into the matter, the Director may disclose the

information to another person, including the licensee, or to the Residents’

Council or Family Council.

Licensee

to be notified

(6) If

the Director discloses the information to the Residents’ Council or Family

Council under subsection (5), the Director is required to provide the

information to the licensee.

Information

(7) Without

in any way restricting the generality of the term, for the purposes of this

section, “information” includes anything in,

(

a) a

report under subsection 27 (2); or

(

b) a

report under

section 28.

Whistle-blowing

protection

(1) No person shall retaliate

against another person, whether by action or omission, or threaten to do so

because,

(

a) anything

has been disclosed to an inspector;

(

b) anything

has been disclosed to the Director including, without limiting the generality

of the foregoing,

(

i) a

report has been made under

section 28, or the Director has otherwise been

advised of anything mentioned in paragraphs 1 to 5 of subsection 28 (1),

(ii) the

Director has been advised of a breach of a requirement under this Act, or

(iii) the

Director has been advised of any other matter concerning the care of a resident

or the operation of a long-term care home that the person advising believes

ought to be reported to the Director;

(

c) anything

has been disclosed to any other personnel of the Ministry, or to any other

individual or entity that may be provided for in the regulations; or

(

d) evidence

has been or may be given in a proceeding, including a proceeding in respect of

the enforcement of this Act or the regulations, or in an inquest under the Coroners Act .

Manner

of disclosure, etc.

(2) For

the purposes of subsection (1), disclosure may be by any method, such as by

making a complaint to the Ministry or by calling an action line where one has

been established, subject to any exceptions provided for in the regulations.

Interpretation,

retaliate

(3) Without

in any way restricting the meaning of the word “retaliate”, the following

constitute retaliation for the purposes of subsection (1):

1. Dismissing

a staff member.

2. Disciplining

or suspending a staff member.

3. Imposing

a penalty upon any person.

4. Intimidating,

coercing or harassing any person.

retaliation against residents

(4) A

resident shall not be discharged from a long-term care home, threatened with

discharge, or in any way be subjected to discriminatory treatment because of

anything mentioned in subsection (1), even if the resident or another person

acted maliciously or in bad faith, and no family member of a resident,

substitute decision-maker of a resident, or person of importance to a resident

shall be threatened with the possibility of any of those being done to the

resident.

Interpretation,

discriminatory treatment

(5) Without

in any way restricting the meaning of the term “discriminatory treatment”, for

the purposes of subsection (4) discriminatory treatment includes any change or

discontinuation of any service to or care of a resident or the threat of any

such change or discontinuation.

May

not discourage reporting

(6) None

of the following persons shall do anything that discourages, is aimed at

discouraging or that has the effect of discouraging a person from doing

anything mentioned in clauses (1) (

a) to (d):

1. The

licensee of a long-term care home or a person who manages a long-term care home

pursuant to a contract described in

section 113.

2. If

the licensee or the person who manages the home is a corporation, an officer or

director of the corporation.

3. In

the case of a home approved under

Part IX a member of the committee of

management for the home under

section 135 or of the board of management for the

home under

section 128 or 132.

4. A

staff member.

May

not encourage failure to report

(7) No

person mentioned in paragraphs 1 to 4 of subsection (6) shall do anything to

encourage a person to fail to do anything mentioned in clauses (1) (

a) to (d).

Protection

from legal action

(8) No

action or other proceeding shall be commenced against any person for doing

anything mentioned in clauses (1) (

a) to (

d) unless the person acted

maliciously or in bad faith.

Offence

(9) Every

person is guilty of an offence who does anything prohibited by subsection (1),

(4), (6) or (7).

Complaint

to Ontario Labour Relations Board

(1) Where a staff member complains

that an employer or person acting on behalf of an employer has contravened

subsection 30 (1), the staff member may either have the matter dealt with by

final and binding settlement by arbitration under a collective agreement, if

any, or file a complaint with the Board in which case any rules governing the

practice and procedure of the Board apply with all necessary modifications to the

complaint.

Inquiry

by Board

(2) The

Board may inquire into any complaint filed under subsection (1) and

section 96

of the Labour Relations Act, 1995 , except

subsection (5), applies with all necessary modifications as if that section,

except subsection (5), is enacted in and forms part of this Act.

Same

(3) On

an inquiry by the Board into a complaint filed under subsection (1), sections

110, 111, 114 and 116 of the Labour Relations Act, 1995

apply with all necessary modifications.

Onus

of proof

(4) On

an inquiry by the Board into a complaint filed under subsection (1), the burden

of proof that an employer or person acting on behalf of an employer did not act

contrary to subsection 30 (1) lies upon the employer or the person acting on

behalf of the employer.

Board

may substitute penalty

(5) Where,

on an inquiry by the Board into a complaint filed under subsection (1), the

Board determines that a staff member has been discharged or otherwise

disciplined by an employer for cause and the contract of employment or the

collective agreement, as the case may be, does not contain a specific penalty

for the infraction, the Board may substitute such other penalty for the

discharge or discipline as to the Board seems just and reasonable in all the

circumstances.

Interpretation

(6) In

this section,

“Board”

means the Ontario Labour Relations Board; (“Commission”)

“employer”,

in relation to a staff member, means,

(

a) where

the staff member is an employee of a licensee or a person who works at a

long-term care home pursuant to a contract or agreement with a licensee, the

licensee, or

(

b) where

the staff member works at a long-term care home pursuant to a contract or

agreement between the licensee and an employment agency or other third party,

the employment agency or third party. (“employeur”)

Obstruction

— information to inspectors, Director

32 Every person is guilty of an offence who

attempts, by any means, to prevent another person from providing information to

an inspector or the Director where the provision of the information is required

or permitted by this Act or the regulations.

Minimizing of Restraining

Policy

to minimize restraining of residents, etc.

(1) Every licensee of a long-term care home,

(

a) shall

ensure that there is a written policy to minimize the restraining of residents

and to ensure that any restraining that is necessary is done in accordance with

this Act and the regulations; and

(

b) shall

ensure that the policy is complied with.

