p42 s2 bill 37 b037ra e.pdf

Ontario — Bills

2ND SESSION, 42ND LEGISLATURE, ONTARIO 70 ELIZABETH II, 2021 Bill 37 (Chapter 39 of the Statutes of Ontario, 2021)

An Act to enact the Fixing Long-Term Care Act, 2021 and amend or repeal various Acts The Hon. R. Phillips Minister of Long-Term Care 1st Reading October 28, 2021 2nd Reading November 18, 2021 3rd Reading December 7, 2021 Royal Assent December 9, 2021

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SCHEDULE 1 FIXING LONG-TERM CARE ACT, 2021 The Long-Term Care Homes Act, 2007 is repealed and replaced.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 fo r 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 rig ht to be provided with car e 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 Resident s’ 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 oper ation 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 requ ired 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.

ii 4. Currently,

section 106 of the Act requires the Registrar to make available for public inspection the information contained in registers establ ished 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 licens ee 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

An Act to enact the Fixing Long-Term Care Act, 2021 and amend or repeal various Acts CONTENTS 1. Contents of this Act 2. Commencement 3.

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 2

(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 1. Home: the fundamental principle 2.

Interpretation

PART II RESIDENTS: RIGHTS, CARE AND SERVICES RESIDENTS’ BILL OF RIGHTS 3. Residents’ Bill of Rights MISSION STATEMENT 4. Mission statement SAFE AND SECURE HOME 5. Home to be safe, secure environment PLAN OF CARE 6. Plan of care 7. Consent CARE AND SERVICES 8. Direct hours of care target — personal support workers, nurses 9. Direct hours of care target — allied health care professionals 10. Measuring progress 11. Nursing and personal support services 12. Palliative care 13. Restorative care 14. Recreational and social activities 15. Dietary services and hydration 16. Medical services 17.

Information and referral assistance 18. Religious and spiritual practices 19. Accommodation services 20. Volunteer program 21. Staffing and care standards 22. Standards for programs and services 23. Infection prevention and control program PREVENTION OF ABUSE AND NEGLECT 24. Duty to protect 25. Policy to promote zero tolerance REPORTING AND COMPLAINTS 26. Complaints procedure — licensee 27. Licensee must investigate, respond and act 28. Reporting certain matters to Director 29. Inspections or inquiries where information received by Director 30. Whistle-blowing protection 31.

Complaint to Ontario Labour Relations Board 32. Obstruction — information to inspectors, Director MINIMIZING OF RESTRAINING 33. Policy to minimize restraining of residents, etc. 34. Protection from certain restraining 35. Restraining by physical devices 36. PASDs that limit or inhibit movement 37. Records on restraining of residents 38. Prohibited devices that limit movement 39. Common law duty OFFICE OF THE LONG-TERM CARE HOMES RESIDENT AND FAMILY ADVISER 40. Office of the Long-Term Care Homes Resident and Family Adviser REGULATIONS 41. Regulations

PART III QUALITY 42. Continuous quality improvement 43. Resident and Family/Caregiver Experience Survey 44. Long-Term Care Quality Centre

3 45. Regulations

PART IV ADMISSION OF RESIDENTS 46. Application of

Part 47. Designation of placement co-ordinators 48. Placement co-ordinator to comply with Act, etc. 49. Requirements for admission to home 50. Eligibility for long-term care home admission 51. Authorization for admission to a home 52. Elements of consent 53. Substitute decision-maker may apply for person 54. Transfer of application 55. Controls on licensee 56. Suspension of admissions where risk of harm 57. Preference for veterans 58. Immunity — placement co-ordinator’s employees and agents 59. Hearing — ineligibility 60. Appeal to Divisional Court 61. Regulations

