Long-Term Care and Nursing Home Legislation Mandates Health Care and Prohibits Neglect and Abuse

In Ontario the passage of the Long-Term Care Homes Act, 2007 represents an advancement of the rights and protection for residents of long-term care and nursing homes. Residents and their family members who advocate on their behalf should be aware of the provisions of the Act and its regulation so that they will be able to enforce the duties and obligations of these homes and prevent neglect and abuse.

Organized Programs of Health Care

The operator of a long-term care home must ensure that there is an organized program of medical, nursing and personal support services for the home. A registered nurse must be present at all times.

Operators of long-term care homes must also develop and implement certain interdisciplinary programs in the home. These include:

(a) A falls prevention and management program to reduce the incidence of falls and the risk of injury,

(b) A skin and wound care program to promote skin integrity, prevent the development of wounds and pressure ulcers, and provide effective skin and wound care interventions,

(c) A continence care and bowel management program to promote continence and to ensure that residents are clean, dry and comfortable,

(d) A pain management program to identify pain in residents and manage pain.

Each of these programs must,

(a) provide for screening protocols; and

(b) provide for assessment and reassessment instruments.

Plans of Care

There must be a written plan of care for each resident that sets out,

(a) the planned care for the resident;

(b) the goals the care is intended to achieve; and

(c) clear directions to staff and others who provide direct care to the resident.

The care set out in the plan of care must be based on an assessment of the resident and the needs and preferences of the resident who is also to be given an explanation of the plan of care. The plan of care must cover all aspects of care, including medical, nursing, personal support, nutritional, dietary, recreational, social, restorative, religious and spiritual care.

The operator of a long-term care home has a duty to protect residents from abuse by anyone and to ensure that residents are not neglected by the home or its staff. In this context abuse includes physical, sexual, emotional, verbal or financial abuse. Each abuse is defined in detail in the regulation to the Act.

Bill of Rights

The Act also creates a resident’s bill of rights. These rights which total 27 in number include:

(a) the right to be protected from abuse,

(b) the right not to be neglected by the licensee or staff,

(c) the right to be properly cared for in a manner consistent with his or her needs,

(d) the right to be told who is responsible for and who is providing the resident’s direct care,

(e) the right to,

i. participate fully in the development, implementation, review and revision of his or her plan of care,

ii. give or refuse consent to any treatment, care or services for which his or her consent is required by law and to be informed of the consequences of giving or refusing consent,

iii. participate fully in making any decision concerning any aspect of his or her care, including any decision concerning his or her admission, discharge or transfer to or from a long-term care home or a secure unit and to obtain an independent opinion with regard to any of those matters, and

iv. have his or her personal health information within the meaning of the Personal Health Information Protection Act, 2004 kept confidential in accordance with that Act, and to have access to his or her records of personal health information, including his or her plan of care, in accordance with that Act,

(f) the right to designate a person to receive information concerning any transfer or any hospitalization of the resident and to have that person receive that information immediately,

(g) the right to have any friend, family member, or other person of importance to the resident attend any meeting with the licensee or the staff of the home.

Every resident is entitled to enforce these rights as a contract. Lawyers can assist in advising of the application of these rights and regulations to specific situations.

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