Policy

to comply with regulations

(2) The

policy must comply with such requirements as may be provided for in the

regulations.

Protection

from certain restraining

(1) Every licensee of a long-term

care home shall ensure that no resident of the home is:

1. Restrained,

in any way, for the convenience of the licensee or staff.

2. Restrained,

in any way, as a disciplinary measure.

3. Restrained

by the use of a physical device, other than in accordance with

section 35 or

under the common law duty referred to in

section 39.

4. Restrained

by the administration of a drug to control the resident, other than under the

common law duty referred to in

section 39.

5. Restrained,

by the use of barriers, locks or other devices or controls, from leaving a room

or any part of a home, including the grounds of the home, or entering parts of

the home generally accessible to other residents, other than under the common

law duty referred to in

section 39.

Devices

that resident can release

(2) The

use of a physical device from which a resident is both physically and

cognitively able to release themself is not a restraining of the resident.

Use

of PASD to assist resident

(3) The

use of a personal assistance services device (“PASD”), within the meaning of

subsection 36 (2), to assist a resident with a routine activity of living is

not a restraining of the resident.

Administration

of drugs, etc., as treatment

(4) The

administration of a drug to a resident as a treatment set out in the resident’s

plan of care is not a restraining of the resident.

Perimeter

barriers, etc., of home, grounds

(5) The

use of barriers, locks or other devices or controls at entrances and exits to

the home or the grounds of the home is not a restraining of a resident unless

the resident is prevented from leaving.

Safety

measures at stairways

(6) The

use of barriers, locks or other devices or controls at stairways as a safety

measure is not a restraining of a resident.

Restraining

by physical devices

(1) A resident may be restrained by

a physical device as described in paragraph 3 of subsection 34 (1) if the

restraining of the resident is included in the resident’s plan of care.

Provision

in plan of care

(2) The

restraining of a resident by a physical device may be included in a resident’s

plan of care only if all of the following are satisfied:

1. There

is a significant risk that the resident or another person would suffer serious

bodily harm if the resident were not restrained.

2. Alternatives

to restraining the resident have been considered, and tried where appropriate,

but would not be, or have not been, effective to address the risk referred to

in paragraph 1.

3. The

method of restraining is reasonable, in light of the resident’s physical and

mental condition and personal history, and is the least restrictive of such

reasonable methods that would be effective to address the risk referred to in

paragraph 1.

4. A

physician, registered nurse in the extended class or other person provided for

in the regulations has ordered or approved the restraining.

5. The

restraining of the resident has been consented to by the resident or, if the

resident is incapable, a substitute decision-maker of the resident with

authority to give that consent.

6. The

plan of care provides for everything required under subsection (3).

Requirement

if resident is restrained

(3) If

a resident is being restrained by a physical device under subsection (1), the

licensee shall ensure that,

(

a) the

device is used in accordance with any requirements provided for in the

regulations;

(

b) the

resident is monitored while restrained, in accordance with the requirements

provided for in the regulations;

(

c) the

resident is released and repositioned, from time to time, while restrained, in

accordance with the requirements provided for in the regulations;

(

d) the

resident’s condition is reassessed and the effectiveness of the restraining

evaluated, in accordance with the requirements provided for in the regulations;

(

e) the

resident is restrained only for as long as is necessary to address the risk

referred to in paragraph 1 of subsection (2);

(

f) the

method of restraining used is discontinued if, as a result of the reassessment

of the resident’s condition, one of the following is identified that would

address the risk referred to in paragraph 1 of subsection (2):

(

i) an

alternative to restraining, or

(ii) a

less restrictive method of restraining that would be reasonable, in light of

the resident’s physical and mental condition and personal history; and

(

g) any

other requirements provided for in the regulations are satisfied.

PASDs

that limit or inhibit movement

(1) This

section applies to the use

of a PASD if the PASD has the effect of limiting or inhibiting a resident’s

freedom of movement and the resident is not able, either physically or

cognitively, to release themself from the PASD.

Definition

of PASD

(2) In

this section,

“PASD”

means personal assistance services device, being a device used to assist a

person with a routine activity of living.

When

PASD may be used

(3) Every

licensee of a long-term care home shall ensure that a PASD described in

subsection (1) is used to assist a resident with a routine activity of living

only if the use of the PASD is included in the resident’s plan of care.

Inclusion

in plan of care

(4) The

use of a PASD under subsection (3) to assist a resident with a routine activity

of living may be included in a resident’s plan of care only if all of the

following are satisfied:

1. Alternatives

to the use of a PASD have been considered, and tried where appropriate, but

would not be, or have not been, effective to assist the resident with the

routine activity of living.

2. The

use of the PASD is reasonable, in light of the resident’s physical and mental

condition and personal history, and is the least restrictive of such reasonable

PASDs that would be effective to assist the resident with the routine activity

of living.

3. The

use of the PASD has been approved by,

i. a

physician,

ii. a

registered nurse,

iii. a

registered practical nurse,

iv. a

member of the College of Occupational Therapists of Ontario,

v. a

member of the College of Physiotherapists of Ontario, or

vi. any

other person provided for in the regulations.

4. The

use of the PASD has been consented to by the resident or, if the resident is

incapable, a substitute decision-maker of the resident with authority to give

that consent.

5. The

plan of care provides for everything required under subsection (5).

Use

of PASD

(5) If

a PASD is used under subsection (3), the licensee shall ensure that the PASD is

used in accordance with any requirements provided for in the regulations.

PASD

used to restrain

(6) For

greater certainty, if a PASD is being used to restrain a resident rather than

to assist the resident with a routine activity of living,

section 35 applies

with respect to that use instead of this section.

Records

on restraining of residents

37 Every licensee of a long-term care home shall

keep records in the home, as provided for in the regulations, in relation to

the following:

1. The

restraining of a resident.

2. The

use of a PASD, within the meaning of

section 36.

