Summary#

Bill 37, Providing More Care, Protecting Seniors, and Building More Beds Act, 2021, became law as Chapter 39 of Ontario’s 2021 statutes. It repeals and replaces the Long-Term Care Homes Act, 2007 with the Fixing Long-Term Care Act, 2021, makes related changes to other Acts, and amends the Retirement Homes Act, 2010. Its stated goal is to improve long-term care, protect residents and build more beds; the Act does not itself require a set number of new beds to be built.

• Long-term-care home licensees must respect a list of residents’ rights, including rights to have their choices respected and to receive care based on a palliative-care philosophy. Residents may enforce those rights against a licensee as though they were contract terms.
• The law sets province-wide average direct-care targets: four hours per resident per day from personal support workers and registered nurses and practical nurses by March 31, 2025, and 36 minutes per resident per day from allied health care professionals by March 31, 2023. The averages are calculated across all homes, not as a minimum for each home.
• Licensees must provide care programs, infection prevention and control, emergency plans that cover epidemics and pandemics, yearly resident and family/caregiver surveys, and a Residents’ Council in every home. The Minister may establish a Long-Term Care Quality Centre, but the Act does not require that one be established.
• The Minister and Director get powers over funding and licences; inspectors and the Director can order corrective action, impose administrative penalties, and, in some cases, suspend or revoke licences or place a home under supervision.
• Retirement-home licensees must make accommodation and price information available on request. The Registrar also gains powers to make orders in prescribed extraordinary circumstances where there is a risk of harm to residents.
• The Act was enacted, but the new long-term-care law starts on a date to be named by proclamation. Some retirement-home changes also require proclamation; the supplied material does not give those dates.

What it means for you#

• Long-term-care residents: The law sets out rights to participate in decisions about care, make complaints, and be free from abuse and neglect. A home must have a written care plan for each resident and provide care according to that plan, subject to the resident’s consent.
• People seeking a long-term-care bed: Admission still depends on eligibility and authorization by a placement co-ordinator, as well as the home’s approval on specified grounds. The law does not promise admission or a bed within a set time.
• Families and caregivers: Homes must survey residents, families and caregivers at least yearly, make results and improvement actions available to residents and families, and seek advice from councils. A Family Council is optional, but a home must help establish one if a family member or person important to a resident requests it.
• Long-term-care home operators and staff: Licensees must meet the care, staffing, infection-control, training and emergency-planning duties in the Act and regulations. Staff and certain professionals must report specified suspected harm, abuse, neglect or misuse; the law protects people who report from retaliation.
• Retirement-home residents and people comparing homes: You can request information about accommodation and prices. Inspection reports must exclude personal information and health information; the law limits the information included about whether a contravention occurred.
• The public: The Minister and Director must make specified reports, orders and other information public, subject to rules in the Act and regulations.

Money#

No publicly available information on the total or annual cost is in the supplied material.

• The Minister may provide funding to long-term-care homes and attach conditions, but the Act does not set out a funding amount.
• The staffing targets and other duties may require homes to provide staff and services, but no cost estimate or staffing plan is provided.
• An inspector or Director may order a licensee to pay for work needed to achieve compliance. Administrative penalties can be up to $250,000 for a failure to comply.
• Residents may still be charged for accommodation and certain agreed extra items, within limits set by regulations. The supplied material does not specify changes to those limits.

What is unclear#

• The Act leaves many operating details to regulations, including which staff hours count toward the targets, how targets are measured, and standards for care programs.
• The Act sets province-wide staffing averages but does not say how the hours should be distributed among individual homes.
• The supplied material does not give a commencement date for the new long-term-care law or the retirement-home provisions that require proclamation.
• The Act allows licensing and temporary additional beds, but does not specify a construction target, a plan to build beds, or funding for new construction.
• The Registrar’s new retirement-home order power depends on “extraordinary circumstances” set out in regulations; those circumstances are not specified in the supplied text.

Case for#

• A possible argument for the bill is that resident rights are clearer and can be enforced against a licensee, rather than being only statements of principle.
• The direct-care targets, annual public progress reports and plans required when targets are missed create measurable goals and require the Minister to explain shortfalls.
• Required emergency plans, infection-control programs and yearly experience surveys address safety and quality through ongoing duties on each home.
• Inspection, penalty and supervision powers give government tools to respond when a home does not meet legal requirements.

Case against#

• The staffing targets are province-wide averages, so they do not guarantee a particular resident or home a set number of direct-care hours.
• The Act sets substantial duties but does not itself provide a funding amount or explain how homes will meet staffing targets.
• Many important details depend on regulations that are not included here, leaving key standards and processes unsettled in the supplied material.
• The bill’s title refers to building more beds, but the text supplied does not require a specific number of new beds or provide money to build them.
• Limiting personal details in retirement-home inspection reports protects privacy, but may also leave the public with less information about some findings.