PART V COUNCILS RESIDENTS’ COUNCIL 62. Residents’ Council 63. Powers of Residents’ Council 64. Residents’ Council assistant FAMILY COUNCIL 65. Family Council 66. Powers of Family Council 67. Family Council assistant GENERAL 68. Licensee to co-operate with and assist Councils 69. Licensee duty to meet with Council 70. Attendance at meetings — licensees, staff, etc. 71. No interference by licensee 72. Immunity — Council members, assistants 73. Duty of licensee to consult Councils 74. Regulations

PART VI OPERATION OF HOMES DIRECTORS, OFFICERS AND OTHER STAFF 75. Duties of directors and officers of a corporation 76. Administrator 77. Director of Nursing and Personal Care 78. Medical Director 79. Staff qualifications 80. Continuity of care — limit on temporary, casual or agency staff 81. Screening measures 82. Training 83. Orientation for volunteers RESIDENTS — INFORMATION, AGREEMENTS, ETC. 84. Information for residents, etc. 85. Posting of information 86. Regulated documents for resident 87. Voidable agreements 88. Agreement cannot prevent withdrawal of consent, etc. 89. Coercion prohibited GENERAL MANAGEMENT 90. Emergency plans 91. Reports REGULATIONS 92. Regulations

PART VII FUNDING 93. Funding 94. Resident charges 95. Accounts and records

4 96. Non-arm’s length transactions, limitation 97. Regulations

PART VIII LICENSING 98. Licence required 99. Public interest — need 100. Public interest — who can be issued a licence 101. Limitations on eligibility for licence 102. Issue of licence 103. Undertaking to issue licence 104. Conditions of licence 105. Term of licence 106. End of term 107. Beds allowed under licence 108. Transfers, limitation 109. Public consultation 110. Exercise of security interests 111. Notice 112. Gaining controlling interest 113. Management contracts 114. Temporary licences 115. Temporary emergency licences 116. Amendments with consent 117. Competitive process 118. No appeal 119. Review by Minister 120. Regulations

PART IX MUNICIPAL HOMES AND FIRST NATIONS HOMES

INTERPRETATION 121.

Interpretation SOUTHERN HOMES 122. Southern municipal homes 123. Joint homes — south 124. Agreement to help maintain home — south NORTHERN HOMES 125. Northern municipal homes 126. Joint homes — north 127. Agreement to help maintain home — north 128. Territorial district home under board of management 129. Operating costs — apportionment by board of management 130. Capital costs — apportionment by board of management 131. Regulations, apportionments by boards of management FIRST NATIONS HOMES 132. First Nations homes GENERAL 133. Approval required 134. Application of

Part VIII 135. Committee of management, appointment 136. Trust funds 137. Personal information, disclosure to inspectors, etc. 138. Director may make orders re renovations, etc. 139. Director may take control with consent 140. Taking control on certain grounds 141. Provisional exercise of power without hearing 142. Powers where control is taken 143. Regulations

PART X COMPLIANCE AND ENFORCEMENT INSPECTIONS 144. Appointment of inspectors 145. Purpose of inspection 146. Annual inspection 147. Inspections unannounced 148. Meeting with councils 149. Powers of entry

5 150. Powers on inspection 151. Warrant 152. Inspection report 153. Obstruction, etc. ENFORCEMENT 154. Actions by inspector if non-compliance found 155. Compliance orders 156. Order that funding be returned or withheld 157. Order requiring management 158. Notice of administrative penalty 159. Suspension or revocation 160. Supervisor, rules relating to employees 161. Minister’s suspension 162. Due diligence, mistake do not prevent orders or penalties 163. More than one order or notice 164. Enforcement under other Acts 165. Order or notice not a bar to conviction 166. Form and service of orders and notices 167.