Prohibited

devices that limit movement

38 Every licensee of a long-term care home shall

ensure that no device provided for in the regulations is used on a resident,

(

a) to

restrain the resident; or

(

b) to

assist a resident with a routine activity of living, if the device would have

the effect of limiting or inhibiting the resident’s freedom of movement.

Common

law duty

(1) Nothing in this Act affects the

common law duty of a caregiver to restrain or confine a person when immediate

action is necessary to prevent serious bodily harm to the person or to others.

Restraining

by physical device under common law duty

(2) If

a resident is being restrained by a physical device pursuant to the common law

duty referred to in subsection (1), the licensee shall ensure that the device

is used in accordance with any requirements provided for in the regulations and

that any other requirements provided for in the regulations are satisfied.

Restraining

by administration of drug, etc., under common law duty

(3) A

resident may not be restrained by the administration of a drug pursuant to the

common law duty referred to in subsection (1) unless the administration of the

drug is ordered by a physician or other person provided for in the regulations.

Same

(4) If

a resident is being restrained by the administration of a drug pursuant to the

common law duty referred to in subsection (1), the licensee shall ensure that

the drug is used in accordance with any requirements provided for in the

regulations and that any other requirements provided for in the regulations are

satisfied.

Confinement

(5) If

a resident is being confined pursuant to the common law duty referred to in

subsection (1), the licensee shall ensure that the confining is in accordance

with any requirements provided for in the regulations and that any other

requirements provided for in the regulations are satisfied.

Office of the Long-Term Care Homes Resident and Family Adviser

Office

of the Long-Term Care Homes Resident and Family Adviser

40 The Minister may establish an Office of the

Long-Term Care Homes Resident and Family Adviser to,

(

a) assist

and provide information to residents and their families and others;

(

b) advise

the Minister on matters and issues concerning the interests of residents; and

(

c) perform

any other functions provided for in the regulations or assigned by the

Minister.

Regulations

Regulations

(1) The Lieutenant Governor in

Council may make regulations for carrying out the purposes and provisions of

this Part.

Specific

inclusions

(2) Without

restricting the generality of subsection (1), the Lieutenant Governor in

Council may make regulations,

(

a) governing

anything that a licensee is required to do, ensure or provide under this Part,

including establishing standards or outcomes that must be met;

(

b) governing

temperature requirements for long-term care homes;

(

c) requiring

and governing the assessment and classification of residents for the purpose of

determining care requirements and other needs of residents;

(

d) governing

the mission statements provided for in

section 4 and the requirements under

that section;

(

e) governing

plans of care, including governing their development and implementation and

setting requirements in addition to what is required under

section 6;

(

f) setting

higher targets, interim targets and extended target dates for the purposes of

sections 8 and 9 and generally respecting the application of those sections,

including setting the applicable calculation periods;

(

g) governing

the meaning of “number of hours of direct care actually worked” and “resident

days” for the purposes of sections 8 and 9;

(

h) defining

“allied health care professional” for the purposes of

section 9;

(

i) defining

“regular nursing staff” for the purposes of subsection 11 (3);

(

j) requiring

certain classes of long-term care homes to have more registered nurses on duty

than are required by subsection 11 (3) and providing for rules governing such a

requirement;

(

k) respecting

and governing palliative care and the development of a palliative care

philosophy for the purposes of

section 12;

(

l) governing

the requirements of the infection prevention and control program under

section

23, and prescribing conditions and requirements that must be complied with

under that section;

(

m) requiring

certain classes of long-term care homes to have more infection prevention and

control leads appointed than are required by subsection 23 (4);

(

n) governing

responsibilities that an infection prevention and control lead is required to

perform;

(

o) providing

for the qualification of an infection prevention and control lead for the

purposes of subsection 23 (5);

(

p) governing

the format and other requirements for complaints for the purposes of clause 26

(1) (

c) and governing the accompanying documentation for the purposes of

subsection 26 (2);

(

q) specifying,

for the purposes of paragraph 4 of subsection 28 (1) and paragraph 5 of

subsection 29 (1), what constitutes misuse or misappropriation of a resident’s

money;

(

r) specifying,

for the purposes of paragraph 5 of subsection 28 (1) and paragraph 6 of

subsection 29 (1), what constitutes misuse or misappropriation of funding

provided to a licensee;

(

s) providing

for additional persons and entities for the purposes of clause 30 (1) (c), and

governing exceptions for the purposes of subsection 30 (2);

(

t) governing

the confining of residents, including the setting of requirements in addition

to those set out in this Part;

(

u) providing

for anything that under this Part may or must be provided for in regulations,

or that is to be done in compliance with or in accordance with the regulations.

PART III

QUALITY

Continuous

quality improvement

42 Every licensee of a

long-term care home shall implement a continuous quality improvement initiative as provided for in the

regulations.

Resident

and Family/Caregiver Experience Survey

(1) Every licensee of a long-term

care home shall ensure that, unless otherwise directed by the Minister, at

least once in every year a survey is taken of the residents, their families and

caregivers to measure their experience with the home and the care, services,

programs and goods provided at the home.

Administration

(2) Where

the regulations provide for how the survey is to be administered, the licensee

shall ensure that the survey is administered in the manner and in the form

provided for in the regulations, and that it contains the content provided for

in the regulations.

Action

(3) A

licensee shall make every reasonable effort to act on the results of the survey

and to improve the long-term care home and the care, services, programs and

goods accordingly.

Advice

(4) The

licensee shall seek the advice of the Residents’ Council and the Family

Council, if any, in carrying out the survey and in acting on its results.

Documentation

(5) The

licensee shall ensure that,

(

a) the

results of the survey are documented and made available to the Residents’

Council and the Family Council, if any, to seek their advice under subsection

(4);

(

b) the

actions taken to improve the long-term care home, and the care, services,

programs and goods based on the results of the survey are documented and made

available to the Residents’ Council and the Family Council, if any;

(

c) the

documentation required by clauses (

a) and (

b) is made available to residents

and their families; and

(

d) the

documentation required by clauses (

a) and (

b) is kept in the long-term care

home and is made available during an inspection under

Part X.

