New national standards for long-term care (LTC) are now complete, after the Health Standards Organization released its set of comprehensive health care standards last week.

The Canadian Standards Association released its standards on LTC physical infrastructure in December.

The standards, so far, are not mandatory.

The federal government called for the new sets of standards after the discovery of appalling conditions in some LTC facilities in the early days of the Covid-19 pandemic.

Military personnel described a heartbreaking litany of failures after they were called in to help in some LTC facilities in 2020. The National Institute on Ageing reported in July 2022 that more than 17,000 LTC residents had died of Covid since the initial outbreak, accounting for 43 per cent of Canada’s overall Covid-19 deaths.

The two new sets of standards are meant to address the shortcomings in infection control and resident care that have become glaring since the initial Covid outbreak.

In a joint statement, federal seniors minister Kamal Khera and health minister Jean-Yves Duclos said “These standards are an important step in helping to ensure quality care for seniors and will raise the bar for safe and respectful care in LTC homes across Canada.

“Together, these standards provide guidance for delivering services that are safe, reliable, and most importantly centred on residents’ needs. They aim to foster a healthy and competent workforce, create safer physical environments, and promote a culture of quality improvement and learning across LTC homes.”

The Canadian Association for Long Term Care (CALTC) supports the new standards, but they say it will take considerable investment to make them possible. “There are still deep concerns that without significant government investment in long-term care homes the standards will remain an aspiration and not a reality,” a CALTC statement reads.

Jodi Hall, CEO of CALTC, said “mistakes were made” in some care homes as they struggled with the early waves of the Covid pandemic. But, she said, the problems that came to light in 2020 had been simmering for some time.

“Many of the issues faced by homes were the result of systemic and structural issues that predated the pandemic – such as low staffing levels, outdated buildings and chronic underfunding – exactly the issues the new national standards attempt to address,” Hall said.

“CALTC and its members had been raising concerns about these issues for years prior to the pandemic, but the problems persisted – and still persist. Despite some efforts across the country to develop reforms, there are still not adequate levels of funding.”

 The federal government pledged $3 billion in its 2021 budget to address the problems, and spent $850,000 on the establishment of the new standards.

Khera told Respect that the federal government is working with the provinces and territories to improve the situation in LTC homes.

“The reality is that the delivery of most health care services, including the delivery of long-term care, is under the provincial/territorial jurisdiction,” she said.

“I am pleased that some provinces and territories have already shown interest in implementing [the new standards],” Khera said. “Actually, 68 per cent of long-term care homes will be accredited with these standards through Accreditation Canada. Our goal is to have 100 per cent of LTC homes across the country accredited with these standards, and that’s why we’re investing $3 billion over five years to support provinces and territories in improving long-term care in their areas.”

But Hall says investment well beyond the $3 billion is needed, and it will need to come from federal and provincial/territorial governments.

She added that ongoing talks between Ottawa and the provinces and territories are an opportunity to start the process on the right track. 

“The federal-provincial-territorial negotiations offer an important opportunity to announce record—and much-needed—investments in long-term care,” she said.

If the funding and the political commitment fall short—and some provinces, notably Ontario, have been less than enthusiastic—the danger remains that Canadian seniors will still face a patchwork of expectations and service delivery.

Khera said there will be further opportunities to advance the national standards as discussions around a Safe Long-Term Care Act continue.

“We are committed to do more to improve long-term care across the country,” she said. “I look forward to the upcoming consultations on the Safe Long-Term Care Act to determine what should be included in the Act, while respecting the jurisdiction of provinces and territories.”