Regulation - LGIC

Amending Ontario Regulation 246/22 under the Fixing Long-Term Care Act, 2021 titled "General" to advance the plan to fix long-term care in the areas of: staffing, pandemic recovery and stabilization, and clarifying and technical amendments.

Regulation Number(s):
Ontario Regulation 246/22
Instrument Type:
Regulation - LGIC
Bill or Act:
Fixing Long-Term Care Act, 2021
Summary of Proposal:
The ministry proposes to amend Ontario Regulation 246/22 as part of an ongoing evolution of the governing framework intended to enhance the quality of care and life for residents in long-term care.

Proposed amendments include:


Staffing Qualifications (if approved, proposed May 1, 2024 in force date):
- Amend staffing qualifications for some roles specified in the Regulation to ensure requirements are proportionate with the responsibilities and accountabilities of the role (for details, including proposed draft text of the staffing qualifications amendments, see: Addendum: Staffing Qualifications (detailed summary) and Addendum: FLTCA Regulation (General) - CONSULTATION DRAFT.
- Support nursing students to work in long-term care homes as externs outside of clinical placements, through amendments that provide for how student externs could carry out certain responsibilities in long-term care homes, including administering drugs and other potential functions.

Staffing Flexibility (if approved, proposed July 1, 2024 in force date):
- Permit Registered Practical Nurses to complete RAI-MDS assessments, particularly in instances where a resident is seeking a transfer to their preferred long-term care home, to support regulated health professionals to work to their full scope of practice in long-term care homes.

Pandemic Recovery and Stabilization (if approved, proposed July 1, 2024 in force date):
- Broaden provisions related to the pandemic framework to provide greater clarity to licensees on requirements in emergency situations and de-escalation to non-emergency situations. Options for consideration include moving towards broader emergency situations from specific pandemic-related language.
- As well, the ministry is considering a mechanism to trigger the potential use of these provisions in the future such as possible time-limited direction from the Minister.
- Require that a home's Residents' Council and Family Council be involved in the review of existing visitor policies and any future revisions.

Clarifying and Technical Amendments:

Air Conditioning (if approved, proposed May 1, 2024 in force date):
Further clarify air conditioning obligations related to:
- The limited circumstances in which a licensee would not have to install a portable or window air conditioning unit.
- The circumstances when a licensee must implement the heat-related illness prevention and management plan.
- Consistency in language between the air conditioning and air temperature requirements.
- Other housekeeping amendments.

Technical Amendments (if approved, proposed July 1, 2024 in force date):
- Technical amendments including but not limited to providing greater flexibility to support the designation of "imminent home closure" before or after a home's closure date has passed, refining the definition of "replacement home" to improve resident admissions, system flow and better align with the realities of how the system operates, removing redundant/duplicative information from the Regulation.

- For draft text of the proposed clarifying and technical amendments, see Addendum: FLTCA Regulation (General) - CONSULTATION DRAFT.

Analysis of Regulatory Impact:
The proposed amendments are anticipated to be beneficial for long-term care residents and licensees, most notably through the continued delivery of safe, high-quality care to long-term care residents-a paramount consideration informing the ministry's regulatory reform initiatives.
The proposed amendments are largely refining or clarifying in nature and anticipated to result in a net minor or neutral regulatory impact to licensees. Based on a preliminary assessment, the majority of costs and/or savings associated with this proposal would be primarily administrative in nature and associated with staff time expended or saved to comply with the amended requirements.
Any regulatory impact of this proposal would vary based on home size and existing policies and procedures.
Proposed amendments are responsive to recommendations from a range of stakeholders including the voices of residents and families, as well as the perspectives of professional and sector associations and long-term care licensees, among others.
If approved, the proposal would benefit long-term care residents, staff and licensees by:

- Supporting the ongoing delivery of quality care to long-term care residents in Ontario by enabling innovative and flexible staffing solutions while staffing continues to stabilize.
- Contributing to a robust and nimble regulatory framework that supports licensees to uphold resident safety and quality of life in emergency and non-emergency situations.
- Clarifying licensee obligations and streamlining administrative requirements so that licensees can focus on what matters most; the safety and wellbeing of long-term care residents.

The ministry will continue to engage key partners to further explore the regulatory impacts associated with this proposal.

If approved, the regulatory amendments are proposed to come into effect on July 1, 2024 with the exception of amendments related to staffing qualifications, nursing externs, and air conditioning, which are proposed to come into effect on May 1, 2024.
Further Information:
Proposal Number:
Posting Date:
February 9, 2024
Comments Due Date:
March 10, 2024
Contact Address:
6th Floor, 400 University Avenue Toronto ON M5G 1S5