Long-Term

Care Quality Centre

(1) The Minister may establish a

Long-Term Care Quality Centre.

Functions,

purposes

(2) The

functions and purposes of the Long-Term Care Quality Centre are,

(

a) to

support mission-driven organizations;

(

b) to

advance and share research on innovative and evidence-informed person-centred

models of care; and

(

c) any

other functions or purposes provided for in the regulations.

Regulations

(1) The Lieutenant Governor in

Council may make regulations for carrying out the purposes and provisions of

this Part.

Specific

inclusions

(2) Without

restricting the generality of subsection (1), the Lieutenant Governor in

Council may make regulations,

(

a) governing

the requirements for a continuous quality improvement initiative, including its

development and its implementation;

(

b) providing

for and governing the survey of residents, families and caregivers, including

its content, form and administration;

(

c) providing

for and governing the composition and additional functions and purposes of the

Long-Term Care Quality Centre;

(

d) providing

for anything that under this Part may or must be provided for in regulations,

or that is to be done in compliance with or in accordance with the regulations.

PART IV

ADMISSION OF RESIDENTS

Application

Part

(1) This Part applies to the

admission of a person to a long-term care home as a resident and any transfer

within a home to a specialized unit.

Transfer

(2) Where

a person is to be transferred to a specialized unit within the long-term care

home, this Part applies as though the transfer were an admission of the person

to the home.

Definition

(3) In

this section,

“specialized

unit” means any unit designated by or in accordance with the regulations to

provide or offer certain types of accommodation, care, services, programs and

goods to residents.

Designation

of placement co-ordinators

(1) The Minister shall designate one

or more persons, classes of persons or other entities as placement

co-ordinators for the long-term care homes in specified geographic areas.

Ineligible

persons and entities

(2) The

Minister shall not designate a person or entity if the person or entity is in a

class of persons or entities described in the regulations as ineligible for

designation as a placement co-ordinator.

Changes

in designations

(3) The

Minister may revoke a designation or make a new designation.

Placement

co-ordinator to comply with Act, etc.

48 A placement co-ordinator shall act in

accordance with this Act and the regulations.

Requirements

for admission to home

49 The following are required in order for a

person to be admitted as a resident of a long-term care home:

1. A

placement co-ordinator must have determined that the person is eligible for

long-term care home admission under

section 50.

2. The

placement co-ordinator for the geographic area where the home is located must

have authorized the admission of the person to that specific home under

section

Eligibility

for long-term care home admission

(1) A person may apply to a

placement co-ordinator for a determination that the person is eligible for

long-term care home admission.

Criteria

for eligibility

(2) The

criteria for determining eligibility for long-term care home admission shall be

provided for in the regulations.

Application

in accordance with regulations

(3) An

application shall be made in accordance with the regulations.

Required

assessments

(4) The

placement co-ordinator shall determine whether or not the applicant is eligible

for long-term care home admission only if the placement co-ordinator has the

following:

1. An

assessment of the applicant’s physical and mental health, and the applicant’s

requirements for medical treatment and health care.

2. An

assessment of the applicant’s,

i. functional

capacity,

ii. requirements

for personal care,

iii. current

behaviour, and

iv. behaviour

during the year preceding the assessment.

3. Any

other assessment or information provided for in the regulations.

Requirements

re assessments

(5) The

following apply with respect to the assessments under paragraphs 1 and 2 of

subsection (4):

1. The

assessment under paragraph 1 of subsection (4) must be in the form provided by

the Director and the form provided by the Director must include information

explaining,

i. the

process of determining eligibility and admitting persons into long-term care

homes, and

ii. what

use will be made of the assessment.

2. The

assessment under paragraph 1 of subsection (4) must be made by a physician or

registered nurse.

3. The

assessment under paragraph 2 of subsection (4) must be made by an employee or

agent of the placement co-ordinator who is also,

i. a

registered nurse,

ii. a

social worker who is registered under the Social Work and

Social Service Work Act, 1998 , or

iii. any

other person provided for in the regulations.

4. The

assessments under paragraphs 1 and 2 of subsection (4) must be made by

different individuals.

Assessments,

etc., to be taken into account

(6) In

determining whether or not the applicant is eligible for long-term care home

admission, the placement co-ordinator shall take into account all the

assessments and information required under subsection (4) and such other

information as the placement co-ordinator has that is relevant to the

determination of eligibility.

Determination

of eligibility — information about process

(7) If

the placement co-ordinator determines that the applicant is eligible for

long-term care home admission, the placement co-ordinator shall, at the time of

making the determination, provide information to the applicant about the

process for admitting persons into long-term care homes and explain the

process, the choices that the applicant has in the process and the implications

of those choices.

Determination

of ineligibility — assistance and notice

(8) If

the placement co-ordinator determines that the applicant is not eligible for

long-term care home admission,

(

a) the

placement co-ordinator shall suggest alternative services and make appropriate

referrals on behalf of the applicant; and

(

b) the

placement co-ordinator shall ensure that the applicant is notified in writing

of,

(

i) the

determination of ineligibility,

(ii) the

reasons for the determination, and

(iii) the

applicant’s right to apply to the Appeal Board for a review of the

determination.

Review

of determination of ineligibility

(9) The

applicant may apply to the Appeal Board for a review of the determination of

ineligibility made by the placement co-ordinator, and the Appeal Board shall

deal with the appeal in accordance with

section 59.

Authorization

for admission to a home

(1) A person who has been determined

to be eligible for long-term care home admission may apply to a placement

co-ordinator for an authorization of admission, by the appropriate placement

co-ordinator, to such long-term care home or homes as the person selects.

Appropriate

placement co-ordinator

(2) In

this section,

“appropriate

placement co-ordinator” means, in relation to a long-term care home, the

placement co-ordinator designated pursuant to subsection 47 (1) for the

geographic area where the home is located.

Assistance

with choosing homes

(3) The

placement co-ordinator who determined that the applicant is eligible for

long-term care home admission shall, if the applicant wishes, assist the

applicant in selecting the long-term care home or homes with respect to which

the applicant will apply for authorization of admission.

