O. Reg. 246/13: GENERAL

Link to law: http://www.ontario.ca/laws/regulation/r13246
Published: 2013-08-28

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ONTARIO REGULATION 246/13

made under the

LONG-TERM CARE HOMES ACT, 2007

Made: August 14, 2013
Filed: August 28, 2013
Published on e-Laws: August 28, 2013
Printed in The Ontario Gazette: September 14, 2013


Amending O. Reg. 79/10

(GENERAL)

1. The definition of “registered dietitian” in section 1 of Ontario Regulation 79/10 is revoked and the following substituted:

“registered dietitian” means a member of the College of Dietitians of Ontario who holds a temporary or general certificate of registration under the Dietetics Act, 1991; (“diététiste agréé”)

2. Paragraph 2 of subsection 9 (1) of the Regulation is revoked and the following substituted:

2. All doors leading to non-residential areas must be equipped with locks to restrict unsupervised access to those areas by residents, and those doors must be kept closed and locked when they are not being supervised by staff.

3. Section 66 of the Regulation is amended by adding the following subsection:

(4) Despite subsection (2), a person who was working or employed as a designated lead in a long-term care home immediately before July 1, 2010 may be designated as the designated lead in a different long-term care home if the person worked or was employed as a designated lead in a long-term care home,

(a) on a full-time basis for at least three years during the five years immediately before being designated in the different home; or

(b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being designated in the different home.

4. Subsection 67 (3) of the Regulation is revoked and the following substituted:

(3) This section does not apply with respect to,

(a) a staff member who was providing recreational and social activities in the home immediately before July 1, 2010; or

(b) a person who was a staff member providing recreational and social activities in a long-term care home immediately before July 1, 2010, and who worked or was employed as a staff member providing recreational and social activities in a long-term care home,

(i) on a full-time basis for at least three years during the five years immediately before being employed in a different home, or

(ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in a different home.

5. (1) Subsection 75 (2) of the Regulation is amended by striking out “a member” and substituting “an active member”.

(2) Section 75 of the Regulation is amended by adding the following subsection:

(2.1) Despite subsection (2), a person who was working or employed as a nutrition manager in a long-term care home immediately before July 1, 2010 may be hired as the nutrition manager in a different long-term care home if the person worked or was employed as a nutrition manager in a long-term care home,

(a) on a full-time basis for at least three years during the five years immediately before being hired in the different home; or

(b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being hired in the different home.

6. (1) Clauses 76 (2) (c) and (d) of the Regulation are revoked and the following substituted:

(c) holds a certificate of qualification in the trade of Cook or Institutional Cook that was issued,

(i) by the Director of Apprenticeship under the Apprenticeship and Certification Act, 1998, or

(ii) by the Registrar of the College under the Ontario College of Trades and Apprenticeship Act, 2009; or

(d) meets the requirement set out in clause 78 (5) (c).

(2) Clause 76 (3) (c) of the Regulation is amended by striking out “subsection 78 (5)” and substituting “subsection 78 (6)”.

(3) Section 76 of the Regulation is amended by adding the following subsection:

(4) Despite subsection (2), a person who was working or employed as a cook in a long-term care home immediately before July 1, 2010 may be hired as the cook in a different long-term care home if the person,

(a) worked or was employed as a cook in a long-term care home,

(i) on a full-time basis for at least three years during the five years immediately before being employed in the different home, or

(ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in the different home; and

(b) met the requirements under subsection (3) while at the former home.

7. Section 78 of the Regulation is revoked and the following substituted:

Food service workers, training and qualifications

78. (1) Every licensee of a long-term care home shall ensure that food service workers hired on or after July 1, 2010, other than cooks to whom section 76 applies,

(a) have successfully completed or are enrolled in a Food Service Worker program at a college established under the Ontario Colleges of Applied Arts and Technology Act, 2002 or a Food Service Worker program provided by a registered private career college and approved by the Superintendent of Private Career Colleges under the Private Career Colleges Act, 2005;

(b) have successfully completed an apprenticeship program in the trade of Cook, Institutional Cook or Assistant Cook under the Apprenticeship and Certification Act, 1998 or the Ontario College of Trades and Apprenticeship Act, 2009; or

(c) have entered into a registered training agreement in the trade of Cook, Institutional Cook or Assistant Cook under the Apprenticeship and Certification Act, 1998 or the Ontario College of Trades and Apprenticeship Act, 2009.