Filing with court 168. Offence REVIEWS AND APPEALS 169. Review of inspector’s order or notice 170. Appeal from order, notice, decision 171. When and how appeal to be made 172. No automatic stay of order or decision 173. Parties 174. Hearing 175. Decision of Appeal Board 176. Appeal to court 177. Funding not to be considered MISCELLANEOUS AND ACCESS TO INFORMATION 178. Recognition 179. Publication 180. Reports, etc., to be public 181. Copy constitutes evidence 182. Compellability, civil suit 183. Regulations

PART XI ADMINISTRATION, MISCELLANEOUS 184. Directives by Minister 185. Director — appointment 186. Altering or revoking orders 187. Personal information, collection 188. Restriction on terms 189. Affidavits 190. Service 191. Immunity 192. Penalties 193. Regulations 194. Public consultation before making initial regulations 195. Amendments 196. General provisions re regulations

PART XII TRANSITIONAL 197. Transitional — compliance 198. Transitional — interim manager 199. Transition, licences 200. Transition, municipal homes 201. Further transitional, Charitable Institutions Act 202. Further transitional, Homes for the Aged and Rest Homes Act

PART XIII AMENDMENTS TO THIS ACT 203. Amendments to this Act

PART XIV REPEAL 204. Repeal

PART XV COMMENCEMENT AND

SHORT TITLE 205. Commencement 206.

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 t o 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 i s 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 li ve with dignity and in security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met.

Interpretation 2

(1) In this Act, “abuse”, in relation to a resident, means physical, sexual, emotional, verba l 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 t he 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 in

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, or (

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,

8 (

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 understan ds it or not.

PART II RESIDENTS: RIGHTS, CARE AND SERVICES RESIDENTS’ BILL OF RIGHTS Residents’ Bill of Rights 3

(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.

9 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 thei r 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 accor dance 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 importan ce 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 n ot 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 poli cies 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.

10 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 gover ning how rights set out in the Residents’ Bill of Rights shall be respected and promoted by the licensee. MISSION STATEMENT Mission statement 4

(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 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 6

(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,

11 (

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.

12 CARE AND SERVICES Direct hours of care target — personal support workers, nurses 8

(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 w ork 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) an d (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 t he 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 nurse s 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 9

(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, 2022. Additional targets

(5) To further the purposes of this section, additional targets that are higher than th ose set out in subsection s (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 hea lth 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.

13 Measuring progress 10

(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 basi s. Assessment

(2) For the purposes of subsection (1), the Minister shall assess whether there are barriers or risks to achieving the targets an d 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 tar get 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 11

(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 h ome 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 12

(1) Every licensee of a long -term care home shall ensure that, subject to sectio n 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 13

(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

14 (

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 prov ided 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 14

(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 15

(1) Every licensee of a long-term care home shall ensure that there is, (

a) an organize d 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 17

(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 19

(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 line n 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 20

(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. To 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.

15 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 22

(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 23

(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 24

(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. If 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 25

(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;

16 (

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 mandato ry 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 requireme nts 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 26

(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 t o 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 lice nsee 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 27

(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 28

(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.

17 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 perso n 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 29

(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 followin g 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.

18 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 con cerned 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 in spector 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 operati on 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 Counc il. 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 30

(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 unde r

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 o r 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. No 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), ev en 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 t o 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 31

(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.

20 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 collect ive 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. (“empl oyeur”) 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. 33

(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 34

(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 th e 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.

21 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 35

(1) A resident may be restrained by a physical device as described in paragraph 3 of subsection 34 (1) if the res training 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 s ignificant 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 a nd 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 36

(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:

22 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 effec tive 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 activ ity 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 r esident 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 39

(1) Nothing in this Act affects the common law duty of a caregiver to restrain or confine a per son 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 i n subsection (1), the licensee shall ensure that the device is used in accordance with any requirements provided for in the regulations and that an y 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 th e 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.

23 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 41

(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 cl ause 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);

24 (

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 43

(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 th e care, services, programs and goods provided at the home. Administration

(2) Where the regulations provide for how the su rvey 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 r easonable 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 44

(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 45

(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, i ncluding its development and its implementation; (

b) providing for and governing the survey of residents, families and caregivers, including its content, form and administration;

25 (

c) providing for and governing the composition and additional functions an d 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 of

Part 46

(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 47

(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 51. Eligibility for long-term care home admission 50

(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 admissio n 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,

26 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 o f 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 51

(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 designa ted pursuant to subsection 47 (1) for the geographic area where the home is located.