Person’s

preferences

(4) In

assisting the applicant under subsection (3), the placement co-ordinator shall

consider the applicant’s preferences relating to admission, based on ethnic,

religious, spiritual, linguistic, familial and cultural factors.

Application

in accordance with regulations

(5) An

application for authorization of admission shall be made in accordance with the

regulations and the applicant shall provide written consent to the disclosure

of all information necessary to deal with the application.

Co-ordination

with appropriate placement co-ordinators

(6) If

a home selected by an applicant is not in the geographic area of the placement

co-ordinator to whom the application was made, that placement co-ordinator

shall co-ordinate with the appropriate placement co-ordinator for that home.

Licensee

consideration and approval

(7) The

appropriate placement co-ordinator shall give the licensee of each selected

home copies of the assessments and information that were required to have been

taken into account, under subsection 50 (6), and the licensee shall review the

assessments and information and shall approve the applicant’s admission to the

home unless,

(

a) the

home lacks the physical facilities necessary to meet the applicant’s care

requirements;

(

b) the

staff of the home lack the nursing expertise necessary to meet the applicant’s

care requirements; or

(

c) circumstances

exist which are provided for in the regulations as being a ground for

withholding approval.

Notice

if licensee gives approval

(8) If

the licensee approves the applicant’s admission, the licensee shall give the

appropriate placement co-ordinator a written notice which shall include an

acknowledgement that the licensee has reviewed the assessments and information

the licensee is required to review under subsection (7).

Written

notice if licensee withholds approval

(9) If

the licensee withholds approval for admission, the licensee shall give to

persons described in subsection (10) a written notice setting out,

(

a) the

ground or grounds on which the licensee is withholding approval;

(

b) a

detailed explanation of the supporting facts, as they relate both to the home

and to the applicant’s condition and requirements for care;

(

c) an

explanation of how the supporting facts justify the decision to withhold

approval; and

(

d) contact

information for the Director.

Persons

to whom notice given

(10) The

persons referred to in subsection (9) are the following:

1. The

applicant.

2. The

appropriate placement co-ordinator.

Conditions

of authorization of admission

(11) The

appropriate placement co-ordinator may authorize the admission of the applicant

to a home only if,

(

a) for

each of the assessments required under subsection 50 (4), either the assessment

or a reassessment was made within the three months preceding the authorization

of admission, or within the preceding three months there was a significant

change in the person’s condition or circumstances in which case a reassessment

was made at that time;

(

b) the

applicant is still eligible for long-term care home admission following the

review of any reassessment described in clause (

a) and any redetermination

required under subsection (12);

(

c) the

licensee of the home approves the person’s admission to the home; and

(

d) the

person provides consent to being admitted to the home.

Review

of reassessments, etc.

(12) The

placement co-ordinator who determined the applicant was eligible for long-term

care home admission under

section 50, or the placement co-ordinator to whom the

responsibility has been transferred under

section 54 shall,

(

a) review

any reassessment required under clause (11) (a); and

(

b) if

after that review the placement co-ordinator is of the opinion that the

applicant may no longer be eligible for long-term care home admission, make a

new determination, under

section 50, of the applicant’s eligibility.

Application,

if new determination required

(13) For

greater certainty, subsections 50 (4), (5), (6), (8) and (9) apply with respect

to the new determination required under clause (12) (b).

Reassessment

to licensee who has approved admission

(14) If

a reassessment required under clause (11) (

a) has been done since the licensee

approved the applicant’s admission to the home, the appropriate placement

co-ordinator shall give the licensee a copy of the reassessment and the

licensee shall review the reassessment in accordance with the following:

1. The

licensee may withdraw the approval only in the circumstances set out in clauses

(7) (

a) to (c), and such a withdrawal may only be made in accordance with the

requirements provided for in the regulations.

2. If

the licensee decides not to withdraw the approval, the licensee shall give the

appropriate placement co-ordinator a written notice that includes an

acknowledgement that the licensee has reviewed the reassessment.

3. If

the licensee decides to withdraw the approval, subsections (9) and (10) apply

with necessary modifications.

Alternative

services, referrals

(15) The

placement co-ordinator to whom the application was made under subsection

(1) shall suggest alternative services and make appropriate referrals on behalf of

an applicant under any of the following circumstances:

1. If

the admission of the applicant to a home is delayed.

2. If

a licensee withholds approval for admission of the applicant or withdraws

approval for admission of the applicant.

Elements

of consent

(1) The following are the elements

required for consent to admission to a long-term care home:

1. The

consent must relate to the admission.

2. The

consent must be informed.

3. The

consent must be given voluntarily.

4. The

consent must not be obtained through misrepresentation or fraud.

Informed

consent

(2) A

consent to admission is informed if, before giving it,

(

a) the

person received the information about the matters set out in subsection

(3) that a reasonable person in the same circumstances would require in order to

make a decision about the admission; and

(

b) the

person received responses to their requests for additional information about

those matters.

Same

(3) The

matters referred to in subsection (2) are:

1. What

the admission entails.

2. The

expected advantages and disadvantages of the admission.

3. Alternatives

to the admission.

4. The

likely consequences of not being admitted.

Substitute

decision-maker may apply for person

53 A substitute decision-maker may apply on behalf

of a person under

section 50 or 51.

Transfer

of application

54 Responsibility for an application under

section

50 or 51 may be transferred, with the consent of the applicant, from one

placement co-ordinator to another and, upon such a transfer being made, the new

placement co-ordinator shall be deemed, for the purposes of this Part, to be

the placement co-ordinator to whom the application was made.

Controls

on licensee

55 A licensee of a long-term care home shall not

admit a person unless the person’s admission to the home is authorized by the

placement co-ordinator for the geographic area where the home is located, and

shall admit a person whose admission is so authorized.

Suspension

of admissions where risk of harm

(1) If the Director believes there

is a risk of harm to the health or well-being of residents of a long-term care

home or persons who might be admitted as residents, the Director may direct the

placement co-ordinator for the geographic area where the home is located to

cease authorizing admissions to the home for such period of time and subject to

such conditions as the Director specifies.