(2) The licensee shall cease to employ as a food service worker a person who was required to be enrolled in a program described in subsection (1) if,

(a) in the case of a program referred to in clause (1) (a), the person ceases to be enrolled in the program or fails to successfully complete the program within three years of being hired; or

(b) in the case of a program referred to in clause (1) (c), the registration of the person’s training agreement is cancelled, suspended or revoked, or the person fails to receive his or her statement of successful completion of a program under the Apprenticeship and Certification Act, 1998, or certificate of successful completion of a program under the Ontario College of Trades and Apprenticeship Act, 2009, as the case may be,

(i) within three years of being hired, in the case of an apprenticeship program in the trade of Assistant Cook, or

(ii) within five years of being hired, in the case of an apprenticeship program in the trade of Cook or Institutional Cook.

(3) The licensee shall ensure that food service workers who were employed at the home before July 1, 2010, and who do not have the qualifications required under subsection (1), complete a food handler training program on or before October 1, 2010, unless they meet the requirements under subsection (1) sooner.

(4) Despite subsection (1), a person who was working or employed as a food service worker in a long-term care home immediately before July 1, 2010 may be hired as a food service worker in a different home if he or she,

(a) worked or was employed as a food service worker in a long-term care home,

(i) on a full-time basis for at least three years during the five years immediately before being employed in the different home, or

(ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in the different home; and

(b) completed a food handler training program on or before October 1, 2010, unless he or she met the requirements under subsection (1) before then.

(5) Subsection (1) does not apply with respect to,

(a) students hired on a seasonal or part-time basis, who have successfully completed a food handler training program;

(b) persons who meet the qualifications in subsection 75 (2) or 76 (2) or who are exempt from meeting those qualifications as they meet the requirements under subsection 75 (2.1) or 76 (4); or

(c) persons who have a post-secondary diploma in food and nutrition management or a post-secondary degree in food and nutrition.

(6) In this section,

“food handler training program” means the food handler training program offered or approved by the board of health for the public health unit in which the long-term care home is located.

8. Section 92 of the Regulation is amended by adding the following subsection:

(4) Despite subsection (2), a person who was working or employed as a designated lead in a long-term care home immediately before July 1, 2010 may be designated as the designated lead in a different long-term care home if the person worked or was employed as a designated lead in a long-term care home,

(a) on a full-time basis for at least three years during the five years immediately before being designated in the different home; or

(b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being designated in the different home.

9. (1) Paragraph 1 of subsection 107 (1) of the Regulation is revoked and the following substituted:

1. An emergency, including fire, unplanned evacuation or intake of evacuees.

(2) Paragraphs 2 and 4 of subsection 107 (3) of the Regulation are revoked and the following substituted:

2. An environmental hazard that affects the provision of care or the safety, security or well-being of one or more residents for a period greater than six hours, including,

i. a breakdown or failure of the security system,

ii. a breakdown of major equipment or a system in the home,

iii. a loss of essential services, or

iv. flooding.

. . . . .

4. Subject to subsection (3.1), an incident that causes an injury to a resident for which the resident is taken to a hospital and that results in a significant change in the resident’s health condition.

(3) Section 107 of the Regulation is amended by adding the following subsection:

(3.1) Where an incident occurs that causes an injury to a resident for which the resident is taken to a hospital, but the licensee is unable to determine within one business day whether the injury has resulted in a significant change in the resident’s health condition, the licensee shall,

(a) contact the hospital within three calendar days after the occurrence of the incident to determine whether the injury has resulted in a significant change in the resident’s health condition; and

(b) where the licensee determines that the injury has resulted in a significant change in the resident’s health condition or remains unable to determine whether the injury has resulted in a significant change in the resident’s health condition, inform the Director of the incident no later than three business days after the occurrence of the incident, and follow with the report required under subsection (4).

(4) Subsection 107 (4) of the Regulation is amended by striking out “subsection (1) or (3)” in the portion before paragraph 1 and substituting “subsection (1), (3) or (3.1)”.

(5) Section 107 of the Regulation is amended by adding the following subsection:

(7) In this section,

“significant change” means a major change in the resident’s health condition that,

(a) will not resolve itself without further intervention,

(b) impacts on more than one aspect of the resident’s health condition, and

(c) requires an assessment by the interdisciplinary team or a revision to the resident’s plan of care.

