Public Hospital Advisory: Ministry of Health relaxes approval process to enable hospitals to build COVID-19 capacity

April 1, 2020 | Kathryn M. Frelick, Karima Kanani, Meg Berkovitz

Public hospitals across the province are working with their system partners and communities to build capacity to manage patients suffering from COVID-19 and to create flexible space to minimize the risk of exposure to other patients and staff.  This includes the creation of new spaces or premises to assess and provide care to COVID-19 patients, and/or the transfer of hospital patients to other locations in order to create additional space to provide care.

Section 4(2) of Ontario’s Public Hospitals Act (“PHA”) requires the approval of the Minister of Health to operate or use any “institution, building or other premises or place” for the purposes of a hospital.  On March 26, 2020, the Assistant Deputy Minister of Health issued a communication to all Ontario public hospitals, waiving the submission requirements under the Ministry of Health’s Section 4 Approvals Protocol. 

In addition, the communication provides a general approval to all public hospitals under subsection 4(2) of the PHA to operate and use premises, which could include a hotel, retirement home or community centre, for the purposes of a hospital, provided that the following conditions are met:

  • the hospital leases, licenses or otherwise acquires a temporary right to occupy the premises after March 26, 2020 to address the hospital’s need, arising from COVID-19, to create greater capacity for treatment of patients;
  • the term of any lease entered into does not extend beyond June 30, 2020;
  • the premises are selected with due regard to their suitability for the intended purposes and the safety of patients, hospital staff and others; and
  • the hospital agrees to provide the Ministry any information that the Ministry requests relating to the premises, including the address, specific premises or portion of premises being occupied, purposes for which the premises are used, number of beds operated on the premises, details respecting rent, copy of the lease or license agreement, etc.

The general approval is temporary and effective until June 30, 2020, unless it is revoked earlier.

The general approval does not apply to the purchase of property by a hospital.  If a hospital is proposing to purchase premises, it is required to seek Ministry approval in accordance with the Section 4 Approvals Protocol.

In these uncertain and rapidly evolving times, Miller Thomson Health Industry lawyers remain available to support public hospitals on all aspects of their COVID-19 planning, including leasing or licensing arrangements for space to expand capacity for patient care.


Miller Thomson is closely monitoring the COVID-19 situation to ensure that we provide our clients with appropriate support in this rapidly changing environment. For articles, information updates and firm developments, please visit our COVID-19 Resources page.


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