Compliance

with direction

(2) A

placement co-ordinator who receives a direction under subsection (1) shall

comply with it.

Preference

for veterans

57 The Minister shall ensure that preference is

given to veterans for access to beds that,

(

a) are

located in long-term care homes for which funding is provided under an

relating to veterans; and

(

b) are

designated by the Minister as veterans’ priority access beds.

Immunity

— placement co-ordinator’s employees and agents

(1) No action or other proceeding

shall be commenced against an employee or agent of a placement co-ordinator for

any act done in good faith in the performance or intended performance of the

person’s duty or for any alleged neglect or default in the performance in good

faith of the person’s duty.

Placement

co-ordinator’s liability

(2) Subsection

(1) does not relieve a placement co-ordinator of liability for the acts or

omissions of its employees or agents.

Hearing

— ineligibility

(1) When the Appeal Board receives

an application for a review of a determination of ineligibility, it shall

promptly appoint a time and place for a hearing.

Same

(2) The

hearing shall begin within 21 days after the day the Appeal Board receives the

application for the hearing, unless the parties agree to a postponement.

Notice

to parties

(3) The

Appeal Board shall notify each of the parties of the time and place of the

hearing at least seven days before the hearing begins.

Parties

(4) The

parties to the proceeding before the Appeal Board are the applicant who was

determined to be ineligible for admission, the placement co-ordinator who made

the determination and such other parties as the Appeal Board specifies.

Notice

to Minister

(5) When

a placement co-ordinator is notified by the Appeal Board of a hearing, the

placement co-ordinator shall promptly give the Minister written notice of the

hearing together with written reasons for the determination of ineligibility made

by the placement co-ordinator.

Minister

entitled to be heard

(6) The

Minister is entitled to be heard by counsel or otherwise in a proceeding before

the Appeal Board under this section.

Evidence

of person with a disability

(7) If

a party to a proceeding before the Appeal Board under this Act wishes to give

evidence in the proceeding or wishes to call another person as a witness to

give evidence in the proceeding but the party or other person is unable to

attend the hearing by reason of age, infirmity or physical disability, the

Appeal Board members holding the hearing may, at the request of the party,

attend upon the party or the other person, as the case may be, and take their

evidence.

Medical

report proves inability

(8) A

medical report signed by a physician stating that the physician believes that

the person is unable to attend the hearing by reason of age, infirmity or

physical disability is proof, in the absence of evidence to the contrary, of

the inability of the person to attend the hearing.

Opportunity

for all parties

(9) No

Appeal Board member shall take evidence from a party or other person under

subsection (7) unless reasonable notice of the time and place for taking the

evidence is given to all parties to the proceeding and each party attending is

given an opportunity to examine or cross-examine the party or other person, as

the case may be.

Recording

of evidence

(10) The

oral evidence taken before the Appeal Board at a hearing and the oral evidence

taken from a party or other person under subsection (7) shall be recorded and,

if required, copies of a transcript of the evidence shall be furnished on the

same terms as in the Superior Court of Justice.

Health

Insurance Act

(11) Subsections

23 (1), (2), (4) and (6) of the Health Insurance Act

apply to the proceedings and decisions of the Appeal Board under this Part.

Powers

of Appeal Board

(12) After

a hearing by the Appeal Board, the Appeal Board may,

(

a) affirm

the determination of ineligibility made by the placement co-ordinator;

(

b) rescind

the determination of ineligibility made by the placement co-ordinator and refer

the matter back to the placement co-ordinator for redetermination in accordance

with such directions as the Appeal Board considers proper; or

(

c) rescind

the determination of ineligibility made by the placement co-ordinator,

substitute its opinion for the opinion of the placement co-ordinator and direct

the placement co-ordinator to determine that the applicant is eligible for

admission to a long-term care home.

Decision

and reasons

(13) The

Appeal Board shall render its decision within one day after the end of the

hearing and shall provide written reasons to the parties within seven days

after rendering the decision.

Decision

to Minister

(14) The

placement co-ordinator shall furnish the Minister with a copy of the decision

and reasons of the Appeal Board.

Appeal

to Divisional Court

(1) A party to a review of the

determination of ineligibility by the Appeal Board may appeal its decision to

the Divisional Court on a question of law or fact or both, in accordance with

the rules of court.

Record

(2) If

a party appeals a decision of the Appeal Board to the Divisional Court under

this section, the Appeal Board shall promptly file with the Divisional Court

the record of the proceeding before the Appeal Board and the transcript of the

evidence taken before the Appeal Board, which together constitute the record in

the appeal.

Minister

to be notified

(3) The

placement co-ordinator who commences or is given notice of an appeal shall

promptly give the Minister written notice of the appeal.

Minister

to be heard

(4) The

Minister is entitled to be heard by counsel or otherwise on the argument of an

appeal under this section.

Powers

of court on appeal

(5) On

an appeal under this section, the Divisional Court,

(

a) may

affirm or rescind the decision of the Appeal Board;

(

b) may

refer the matter back to the Appeal Board for rehearing in whole or in

part in

accordance with such directions as the court considers proper;

(

c) may

refer the matter back to the placement co-ordinator for redetermination in

accordance with such directions as the court considers proper;

(

d) may

substitute its opinion for that of the placement co-ordinator or the Appeal

Board; and

(

e) may

direct the placement co-ordinator to determine that the applicant is eligible

for admission to a long-term care home.

Decision

to Minister

(6) The

placement co-ordinator shall furnish the Minister with a copy of the decision

and reasons of the Divisional Court.

Regulations

(1) The Lieutenant Governor in

Council may make regulations for carrying out the purposes and provisions of

this Part.