10. Section 146 of the Regulation is amended by adding the following subsection:

(7.1) A licensee of a long-term care home shall discharge a resident from a specialized unit if the resident was admitted to the specialized unit pursuant to a stipulation made under subsection 198 (7) and the resident is being transferred to a bed in another area in the home as required by section 205.1.

11. Subsection 167 (2) of the Regulation is amended by adding the following clause:

(a.1) if the applicant declines to enter a specialized unit pursuant to a stipulation made under subsection 198 (7);

12. The Regulation is amended by adding the following section:

Former specialized unit residents

172.1 (1) An applicant shall be placed in category 2.1 on the waiting list for a long-term care home if he or she does not meet the requirements for placement in category 1 or 2 and,

(a) is a resident in a specialized unit other than a resident who was admitted to the unit pursuant to a stipulation under subsection 198 (7); or

(b) was a resident in a specialized unit and,

(i) was transferred from the specialized unit to a bed in another area of the home pursuant to subsection 205 (1), and

(ii) applied for admission before being transferred or within six weeks after being transferred.

(2) For greater certainty, this section does not apply where clause 177 (1) (e) applies.

13. Clause 173 (1) (a) of the Regulation is amended by striking out “category 1 or 2” at the end and substituting “category 1, 2 or 2.1”.

14. Subsection 174 (1) of the Regulation is amended by striking out “category 1, 2, 3A or 3B” at the end and substituting “category 1, 2, 2.1, 3A or 3B”.

15. Subsection 177 (1) of the Regulation is revoked and the following substituted:

Re-admission category

(1) Despite sections 171 to 174, an applicant shall be placed in the re-admission category on the waiting list for a long-term care home if,

(a) he or she formerly occupied a bed in the long-term care home as a long-stay resident, but no longer does so because he or she was absent on a medical or psychiatric absence for a longer time than permitted under section 138 and was discharged by the licensee;

(b) he or she formerly occupied a bed in the long-term care home as a long-stay resident, but no longer does so because of an emergency in the long-term care home and he or she was discharged by the licensee;

(c) he or she is a resident of a specialized unit who is applying for admission to the long-term care home where he or she was a resident immediately prior to his or her admission to the specialized unit;

(d) he or she was discharged from a specialized unit because he or she was absent on a medical or psychiatric absence for a longer time than permitted under section 138, and is applying for admission to the long-term care home where he or she was a resident immediately prior to his or her admission to the specialized unit; or

(e) he or she was discharged from a specialized unit in a long-term care home and transferred to a bed in another area of the home, and he or she,

(i) is applying for admission to the long-term care home where he or she was a resident immediately prior to his or her admission to the specialized unit, and

(ii) applied for the admission referred to in subclause (i) before being transferred, or within six weeks after being transferred.

16. The Table to section 181 of the Regulation is revoked and the following substituted:

TABLE
RANKING OF WAITING LIST CATEGORIES (LONG-STAY)

 

Column 1

Column 2

Column 3

Column 4

Column 5

Column 6

Class of Beds

Beds in a related temporary long-term care home, other than veterans’ priority access beds

Beds in a re-opened long-term care home, other than veterans’ priority access beds

Beds in a replacement long-term care home, other than veterans’ priority access beds

Veterans’ priority access beds in a long-term care home, other than a related temporary, re-opened or replacement long-term care home

Veterans’ priority access beds in a related temporary, re-opened or replacement long-term care home

All other long-stay beds in a long-term care home

Waiting List Categories

Related temporary

Re-opened

Replacement

Veteran

Veteran under clause 175 (b)

Exchange

 

Exchange

Exchange

Exchange

Exchange

Veteran under clause 175 (a)

Re-admission

 

Re-admission

Re-admission

Re-admission

Re-admission

Exchange

1

 

1

1

1

1

Re-admission

2

 

2

2

2

2

1

2.1

 

2.1

2.1

2.1

2.1

2

3A

 

3A

3A

3A

3A

2.1

3B

 

3B

3B

3B

3B

3A

4A

 

4A

4A

4A

4A

3B

4B

 

4B

4B

4B

4B

4A

 

 

 

 

 

 

4B

 


17. The Table to section 182 of the Regulation is amended by adding the following item:

6.1

2.1 Former specialized unit residents

Applicants shall be ranked according to the time at which they applied for authorization of their admission to the long-term care home.

