Health and health care for all

Standards of Long-term Care

File 47

RNAO. (2010). Registered Nurse Journal. (September - October)


RNAO Recommendations

Standards of Long-Term Care

  1. Adopt strict standards to ensure equitable access to high-quality, age-appropriate long term care when and where it is needed, including a 30-day guarantee of access to a long-term care home or supportive housing from the community and a seven-day guarantee of placement in a long-term care home from an acute care facility.
  2. Legislate and fund a daily minimum of four hours of direct nursing and personal care for residents of long-term care homes, attached to average acuity. This would include no less than .59 RN hours per resident per day with greater acuity requiring more hours of care.
  3. Require by regulation and fund a daily minimum of 0.5 hours of activation and recreational programs that promote socialization, mental and physical stimulation and / or rehabilitation for each long-term care home resident.
  4. Establish by regulation a long-term care home staffing model that would improve clinical and social outcomes, including enhanced access to dementia care and reduced rates of pressure ulcers and falls. This calls for a staff mix in long-term care homes of one nurse practitioner (NP) for every long-term care home (and no less than one NP for every 200 residents), 20 per cent registered nurses (RN), 25 per cent registered practical nurses (RPN) and 55 per cent personal support workers (PSW), supported by adequate funding.
  5. Ensure funding of an appropriately educated registered nurse dedicated to infection control in every long-term care home in order to implement the infection prevention and control program consistent with best practices and professional standards.
  6. Develop an appropriate framework for managing mental health care within long-term care homes in order to develop admitting and discharge criteria for residents with risk-related mental health concerns
  7. Recognize an individual’s need to age in place and be placed in a long-term care home that is either within their previous continuum of care facility or close to their family and community, if requested.