Specific

inclusions

(2) Without

restricting the generality of subsection (1), the Lieutenant Governor in

Council may make regulations,

(

a) governing

determinations of eligibility for long-term care home admission;

(

b) governing

authorizations of admission to long-term care homes, including, without

limiting the generality of the foregoing,

(

i) providing

for priorities for persons in circumstances specified in the regulations or for

classes of persons specified in the regulations,

(ii) governing

the notices to be given by licensees under subsections 51 (8) and (9);

(

c) governing

placement co-ordinators, including, without limiting the generality of the

foregoing,

(

i) providing

for classes of persons or entities that are ineligible to be designated as

placement co-ordinators,

(ii) providing

for how placement co-ordinators shall co-ordinate with each other,

(iii) governing

the transfer of responsibility for applications between placement co-ordinators

under

section 54;

(

d) requiring

placement co-ordinators to ensure that persons seeking admission to long-term

care homes receive information about their rights and assistance in exercising

their rights;

(

e) providing

for exemptions from provisions of this Part, subject to any conditions that may

be set out in the regulations;

(

f) modifying

the application of this Part for emergencies or other special circumstances

specified in the regulations;

(

g) providing

for applications under

section 51 for admission to a long-term care home to be

made before the home is licensed or approved;

(

h) defining

“veteran” for the purposes of

section 57;

(

i) providing

for anything that under this Part may or must be provided for in regulations,

or that is to be done in compliance with or in accordance with the regulations.

Different

requirements for programs, groups

(3) The

regulations may provide for different requirements for programs or groups specified

in the regulations.

PART V

COUNCILS

Residents’ Council

Residents’

Council

(1) Every licensee of a long-term

care home shall ensure that a Residents’ Council is established in the home.

Only

residents

(2) Only

residents of the long-term care home may be members of the Residents’ Council.

Powers

of Residents’ Council

(1) A Residents’ Council of a

long-term care home has the power to do any or all of the following:

1. Advise

residents respecting their rights and obligations under this Act.

2. Advise

residents respecting the rights and obligations of the licensee under this Act

and under any agreement relating to the home.

3. Attempt

to resolve disputes between the licensee and residents.

4. Sponsor

and plan activities for residents.

5. Collaborate

with community groups and volunteers concerning activities for residents.

6. Advise

the licensee of any concerns or recommendations the Council has about the

operation of the home.

7. Provide

advice and recommendations to the licensee regarding what the residents would

like to see done to improve care or the quality of life in the home.

8. Report

to the Director any concerns and recommendations that in the Council’s opinion

ought to be brought to the Director’s attention.

9. Review,

i. inspection

reports and summaries received under

section 152,

ii. a

written plan for achieving compliance, prepared by the licensee, that the

Director has ordered in accordance with clause 155 (1) (

b) following a referral

under paragraph 4 of subsection 154 (1),

iii. the

detailed allocation, by the licensee, of funding under this Act, the Local Health System Integration Act, 2006 and the Connecting Care Act, 2019 and amounts paid by residents,

iv. the

financial statements relating to the home filed with the Director under the

regulations or provided to a local health integration network or to the Agency,

and

v. the

operation of the home.

10. Exercise

any other powers provided for in the regulations.

Duties

(2) The

Residents’ Council shall comply with any duties provided for in the regulations.

Duty

to respond

(3) If

the Residents’ Council has advised the licensee of concerns or recommendations

under either paragraph 6 or 8 of subsection (1), the licensee shall, within 10

days of receiving the advice, respond to the Residents’ Council in writing.

Minister

to consult

(4) The

Minister shall consult, in a manner the Minister considers appropriate, with organizations

that represent the interests of Residents’ Councils on an annual basis.

Residents’

Council assistant

(1) Every licensee of a long-term

care home shall appoint a Residents’ Council assistant who is acceptable to

that Council to assist the Residents’ Council.

Duties

(2) In

carrying out their duties, a Residents’ Council assistant shall take

instructions from the Residents’ Council, ensure confidentiality where

requested and report to the Residents’ Council.

Family Council

Family

Council

(1) Every long-term care home may

have a Family Council.

Request

for Family Council

(2) If

there is no Family Council, a family member of a resident or a person of

importance to a resident may request the establishment of a Family Council for

a long-term care home.

Licensee

to assist

(3) The

licensee shall assist in the establishment of a Family Council within 30 days

of receiving a request from a person mentioned in subsection (2).

Notification

of Director

(4) When

a Family Council is established, the licensee shall notify the Director or

anyone else provided for in the regulations of the fact within 30 days of the

establishment.

Right

to be a member

(5) Subject

to subsection (6), a family member of a resident or a person of importance to a

resident is entitled to be a member of the Family Council of a long-term care

home.

Who

may not be a member

(6) The

following persons may not be members of the Family Council:

1. The

licensee, and anyone involved in the management of the long-term care home on

behalf of the licensee.

2. An

officer or director of the licensee or of a corporation that manages the long-term

care home on behalf of the licensee or, in the case of a home approved under

Part IX, a member of the committee of management for the home under

section 135

or of the board of management for the home under

section 128 or 132 as the case

may be.

3. A

person with a controlling interest in the licensee.

4. The

Administrator.

5. Any

other staff member.

6. A

person who is employed by the Ministry or has a contractual relationship with

the Minister or with the Crown regarding matters for which the Minister is

responsible and who is involved as part of their responsibilities with

long-term care home matters.

7. Any

other person provided for in the regulations.

Licensee

obligations if no Family Council

(7) If

there is no Family Council, the licensee shall,

(

a) on

an ongoing basis advise residents’ families and persons of importance to

residents of the right to establish a Family Council; and

(

b) convene

semi-annual meetings to advise such persons of the right to establish a Family

Council.

Powers

of Family Council

(1) A Family Council of a long-term

care home has the power to do any or all of the following:

1. Provide

assistance, information and advice to residents, family members of residents

and persons of importance to residents, including when new residents are

admitted to the home.

2. Advise

residents, family members of residents and persons of importance to residents

respecting their rights and obligations under this Act.

3. Advise

residents, family members of residents and persons of importance to residents

respecting the rights and obligations of the licensee under this Act and under

any agreement relating to the home.

4. Attempt

to resolve disputes between the licensee and residents.

