Seniors' Care: Home,  Community and Residential Care Services for Seniors
Print

Glossary of Terms

Accessible
means that which can be easily reached or obtained; a facility that can be easily entered; posing no obstacles to persons with a disability.

Accessibility
means a general term which is used to describe the degree of ease that something (e.g., device, service, and environment) can be used and enjoyed by persons with a disability. The term implies conscious planning, design and/or effort to ensure it is barrier-free to persons with a disability, and by extension, usable and practical for the general population as well.

Actions/Sanctions
Actions/Sanctions include:

  • Written Notification (WN)
  • Plan of Correction, to be implemented voluntarily (VPC)
  • Issuance of a Compliance Order or a Work and Activity Order
  • Referral to the Director when the severity of the non-compliance or the required sanction is beyond the inspector’s scope and issue a non-compliance to the licensee of the LTC Home .

The powers of the Minister or the Director under the LTCHA, regulations and service agreements include:

  • directing the community care access centre placement co-ordinator to cease admissions to the Home;
  • revoking or refusing to renew the LTC Home's license;
  • reducing or withholding funding;
  • taking steps to operate or take control of the LTC Home.

Administrator
A person who has the overall responsibility for the day-to-day operations of a Long-Term Care (LTC) Home, and is accountable to the LTC Home licensee.

Accreditation
Accreditation is a voluntary process that LTC homes may use to assess their services and help them improve the quality, safety and efficiency of their performance for the benefit of their residents and the health system.
The process of Accreditation encourages an organization to:

  • Assess services and determine where to focus improvement efforts
  • Develop standardized processes to improve efficiency
  • Mitigate risk and support the uptake of best practices
  • Build a culture of quality, safety and excellence
  • Publicly promote their commitment to offering safe, high-quality services.

Long-term care (LTC) homes apply for accreditation to Accreditation Canada or the Commission on Accreditation of Rehabilitation Facilities (CARF). Details for each organization, as well as the method for achieving accreditation may be found at the following websites:

Accommodation
Accommodation in a Long-Term Care (LTC) Home can refer to basic accommodation (standard room or any other type of room designated by the Home operator as basic accommodation) or preferred accommodation (semi-private or private room). Costs for each type of room are regulated by a maximum government accommodation rate. See also Accommodation Costs and Preferred Accommodation

Accommodation Costs
The Ministry of Health and Long-Term Care mandates that a minimum of 40 per cent of the beds in a Long-Term Care Home must be available at the basic accommodation rate. A resident paying the basic accommodation rate may be eligible for a reduction in accommodation costs, depending upon specific eligibility criteria. See also Preferred Accommodation

Approved Short Stay Beds
Short-stay beds are a response to the community's need for respite and supportive care programs. An individual is admitted into a Long-Term Care (LTC) Home for a specific short time period. The respite program provides relief to the individual's caregiver. The convalescent care program allows an individual to recover strength, endurance or functioning. LTC Home operators have the opportunity to apply to the Ministry of Health and Long-Term Care to operate short-stay beds within their existing licensed or approved beds, and the Ministry of Health and Long-Term Care approves the beds based on need and suitability of rooms offered. Persons in the respite program usually stay for up to 60 days and those in the supportive care program usually stay for up to 90 days. A person can stay a maximum of 90 days in a short stay program within a year. Eligibility for admission and placement in short-stay beds are determined by the Community Care Access Centre (CCAC). See also Community Care Access Centre

Notification of Cease of Admissions
A directive from the Director to the placement co-ordinator (i.e.: CCAC) for the area where the home is located to cease authorizing admissions to the home for a specific period of time. The ministry makes the cease admissions letters to the CCAC available to the public on the ministry’s public website.

Cease of Admissions to a Long-Term Care Home
As legislated in the Long Term Care Homes Act 2007 (s. 50 (1), the Director may direct that all admissions to a LTC home be ceased for a period of time where there is risk to the health or well-being of residents. This decision is not appealable and remains in place until the Director is satisfied that the licensee of the LTC home has sufficiently mitigated risks to residents.The ministry makes the cease admissions letters to the CCAC available to the public on the ministry’s public website.

Community Care Access Centre (CCAC)
CCACs are agencies funded by the Ministry of Health and Long-Term Care that assist people in need of Home and community care services, including admission into Long-Term Care (LTC) Homes. There are 14 CCACs in Ontario. There is an application process that must be completed by all applicants for placement into a LTC Home. CCAC Case Managers/Placement Coordinators authorize all placements in a LTC Home for both permanent and short-stay admissions and arrange Home care services. See also Approved Short Stay Beds. For more information about CCACs, see the (CCAC) Community Care Access Centres (CCAC) section.

