Long Term Care Homes High-Level Briefing and One-Day Conference

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Long Term Care HomesHigh-Level Briefing and
One-Day Conference

• Ontario Health Coalition
• Alliance of Seniors/Older Canadians Network

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How We Got Here

• Rae Government three acts to formalize system
• Harris Government deregulation, 20,000 new beds
  most for-profit, Red Tape Commission
  recommended new Act
• McGuinty Government some reversals of
  Harris-era deregulation. Continuation of Harris
  tendering more new beds, continuation of
  for-profit privatization. Process leading to new
  Act, regulations.
• Monique Smith Report
• Bill 140
• Sharkey Report
• Sharkey Process
• Regulation Process eliminate Manual, new
  regulations

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Coming Up

• Sharkey process
• Regulations 30 day consultation
• Ombudsmans report recommendations

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Assessing Where We Are At History of
Deregulation/Some Reversals
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Ownership of LTC Homes Cross-Canada Comparison
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Envelope Funding System

• Nursing and Personal Care no profit
• Raw Food no profit
• Programs and Support Services no profit
• Accommodation profit
• Capital separate, profit

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Large For-Profit Chains Operating in Ontario

• Extendicare
• Chartwell
• Revera (was Central Care Corp.)
• Leisure World

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Ontario Health Coalition Key Issues in LTC homes
2006
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Ontario Health Coalition Key Issues in LTC homes
2006
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Ontario Health Coalition Key Issues in LTC homes
2006
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Ontario Health Coalition Key Issues in LTC homes
2006
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Ontario Health Coalition Key Issues in LTC homes
2006
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The missing link acuity increases, funding
increases, care levels stagnant
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Increasing Acuity

• 1992 2007 Acuity increase of 29.7
• In 2007 provincial CMM was 98.13 an increase in
  1.87 since 2006 when the provincial CMM was
  96.33
• Result of redefinition of complex continuing
  care, closing of hospital beds, ageing,
  downloading of mental health patients/closing of
  beds
• By 2007, 74 of Ontarios ltc residents were
  classified as Category F (second highest level of
  acuity)

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Assessing Acuity

• 2001 PriceWaterhouse Coopers Report
• Since then, government has never updated the
  study, but acuity has continued to increase.

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Status of Daily Hands-On CareStagnant Since 2005
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Analysis
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Shirlee Sharkeys Report
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Ontario Health CoalitionKey Recommendations in
2008

• A Minimum Care Standard
• Attached to measured acuity
• Average of 3.5 hours attached to average acuity
• Cover RN, RPN, PSW (daily hands-on care)
• Public reporting, compliance, enforcement
• Note there are existing minimum levels for
  Administrator, Director of Nursing, Food Services
  Supervisor, Therapy Services Coordinator,
  Registered Dietician, Recreation Leisure
  Services

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Ontario Health CoalitionKey Recommendations in
2008

• Appropriate care settings, special care units,
  review downloading
• Development of a Human Resources strategy as a
  priority
• Provide time and opportunities for staff to talk
  with residents for social and rehabilitation
  purposes, and recognize this activity as vital
  for quality of life for both residents and staff.
• Update the findings of the 2001 PriceWaterhouse
  Coopers Report into staffing and acuity levels
  in Ontarios nursing homes as per the Coroners
  Jury Recommendations in the Casa Verde homicide.
• Other recommendations as per our 2006 key issues.

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Current MOHLTC Initiatives

• Sharkey Process
• Regulations Process

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