Stronger Care in Long-Term and Retirement Homes

Summary#

• This Ontario bill changes rules for long-term care homes and retirement homes to improve care for seniors and support caregivers.
• It adds required programs for dementia care and for meeting cultural, language, religious, and spiritual needs. It also strengthens protections against abuse and neglect, and updates who leads clinical care in long-term care homes.
• For retirement homes, it adds a new right to ongoing support from caregivers and allows senior ministry officials to issue directions during infectious disease outbreaks.

Key changes:

• Long-term care homes must run a dementia care program.
• Homes must have a program that recognizes residents’ cultural, linguistic, religious, and spiritual needs, and give residents reasonable chances to practice their beliefs.
• The “Medical Director” role becomes “Clinical Director,” who can be a doctor or a nurse practitioner. The Clinical Director advises on medical care and consults with nursing leaders.
• New offences for abuse or neglect of residents by licensees, staff, volunteers, and service providers. Corporate officers who allow this can also be guilty.
• Stronger investigation tools (warrants, seizures, production orders) and a general offence for any breach of the law or rules by a licensee.
• The Director can require reports about placement and admission from placement co-ordinators.
• Rules can be made on psychotropic drug use and on what information must be available in English and French.
• Retirement home residents gain a right to ongoing support from their caregivers (as defined by regulation).
• Senior ministry officials can give binding directions to retirement homes on preventing and managing infectious respiratory and gastrointestinal diseases.

Timing:

• Most enforcement and investigation changes take effect when the bill becomes law.
• The dementia program, cultural/religious program, Clinical Director requirement, and psychotropic drug rules will start later on a date set by the government.
• The new caregiver right in retirement homes will also start later on a date set by the government.

What it means for you#

• Residents in long-term care

  • Expect a formal dementia care program to support memory, behavior, and daily living.
  • More support to practice your religion and observe spiritual customs.
  • Homes must recognize and respect your culture and language needs.
  • Stronger protection from abuse or neglect, with clearer penalties for those who harm or fail to care for residents.

• Families and caregivers

  • In retirement homes, residents will have a new right to ongoing support from their caregivers (once that part takes effect). This could mean easier access and clearer recognition of your role.
  • You may see clearer processes and reports when psychotropic drugs (like antipsychotics) are used.
  • During outbreaks, retirement homes may follow binding directions from senior ministry officials aimed at preventing and managing spread.

• Staff and volunteers

  • New legal risk if you abuse or neglect a resident. Offences can apply even if the resident is off-site but receiving care from the home’s staff.
  • Expect to take part in new or updated dementia and cultural/religious programs.
  • Greater oversight of psychotropic drug use and more consultation with the Clinical Director.
  • Investigators have stronger powers (with warrants) to ask questions, collect records, and require cooperation.

• Long-term care home operators (licensees)

  • You must set up and run organized dementia and cultural/religious programs.
  • You must appoint a Clinical Director (doctor or nurse practitioner) and ensure they consult with nursing leaders.
  • You can face a general offence for any breach of the Act or regulations, and specific offences for abuse or neglect.
  • Inspectors can require you to pay for expert tests or assessments (not medical tests of residents) and provide the reports.
  • The Director can require reports on placement and admissions.
  • You may need to provide certain information in English and French, based on future regulations.

• Retirement home operators (licensees)

  • Residents will gain a right to ongoing caregiver support (timing set by the government).
  • You must implement binding directions from senior ministry officials during specified infectious disease situations, and consider recommendations.
  • If directions conflict with local public health advice or orders, public health rules win.

Expenses#

No publicly available information.

Proponents' View#

• Creates dedicated dementia care programs so residents get more focused support.
• Respects diverse cultures, languages, religions, and spiritual needs, which can improve quality of life.
• Strengthens protection from abuse and neglect and gives investigators better tools to hold bad actors accountable.
• Lets nurse practitioners serve as Clinical Directors, helping homes fill leadership roles and improve access to care.
• Tightens oversight of psychotropic drugs to encourage safer, more appropriate use.
• Helps retirement homes act quickly during outbreaks with clear directions from senior ministry officials.
• Recognizes the role of caregivers in retirement homes, supporting residents’ well-being.

Opponents' View#

• New requirements and potential fines may raise operating costs for homes, which could be passed on to residents.
• Expanded warrant and seizure powers may raise privacy concerns for residents, families, and staff.
• Allowing ministry officials to issue binding directions without the full regulation process could reduce transparency and consistency.
• Changing from a physician-only Medical Director to a Clinical Director that can be a nurse practitioner may reduce direct physician oversight in some homes.
• Bilingual information rules and mandated expert reports at the licensee’s expense could add administrative burdens.
• Longer time limits for prosecutions increase legal exposure and uncertainty for operators and boards.