Complaint
A complaint may include one concern or a number of different concerns relating to the operation of a Long-Term Care (LTC) Home. Complaints are assessed to determine whether there is a possible non-compliance with the LTCHA or regulation. The information is reviewed to determine the risk to residents and inspections are assigned based on those risks. If you have a concern or complaint about a Long-Term Care (LTC) Home, you are encouraged to call the Ministry's Action Line at 1-866-434-0144 to register your concern or complaint.

Costs
See Accommodation, Accommodation Costs and Preferred Accommodation

Eligibility for Long-Term Care
To live in a long-term care home, one must:

  • be age 18 or older
  • have a valid Ontario Health Insurance Program (OHIP) card
  • have care needs including:
    • 24-hours nursing care and personal care
    • frequent assistance with activities of daily living
    • on-site supervision or monitoring to ensure safety or well-being
    • have care needs which cannot be safely met in the community though publicly-funded community-based services and other care-giving support
    • have care needs which can be met in a long-term care home

Government subsidy - Rate Reduction
If a resident does not have enough income to pay for the basic room, they may be eligible for a subsidy. This is known as a rate reduction. The subsidy is not available to people requesting semi-private or private rooms. If questions or concerns about a rate reduction cannot be answered by staff in the LTC home, please call the Ministry of Health and Long-Term Care Homes Action Line at 1-866-434-0144.

Family Council
An autonomous (self-led and self-determining) group of families and friends of residents that meets on a regular basis with an emphasis on mutual support and advocacy. This group provides a voice in decisions that affect their loved ones and strives to develop a better understanding between families and management/staff of a Long-Term Care Home. Sometimes this group is known by other terms such as family advisory committee. See also Residents' Council

FIPPA means the Freedom of Information and Protection of Privacy Act (R.S.O. 1990, c. F.31), as amended or replaced from time to time;

Home Administrator
The Administrator has overall responsibility for the day-to-day operations of a home.

Homes Designated Under French Language Services Act
Some LTC homes are designated under the French Language Services Act. This means that French-speaking residents are guaranteed services and care by members of the staff who speak French.

Home Structure
The physical layout of the rooms within a Long-Term Care (LTC) Home. LTC Homes are built to design standards set by the Ministry of Health and Long-Term Care. These standards have changed over time. Design standards specify minimum room sizes, maximum numbers of beds per room, washroom facilities, corridor widths and many other criteria. These standards are intended to ensure that the physical layout of a Home is the best way to care for the residents while still providing a comfortable, Home -like setting. While older Homes may not meet more recent design standards, they must still provide the same care as new Homes. The building layout is only a part of the overall residents' experience; other factors such as location, setting, culture and atmosphere also influence a resident's experience in an LTC Home. See also Accommodation

Home Type
There are various types of operators of LTC homes: charitable organizations, municipalities, corporations, partnerships and sole proprietors. The Ministry of Health and Long-Term Care funds LTC homes to provide care and services to their residents. Nursing homes may be either for-profit or non- profit. Charitable and municipal homes are non- profit. Some hospitals in northern communities may also operate LTC beds under the Elderly Capital Assistance program.

Inspection
An inspection by inspectors of the Ministry of Health and Long-Term Care to determine compliance with the Long Term Care Homes Act (LTCHA) and Ontario Regulation 79/10. LTC Home inspectors inspect each LTC Home at least once a year. There are different types of inspections: pre-occupancy and post-occupancy for new Homes, complaint, critical incident, follow up and comprehensive inspections.

Inspection Report Date
This is the date the Long-Term Care (LTC) home inspection report was finalized by the inspector.

Inspection Type
This indicates the type of inspection that was conducted, for example a complaints inspection or a follow up inspection.

Interim Manager
Company or organization contracted by the Ministry to provide Interim Management Services in a LTC home,

Level of Care Funding
The per bed per diem amount set by the Ministry for the operation of LTC home bed. The Level of Care Per Diem is funded from two sources: 1) revenue from accommodation charges to residents, and 2) payments made by a Local Health Integration Network (LHIN) to a licensee for the difference between the Level of Care Per Diem and the sum of the Resident Co-payment Revenue. The level of care per diem is subject to adjustment in accordance with the Ministry’s funding and financial management policies for LTC homes.