27 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 plac ement 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,

28 (

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 52

(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 b eing 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.

29 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 56

(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 agreement between the Government of Ontario and the Government of Canada relating to veterans; and (

b) are designated by the Minister as veterans’ priority access beds. Immunity — placement co-ordinator’s employees and agents 58

(1) No action or other proceeding shall be commenced against an employee or agent of a place ment 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 59

(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.

30 Opportunity for all parties

(9) No Appeal Board member shall take evidence from a party or other person under subsection (7) unless reasonable notic e 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 sam e 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 60

(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 B oard 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.

31 Regulations 61

(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 o ut 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 ho me 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 62

(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 63

(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.

32 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 Integrati on 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 o f 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 Mi nister considers appropriate, with organizations that represent the interests of Residents’ Councils on an annual basis. Residents’ Council assistant 64

(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 65

(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.

33 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 66

(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 per sons 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 relat ing 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 67

(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.

34 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 Cou ncil. 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 per sons involved in the management or operation of the home attend a meeting of either Council only if invited.

No 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 74

(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 75

(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 h ome 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 76

(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 Administra tor 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 77

(1) Every licensee of a long -term care home shall ensure that the long -term care home has a Director of Nursing and Personal Care. Must be R.N.

(2) The Director of Nursing and Personal Care shall be a registered nurse. Role

(3) The Director of Nursing and Personal Care, (

a) shall supervise and direct the nursing staff and personal care staff of the long -term care home and the nursing and personal care provided by them; and (

b) shall perform any other duties provided for in the regulations. Time must work in position

(4) 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 Director of Nursing and Personal Care works full-time in that position; or (

b) less than the prescribed number of beds, the licensee of the home sha ll ensure that Director of Nursing and Personal Care 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.

36 Medical Director 78

(1) Every licensee of a long-term care home shall ensure that the home has a Medical Director. Must be physician

(2) The Medical Director shall be a physician. Role

(3) The Medical Director, (

a) shall advise the licensee on matters relating to medical care in the long -term care home; and (

b) shall perform any other duties provided for in the regulations. Must consult

(4) In performing their duties under clause (3) (a), the Medical Director shall consult with the Director of Nursing and Personal Care and other health professionals working in the long-term care home. Staff qualifications 79 Every licensee of a long -term care home shall ensure that all the staff of the home, including the persons mentioned in sections 76 to 78, (

a) have the proper skills and qualifications to perform their duties; and (

b) possess the qualifications provided for in the regulations. Continuity of care — limit on temporary, casual or agency staff 80

(1) In order to provide a stable and consistent workforce and to improve continuity of care to residents, every licensee o f a long-term care home shall ensure that the use of temporary, casual or agency staff is limited in accordance with the regulations. Agency staff

(2) In subsection (1), “agency staff” means staff who work at the long-term care home pursuant to a contract between the licensee and an employment agency or other third party. Screening measures 81

(1) Every licensee of a long -term care home shall ensure that screening measures are conducted in accordance with the regulations before hiring staff and accepting volunteers. Police record checks

(2) The screening measures shall include police record checks, unless the person being screened is under 18 years of age. When agency staff is hired

(3) For the purposes of subsection (1), a staff member who is agency sta ff, as that term is defined in subsection 80 (2), is considered to be hired when they first work at the home. Where convicted of certain offences, etc.

(4) Every licensee of

Document details

Collection	Ontario — Bills
Citation	p42 s2 bill 37 b037ra e.pdf
Type	bill
Volume / chapter	p42 s2 bill 37 b037ra e.pdf
Language	en
Format	json
Source	PROVINCIAL
Identifier	be2a2d0d49f0f453936c553077ce53288f9d871b

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