Proposed new standards for long-term care issued by a panel of Healthcare Standards Organization experts on Tuesday say residents must receive at least four hours of direct care a day and workers must be paid more.
But experts from the nonprofit organization said the new standards will only be useful if the government puts them into practice and ensures that they are followed.
“These standards are only useful if … they become the basis for compliance and accountability measures, not just accreditation measures,” said Dr. Samir Sinha, chair of the technical committee that developed the updated standards.
The organization issued updated guidance for operating care homes in light of the deadly and tragic toll the COVID-19 pandemic has taken on Canadian residents and their quality of life.
The authors say the ball is now in the government’s court.
“The standards themselves can become the basis for legislation, they could become the basis for policy and other accountability measures,” Sinha said.
Some provinces already require long-term care homes to be accredited according to the organization’s standards, while other homes seek accreditation voluntarily.
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The Health Standards Organization expects about 68 percent of long-term care homes to become voluntarily or mandatory accredited using the updated standards.
But Sinha said that the accreditation will not be enough without the application.
Long-term care as a health service falls under provincial jurisdiction, and there is a patchwork of rules across the country that govern how homes should be designed, operated, and maintained.
Time is of the essence to introduce and enforce new standards of long-term care: authors. #CDNPoli #LongTermCare
Usually, it would be up to provincial governments to enforce the standards if they wanted to, but in the 2021 election, Prime Minister Justin Trudeau promised to legislate long-term care safety across the country.
The Liberals doubled down on that promise as a condition in their trust and supply deal with the New Democrats, in which the opposition party would support the minority government through key votes in the House of Commons to avoid an election until 2025.
But so far both sides have been silent on what such legislation would entail.
“As long-term care falls under provincial and territorial jurisdiction, any legislation will be designed to reflect jurisdictional responsibilities,” Health Canada spokeswoman Tammy Jarbeau said in a statement.
The government set aside $3 billion in the 2021 budget to help provinces and territories implement standards for long-term care, increase wages and improve staff-to-patient ratios.
However, it is likely that much more money will be needed to implement the standards. In 2021, the Parliamentary budget officer estimated that it would cost an additional $4.3bn per year just to expand the number of hours of daily care to the four hours listed by the Health Standards Organization.
Employees of long-term care homes are also not paid on par with other healthcare workers.
“If you were working in a long-term care home, you’d probably be making a lot less than you would as a personal support worker, nurse, occupational therapist, social worker … working in a publicly funded hospital,” Sinha said.
Labor shortages were a key factor in the devastating situation that unfolded during the early days of the pandemic as staff struggled to provide adequate care, and Sinha said the problem persists today as homes for seniors are dealing with COVID-19 and flu outbreaks.
New guidelines for long-term care home design and infection prevention practices were developed along with updated standards of care. They were published last month by the CSA Group, formerly known as the Canadian Standards Association.
CSA Group standards cover everything from the number of residents who must share a room to the materials used to construct the building.
The CSA Group standards are strictly voluntary at this time, but the experts who developed those building standards hope they will be quickly adopted into regulations.
“Time is of the essence as there are plans across the country, in various provinces and territories, to build new long-term care homes,” said Alex Mihailidis, who chaired the CSA Group committee.
“Our hope is that they look at our standard before the blades are in the ground.”
Mihailidis believes that if the standards were in place when COVID-19 hit in 2020, fewer things may have been overlooked, but until the new guidelines are in place and enforced, he said it’s still a matter of waiting and seeing.
“It’s definitely a big step in the right direction,” he said.
This report by The Canadian Press was first published on January 31, 2023.