Licensee
The licensee is the person [corporation, partnership or sole proprietor] who is the holder of a license for a LTC Home, under the LTCHA. This is the person who must comply with the legislation, regulations, standards and policies relating to the operation of a Home.

Licensed / Approved beds
The total number of beds within a Long-Term Care Home that have either been licensed or approved by the Ministry of Health and Long-Term Care. Nursing Homes have licensed beds. Charitable and Municipal Homes have approved beds.

Lifting of Cease of Admissions
A directive from the Director to the placement co-ordinator (i.e.: CCAC) for the area where the home is located to resume authorizing admissions to the home for a specific period of time.

Local Health Integration Network (LHIN)
LHINs are not-for-profit corporations that are responsible for planning, integrating and funding local health services in 14 different geographic areas of the province. LHINs are based on a principle that community-based care is best planned, coordinated and funded in an integrated manner within the local community because local people are best able to determine their health service needs and priorities. LHINs are intended to be the managers for health services that are delivered in hospitals, long-term care homes, community health centres, community support services and mental health agencies. For more information about LHINs, see the Local Health Integration Network (LHIN) section.

Long-Term Care Home
A Long-Term Care (LTC) Home provides care and services for people who no longer are able to live independently or who require onsite nursing care, 24-hour supervision or personal support. LTC Homes are governed under the Long Term Care Homes Act (LTCHA) and Ontario Regulation 79/10., the single legislative authority for safeguarding resident rights, improving the quality of care and improving the accountability of LTC Homes for the care, treatment and well-being of residents.

LTC
Is an abbreviation of Long-Term Care

LTC Home Inspectors
A government official appointed as an inspector to inspect Long-Term Care (LTC) Homes to ensure compliance with the legislation, regulations, standards and policies relating to these Homes. LTC Home Inspectors have inspection powers under the LTCHA.

Long-Term Care Quality Inspection Program
The Long-Term Care Quality Inspection Program (LQIP) (formerly Compliance Management Program) is designed to safeguard residents’ rights, safety and security and improve quality of care and create a culture that is focused on resident outcomes. LQIP safeguards residents’ well-being by continuously following up on complaints and concerns, investigating critical incidents, and by ensuring that all Homes are inspected at least once per year.

Long-Term Care Home Service Accountability Agreement (L-SAA)
An agreement between a Local Health Integration Network who provide funding and a Healthcare Service Provider (HSP) who operates a Long-Term Care Home.

Management Firm
Some Long-Term Care (LTC) Home operators retain a management firm to manage the day-to-day operations in their Home. The name of the management firm is listed in the Home Profile section of Reports on Long-Term Care Homes only if the LTC Home operator has chosen a management firm to manage their Home. This firm does not include service firms or contractors who only manage specific services in a Home such as maintenance or food services.

Ministry
means the Ministry of Health and Long Term Care. Also referred to as MOHLTC in some sections of this website.

MOHLTC
stands for the Ministry of Health and Long-Term Care.

Non-compliance
Means an inspector finds that a licensee has not complied with a requirement under the Act and or the associated regulations.

Orders
Direct instruction from an inspector and Director to comply with the requirements of the Long Term Care Homes Act, 2007. An inspector and the Director have the authority under the Act to issue an order to a licensee. Orders include:

Compliance order
An inspector or the Director may order a licensee to do anything, or refrain from doing anything, to achieve compliance with a requirement under this Act; or prepare, submit and implement a plan for achieving compliance with a requirement under the Act.

Work and activity orders
An inspector or the Director may order a licensee to allow employees of the Ministry, or agents or contractors acting under the authority of the Ministry, to perform any work or activity at the long-term care home that is necessary, in the opinion of the person making the order, to achieve compliance with a requirement under the Act.
The Director may also issue the following orders:

  • Amend or Impose Conditions on Licence Order
  • Renovation of Municipal Home Order
  • Return of Funding Order
  • Mandatory Management Order
  • Revocation of Licence Order
  • Interim Manager Order

Personal Health Information
(PHI) has the same definition as in Section 4 of PHIPA, as may be amended from time to time;

Personal Information
(PI) has the same definition as in Section 2(1) of FIPPA, as may be amended from time to time;

PHIPA
means the Personal Health Information Protection Act, 2004 S.O. 2004,

Preferred Accommodation
This is accommodation in either a semi-private or private room. The Long-Term Care (LTC) operator may charge additional accommodation costs of up to $8.00 per day for semi-private and $18.00 per day for private rooms. The Ministry of Health and Long-Term Care mandates that no more than 60 per cent of the beds in a LTC Home may be preferred accommodation beds. See also Accommodation, Home Structure, Private Room and Semi-Private Room

Private Room
In Long-Term Care (LTC) Homes built after 1998, a private bedroom is a room with one bed and a private washroom. In LTC Homes built before 1998, a private room is a room with one bed that may have a private or shared washroom. See also Home Structure, Preferred Accommodation and Semi-Private Room

Provincial Average
is calculated as the nominator, i.e. the sum of the number of non-compliances per year for each LTC home, divided by the number of LTC homes in the province.

