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Anyone reading the Ontario government’s newly announced reform of long-term care might be pleasantly surprised to find, at the very top of the proposed legislation, a declaration of the “fundamental principle” that “a long-term care home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort.”

Those are nice words, and the reader’s first instinct is to assume that they must have been put there as a response to the catastrophic failure of LTC homes in Ontario, as well as in Quebec and other provinces, during the COVID-19 pandemic.

Seniors living in nursing homes and retirement homes, both publicly and privately operated, made up four out of every five deaths in the country during the first two waves of the pandemic – a toll that was only ended after vaccines were rolled out at the start of this year, and were prioritized for LTC residents.

As of Friday, 15,589 out of 29,682 COVID-19 deaths in Canada – 54 per cent – had involved LTC residents, according to the National Institute on Ageing in Toronto. So a fundamental principle that states seniors should be as safe and comfortable in a nursing home as they are in their own home, and which applies to the basic interpretation of the law, seems like a positive step.

Except that very same clause already appears at the top of the 2007 Long-Term Care Homes Act that the new legislation will repeal, and no one can argue that it did much good during the pandemic.

In fact, the Ford government’s proposed law is startlingly similar to the existing law, right down to the 27-clause Residents’ Bill of Rights, which has always made it clear that people living in Ontario nursing homes are entitled to be protected from abuse and neglect, and to “live in a safe and clean environment.”

Ontario’s proposed reform simply reorders the clauses of the Bill of Rights, and adds two new ones: residents would have “a right to ongoing and safe support from their caregivers”; and the right to palliative care at the end of their lives.

More usefully, it significantly increases the fines for nursing-home operators who violate the regulations meant to protect residents and keep them safe. Individuals could be fined up to $400,000, and corporations up to $1-million, for second offences.

It also says every nursing home must be inspected each year – a clause that exists in the current law but which wasn’t being enforced by the Ford government. It gives inspectors new powers to hand out fines on the spot, and expands the province’s ability to take over management of nursing homes that flout the rules.

It also toughens government oversight of for-profit retirement homes, which will continue to be covered under a separate provincial act.

The reform’s most significant break from the existing Long-Term Care Homes Act is that it legislates a daily minimum of four hours of personal care per nursing home resident by March, 2025. And, belatedly, it obliges LTC homes to have a pandemic response plan that is tested and regularly updated.

These are necessary changes. But the bottom line is that Ontario largely had the same powers of inspection and enforcement before the pandemic. It simply failed to use them.

COVID-19 exposed the degree to which nursing homes and some retirement homes were allowed to become overcrowded warehouses for the elderly, with too few staff, too little training, too many outdated multi-bed wards, and steadily decreasing oversight by government inspectors.

What is needed today is the same as was needed before anyone had heard of the novel coronavirus.

Like the rest of Canada, Ontario needs more nursing home beds, now, to eliminate a waiting list of 38,000 names. And it needs to find and hire – at a living wage – thousands more personal care workers, so they can provide those four hours of daily care to each resident the government is promising.

This should be non-negotiable in a country whose population is aging, and where more and more seniors have conditions that make it impossible for them to live at home.

Without more beds and more caregivers, all the talk about better caring for LTC residents in Canada that was galvanized by the COVID-19 pandemic will amount to empty words.

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