If there are two or more applicants who are ranked in the same position, as between themselves, they shall be ranked based on the date on which they were determined eligible for admission.


18. Section 183 of the Regulation is amended by adding the following subsection:

(3) If a person who is on the waiting list for a long-term care home should be placed in a different category on the waiting list as a result of amendments made to this Regulation by Ontario Regulation 246/13, the placement co-ordinator keeping the waiting list shall place the person in the different category.

19. Section 198 of the Regulation is amended by adding the following subsections:

(7) In making or amending a designation, the Director may, after considering and having regard for the health and well-being of both the residents in the specialized unit and other persons who might be admitted as residents in the specialized unit, stipulate that persons who are on the waiting list for the home under section 165 may be admitted to the specialized unit when there is no one on the waiting list for the specialized unit under section 200.

(8) The Director shall advise a placement co-ordinator in writing when making or withdrawing a stipulation pursuant to subsection (7) with respect to a long-term care home for which the placement co-ordinator is the appropriate placement co-ordinator.

20. Section 203 of the Regulation is amended by adding the following subsection:

(2) Clause (1) (b) does not apply,

(a) when there is no applicant on the waiting list for the specialized unit; and

(b) the Director has made a stipulation under subsection 198 (7) with respect to the specialized unit.

21. Section 204 of the Regulation is amended by adding the following subsection:

(2) Subsection (1) does not apply with respect to a resident who is admitted pursuant to a stipulation made under subsection 198 (7).

22. The Regulation is amended by adding the following sections:

Transfer from specialized unit — resident admitted pursuant to a stipulation

205.1 (1) The licensee of a long-term care home shall transfer a resident who was admitted to the specialized unit pursuant to a stipulation made under subsection 198 (7) to a bed in another area of the home in the class of accommodation chosen by the resident as soon as such a bed becomes available.

(2) Subsection (1) applies despite the rules concerning transfer lists in section 207, subject to first priority being given to residents described in clause 207 (1) (f) and despite subsection 207 (5).

(3) A resident who is transferred under subsection (1) shall be deemed to have been admitted to the home.

(4) The licensee shall notify the placement co-ordinator of every transfer under subsection (1) within 24 hours.

(5) Subsection 205 (3) applies to residents admitted to the specialized unit pursuant to the stipulation under subsection 198 (7).

. . . . .

Special circumstances, convalescent care

208.1 (1) This section applies in the special circumstance of processing the admission of a person to a long-term care home as a short-stay resident in the convalescent care program, so as to expedite, through prompt admission to that program, the program’s purpose of facilitating restoring a person’s strength, endurance or functioning so that he or she can return to his or her residence.

(2) Where an applicant may be admitted to the convalescent care program, placement co-ordinators and licensees are exempt from complying with the requirements under Part III of the Act to the extent necessary to effect admissions to the convalescent care program in accordance with this section.

(3) The following modifications are made to the application of section 43 of the Act:

1. Before the person submits an application for determination of eligibility for admission, the placement co-ordinator shall provide the person with information about the process for admission to a long-term care home as a short-stay resident in the convalescent care program, including,

i. the nature of the referral process for admission under this section,

ii. the factors that the placement co-ordinator will take into consideration when referring the applicant to a bed in the convalescent care program, and

iii. the fact that the person will only be admitted to a home with his or her consent, in accordance with clause 44 (11) (d) and section 46 of the Act.

2. If, after receiving the information referred to in paragraph 1, the person proceeds with an application under section 43 of the Act, the application shall include, in addition to anything else required under that section, the person’s consent to the disclosure of all the information necessary to deal with the application and the person’s admission to a home.

(4) After the person has been determined to be eligible for long-term care home admission, the following modifications are made to the application of section 44 of the Act:

1. The placement co-ordinator shall refer the applicant to one or more homes with a convalescent care program. In determining to which home or homes to refer the applicant, the placement co-ordinator shall take into consideration the following factors:

i. The applicant’s condition and circumstances.

ii. The applicant’s preferences, including any preferences relating to the proximity of the home or homes to the applicant’s family, home and community and support networks.

2. If a home to which the applicant is being referred is not in the geographic area of the placement co-ordinator making the referral, that placement co-ordinator shall co-ordinate with the appropriate placement co-ordinator for that home.