5. Sponsor

and plan activities for residents.

6. Collaborate

with community groups and volunteers concerning activities for residents.

7. Review,

i. inspection

reports and summaries received under

section 152,

ii. a

written plan for achieving compliance, prepared by the licensee, that the

Director has ordered in accordance with clause 155 (1) (

b) following a referral

under paragraph 4 of subsection 154 (1),

iii. the

detailed allocation, by the licensee, of funding under this Act, the Local Health System Integration Act, 2006 and the Connecting Care Act, 2019 and amounts paid by residents,

iv. the

financial statements relating to the home filed with the Director under the

regulations, with the local health integration network for the geographic area

where the home is located under the Local Health System

Integration Act, 2006 and with the Agency, and

v. the

operation of the home.

8. Advise

the licensee of any concerns or recommendations the Council has about the

operation of the home.

9. Report

to the Director any concerns and recommendations that in the Council’s opinion

ought to be brought to the Director’s attention.

10. Exercise

any other powers provided for in the regulations.

Duties

(2) The

Family Council shall comply with any duties provided for in the regulations.

Duty

to respond

(3) If

the Family Council has advised the licensee of concerns or recommendations

under either paragraph 8 or 9 of subsection (1), the licensee shall, within 10

days of receiving the advice, respond to the Family Council in writing.

Minister

to consult

(4) The

Minister shall consult, in a manner the Minister considers appropriate, with organizations

that represent the interests of Family Councils on an annual basis.

Family

Council assistant

(1) If the Family Council so

requests, the licensee shall appoint a Family Council assistant who is

acceptable to that Council to assist the Family Council.

Duties

(2) In

carrying out their duties, a Family Council assistant shall take instructions

from the Family Council, ensure confidentiality where requested and report to the

Family Council.

General

Licensee

to co-operate with and assist Councils

68 A licensee shall co-operate with the Residents’

Council, the Family Council, the Residents’ Council assistant and the Family

Council assistant and shall provide them with such financial and other

information and such assistance as is provided for in the regulations.

Licensee

duty to meet with Council

69 If invited by the Residents’ Council or the

Family Council, the licensee shall meet with that Council or, if the licensee

is a corporation, ensure that representatives of the licensee meet with that

Council.

Attendance

at meetings — licensees, staff, etc.

70 A licensee of a long-term care home shall

attend a meeting of the Residents’ Council or the Family Council only if

invited, and shall ensure that the staff, including the Administrator, and

other persons involved in the management or operation of the home attend a

meeting of either Council only if invited.

interference by licensee

71 A licensee of a long-term care home,

(

a) shall

not interfere with the meetings or operation of the Residents’ Council or the

Family Council;

(

b) shall

not prevent a member of the Residents’ Council or Family Council from entering

the long-term care home to attend a meeting of the Council or to perform any

functions as a member of the Council and shall not otherwise hinder, obstruct

or interfere with such a member carrying out those functions;

(

c) shall

not prevent a Residents’ Council assistant or a Family Council assistant from

entering the long-term care home to carry out their duties or otherwise hinder,

obstruct or interfere with such an assistant carrying out those duties; and

(

d) shall

ensure that no staff member, including the Administrator or other person

involved in the management or operation of the home, does anything that the

licensee is forbidden to do under clauses (

a) to (c).

Immunity

— Council members, assistants

72 No action or other proceeding shall be

commenced against a member of a Residents’ Council or Family Council or a Residents’

Council assistant or Family Council assistant for anything done or omitted to

be done in good faith in the capacity as a member or an assistant.

Duty

of licensee to consult Councils

73 A licensee has a duty to consult regularly with

the Residents’ Council, and with the Family Council, if any, and in any case

shall consult with them at least every three months.

Regulations

(1) The Lieutenant Governor in

Council may make regulations for carrying out the purposes and provisions of

this Part.

Specific

inclusions

(2) Without

restricting the generality of subsection (1), the Lieutenant Governor in

Council may make regulations,

(

a) requiring

a licensee to assist in the formation of Residents’ Councils and Family

Councils, and governing the assistance that the licensee is required to provide

to those Councils;

(

b) respecting

and governing the duties of Residents’ Councils and Family Councils;

(

c) defining

“detailed allocation” for the purpose of subparagraph 9 iii of subsection 63

(1) and subparagraph 7 iii of subsection 66 (1);

(

d) providing

for anything that under this Part may or must be provided for in regulations,

or that is to be done in compliance with or in accordance with the regulations.

PART VI

OPERATION OF HOMES

Directors, Officers and Other Staff

Duties

of directors and officers of a corporation

(1) Where a licensee is a

corporation, every director and every officer of the corporation shall ensure

that the corporation complies with all requirements under this Act.

Municipal

Homes and First Nations Homes

(2) In

the case of a long-term care home approved under

Part IX,

(

a) if

there is a committee of management for the home under

section 135, the

obligation under subsection (1) is an obligation on every member of that

committee; and

(

b) if

there is a board of management for the home under

section 128 or 132, the

obligation under subsection (1) is an obligation on every member of that board.

Offence

(3) Every

person who fails to comply with this

section is guilty of an offence.

Corporate

prosecution not necessary

(4) A

person may be prosecuted and convicted under this

section even if the

corporation has not been prosecuted or convicted.

Administrator

(1) Every licensee of a long-term

care home shall ensure that the home has an Administrator.

Role

(2) The

Administrator,

(

a) shall

be in charge of the long-term care home and be responsible for its management;

and

(

b) shall

perform any other duties provided for in the regulations.

Time

must work in position

(3) If

the number of beds at a long-term care home is,

(

a) equal

to or greater than the prescribed number of beds, the licensee of the home

shall ensure that the Administrator works full-time in that position; or

(

b) less

than the prescribed number of beds, the licensee of the home shall ensure that

the Administrator works in that position, on average, at least the number of

hours per week that is prescribed for the number of beds at the home.

Director

of Nursing and Personal Care

(1) Every licensee of a long-term

care home shall ensure that the long-term care home ha