The Long-Term Care Homes Act (“LTCHA”) and the General Regulation to the LTCHA (Regulation 79/10) came into force on July 1, 2010, bringing with them sweeping changes for all long-term care homes in Ontario.
The LTCHA replaces the Nursing Homes Act, the Charitable Institutions Act and the Homes for the Aged and Rest Homes Act, which were repealed on the day the LTCHA came into force. The Long-Term Care Homes Program Manual is also no longer in effect and its function has largely been assumed by the General Regulation.
The stated purpose of the LTCHA is to enhance the quality of life for residents of long-term care homes by strengthening enforcement, improving care and increasing accountability. The Act itself provides the framework for long-term care homes in Ontario, with the General Regulation setting out the details regarding day-to-day operations for homes that are subject to the Act. The General Regulation in particular is extremely prescriptive in terms of policies, procedures and other systems requirements that homes must have in place.
Changes under the new regulatory regime affect nearly every aspect of long-term care, including corporate governance, licensing and operation of long-term care homes, and the delivery of services and care to residents.
Residents’ rights and complaints processes are entrenched in legislation, as are requirements around plans of care and certain programs and services that must be provided. Specific safeguards against resident abuse and neglect, and extensive provisions relating to the use of restraints are set out in the Act and Regulation. Further, processes for admission of residents, including specific requirements around comprehensive assessment of long-term care applicants, the provision of information to residents/families, and placement of eligible applicants are expanded under the new regime.
From an operational perspective, the Act and Regulation create significant new responsibilities and attendant liability for corporate directors and officers, members of the Committee of Management or Board of Management for Municipal and First Nations Homes under the Act, as well as for administrators.
There are extensive business implications relating to new licensing requirements and the financial and resource demands for compliance with requirements relating to policies and procedures, services, and staffing. The LTCHA provides broad funding discretion for the Ontario Minister of Health and Long-Term Care, including the authority to attach conditions on funding and the use of funding dollars.
In all, the regulatory regime created by the LTCHA and Regulation has considerable implications for long-term care homes from a business, operational, risk management, and liability perspective. Practically speaking, significant resources must be dedicated to ensure the obligations created by the Act and General Regulation are fulfilled, particularly in light of the consequences for failure to do so.
It is consequently critically important for long-term care homes to assess their current practices in the context of the LTCHA and the General Regulation; to have in place appropriate risk management strategies including policies, procedures and processes, as well as adequate insurance coverage; and to ensure directors and officers, administrators and staff are educated on the new regulatory regime and the obligations that come with it.
For further information from Miller Thomson regarding the LTCHA and its regulations, please click on the titles below:
Communiqué for the Health Industry, June 2, 2009: Long Awaited Regulations for the Ontario Long-Term Care Homes Act, 2007 Proposed
Communiqué for the Health Industry, July 9, 2007: Long-Term Care Homes Act, 2007
Communiqué for the Health Industry, October 6, 2006: Long Awaited Long-Term Care Homes Act Introduced