3. Instead of the applicant applying for authorization of admission, the appropriate placement co-ordinator shall provide the necessary information to the licensee or licensees of the home or homes to which the applicant is being referred.

4. In subsections 44 (7) to (10) and (14) of the Act,

i. any reference to a “selected” home shall be read as applying to a home to which the applicant is referred,

ii. the licensee’s written notice of withholding of approval or withdrawal of approval required under subsections 44 (9) and (14) is only required to be given to the appropriate placement co-ordinator, but the appropriate placement co-ordinator shall provide a copy to the applicant upon request.

(5) For the purposes of applying this Regulation under the circumstances where this section applies,

(a) subsections 162 (3) and (4) of this Regulation shall be read as if they said “three business days” rather than “five business days”;

(b) subsection 162 (5) of this Regulation shall be read as if it said “one business day” rather than “three business days”;

(c) clause 166 (1) (b) of this Regulation does not apply;

(d) Column 2 of Item 8 of the Table to section 182 of this Regulation shall be read as if it referred to the time at which the applicant agreed to proceed with an application under section 43 of the Act;

(e) paragraph 2 of subsection 184 (4) of this Regulation shall be read as if it said that the licensee shall give the written notice of the withdrawal of approval for the applicant’s admission only to the appropriate placement co-ordinator, but that the appropriate placement co-ordinator shall provide a copy to the applicant upon request;

(f) clause 185 (1) (a) of this Regulation shall be read as if it only required that the requirements set out in subsection 44 (11) of the Act be complied with.

(6) If a person to whom this section applies does not choose to participate in the process under this section, the placement co-ordinator shall, if the person so desires, provide information about alternative services, make appropriate referrals on behalf of the person and assist in arranging alternative accommodation, care or services for the person as is appropriate in the circumstances.

(7) A person may not apply for admission to a long-term care home as a short-stay resident in the convalescent care program other than through the process under this section.

(8) Despite subsection (7), where a person was determined to be eligible for admission to a long-term care home as a short-stay resident in the convalescent care program before the coming into force of this section, the person’s application shall be dealt with as it would have been before this section came into force.

23. Subsections 212 (5) and (6) of the Regulation are revoked and the following substituted:

(5) A person who was working or employed as an Administrator on July 1, 2010 and has continued to work or be employed in that position may be hired for another position as an Administrator in a different long-term care home if the person,

(a) worked or was employed as an Administrator in a long-term care home,

(i) on a full-time basis for at least three years during the five years immediately before being employed in the different home, or

(ii) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in the different home; and

(b) has successfully completed or, subject to subsection (6), is enrolled in, a program in long-term care home administration or management that is a minimum of 100 hours in duration of instruction time.

(6) The licensee shall cease to employ as an Administrator a person who was required to be enrolled in a program described in clause (4) (d) or (5) (b) if the person ceases to be enrolled in the program or fails to successfully complete the program within the following periods:

1. For a program that includes at least 400 hours of instruction time, the maximum period is five years from the day the person is hired as an Administrator.

2. For a program that includes more than 200 but less than 400 hours of instruction time, the maximum period is three years from the day the person is hired as an Administrator.

3. For a program that includes 200 or less hours of instruction time, the maximum period is two years from the day the person is hired as an Administrator.

24. Section 213 of the Regulation is amended by adding the following subsection:

(5) Despite subsection (4), a person who was working or employed as a Director of Nursing and Personal Care in a long-term care home immediately before July 1, 2010 may be hired as a Director of Nursing and Personal Care in a different home if the person worked or was employed as a Director of Nursing and Personal Care in a long-term care home,

(a) on a full-time basis for at least three years during the five years immediately before being employed in the different home; or

(b) on a part-time basis for the equivalent of at least three full-time years during the seven years immediately before being employed in the different home.

25. Subparagraph 4 x of subsection 317 (2) of the Regulation is amended by striking out “and (5)” and substituting “and (6)”.

26. Subparagraph 9 xiii of subsection 318 (1) of the Regulation is amended by striking out “and (5)” and substituting “and (6)”.

Commencement

27. (1) Subject to subsection (2), this Regulation comes into force on the later of September 15, 2013 and the day it is filed.

(2) Sections 10 to 22 come into force on the later of November 1, 2013 and the day this Regulation is filed.

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