Public Reporting
Under the LTCHA there is a requirement for the ministry to publish all inspection reports and Orders. To comply with this requirement the ministry launched a refreshed public website (February 2012) with links to the public versions of all inspections reports and orders for inspections conducted at LTC homes in the province since July 1, 2010.

Reports
Inspections that are written by a Long-Term Care home inspector

Resident Quality Inspection (RQI)
A comprehensive inspection of a home

Residents' Council
An independent, self-determining group made up of residents in a Long-Term Care (LTC) Home. All residents are entitled to be members. The Residents' Council may have an elected Executive. It meets regularly to receive and discuss residents' concerns, to plan activities, and to have a voice in their Home’s decisions and routines that affect their daily lives. A friend or family member who is the substitute decision maker (SDM) for a resident may represent that resident in the Council. If a Residents' Council does not exist in a LTC Home, the dministrator must inform all residents once a year of their right to form a Council. The LTC Home is required to support and have a Residents' Council. See also Family Council

Semi-Private Room
In Long-Term Care (LTC) Homes built after 1998, a semi-private bedroom is a one-bed room with a shared washroom or a room with two beds that has a shared washroom. In LTC Homes built before 1998, a semi-private room is a room with two beds. See also Home Structure, Preferred Accommodation and Private Room

Single Room
See Home Structure, Semi-Private Room and Private Room

Shared Room
See Home Structure, Semi-Private Room and Standard Room

Short-Stay Beds
See Approved Short-Stay Beds

Standard Room
In Long-Term Care (LTC) Homes built after 1998, a standard bedroom is a room with one or two beds and a shared washroom. In LTC Homes built before 1998, a standard bedroom is a room with three or more beds. The Ministry of Health and Long-Term Care mandates that at least 40 per cent of the beds in a LTC Home must be available at the basic accommodation rate. LTC Home operators must not charge more than the regulated maximum government basic accommodation rate for a standard bedroom. A resident paying the basic accommodation rate may be eligible for a rate reduction, dependent on specific criteria. See Accommodation and Accommodation Costs

Substitute Decision Maker (SDM)
The person that has the legal authority to make decisions relating to personal care issues and/or property matters on behalf of a resident who is not capable of making and understanding the consequences of his or her decisions. See also Residents' Council

Targeted Inspections
An in-depth investigation to inspect a complaint, critical incident or conduct a follow-up inspection

Types of Inspections:
The ministry employs issue-specific inspections focusing on complaints, critical incidents, mandatory reports and follow-up inspections, and the comprehensive Resident Quality Inspections (RQI).

Complaint, Critical Incident and Follow-Up (CCF) Inspections:
LTC home inspectors visit a home to inspect on a complaint, critical incident or conduct a follow-up inspection (together called CCF). The inspection is focused on the issue at hand. Relevant Inspection Protocols are used to inspect the issue in-depth and to determine if the home is compliant or non-compliant with the LTCHA and its regulations. Follow up inspections are conducted when Compliance Orders are issued to ensure that the home has corrected the non-compliance(s) identified in the Orders in a previous inspection.

Resident Quality Inspections:
In Ontario, the Resident Quality Inspections (RQI) are a comprehensive inspection conducted using methodology that was adapted from the Quality Indicator Survey (QIS), a nursing home inspection process, developed over 15 years for the Centres for Medicare and Medicaid and rolled out across the United States. The RQI was adapted to meet specific requirements of LTCHA and the characteristics of LTC home residents

All ministry inspections are prioritized on a daily basis depending on the harm, or risk of harm, presenting to residents. As information is received the ministry continually assess and often re-prioritize inspections to ensure that issues that present harm, or risk of harm, to residents are addressed as a priority. In some cases, several different types of inspections can be combined to allow for addressing higher priority inspections in a streamlined fashion (e.g.: if an RQI is scheduled for a LTC home, a number of other issues may be inspected/addressed simultaneously).
For More Information

Call ServiceOntario, Infoline at 1-866-532-3161
In Toronto, 416-314-5518
TTY 1-800-387-5559
In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm