Nursing Home Basic Care Guarantee
RNAO action alert – RNAO demands government implement a Nursing Home Basic Care Guarantee - please read the following action alert and sign it.
We must demand that government take action to address the severe understaffing and inadequate numbers of registered staff in long-term care. The deadline is July 31, 2020 when Minister Fullerton must table in the legislature her report on the adequacy of regulated staff. There have been 35 reports in the past 21 years! Let this be the government that delivers action, not more study!
Seventy‐nine thousand (79,000) of the province's older adults call Ontario's 626 long‐term care (LTC) facilities home and trust them to meet their physical, social, spiritual and cognitive needs on a daily basis. Tragically, COVID-19 has wreaked havoc through these homes, exposing long-standing shortcomings in the LTC system including severe understaffing and inadequate numbers of registered staff given the increasing acuity, the intensity of nursing care required, and complexity of residents.
On June 9, 2020 RNAO released the Nursing Home Basic Care Guarantee in response to the Long-Term Care Staffing Study Advisory, struck to address Recommendation 85 of the Gillese Inquiry into the criminal acts of a staff member that resulted in the murder of eight residents. Justice Eileen Gillese gave the government a deadline of July 31, 2020 to develop a staffing plan for long‐term care and table it in the legislature.
RNAO’s submission provides detailed, evidence-based analysis supporting the basic care guarantee and staffing formula. It calls for implementing and funding recommendations from past inquiries and commissions, rather than engaging in more study and deliberation. RNAO says such action must begin right away, with Minister Fullerton’s tabling of her staffing plan by July 31, 2020.
RNAO calls on the government to adopt, fund and implement a nursing home basic care guarantee, and its related staffing formula, so residents of nursing homes can be assured safe care and quality of life, their families can sleep at peace, and staff will no longer need to struggle to meet the minimum care needs of their residents. It means that no home – whether for-profit or not-for-profit – will provide care below the guarantee. The staffing formula is based on evidence that builds on earlier reports and studies and addresses resident needs.
The Nursing Home Basic Care Guarantee minimum staffing formula provides no less than four (4) hours of direct nursing and personal care per resident, per day. The formula also calls to ensure the proper skill mix by allocating a minimum of:
- 0.8 hours (48 minutes) of RN care per resident, per day,
- 1 hour (60 minutes) of RPN care per resident, per day and
- 2.2 hours (132 minutes) of PSW care per resident per day.
Each home should have one nurse practitioner (NP) for every 120 residents and a full time registered nurse specializing in infection prevention and control.
RNAO says the recommended four hours of care, based on past studies of care need, is very conservative. In 2017, the government committed to providing these four hours of direct care. Shockingly, only 2.71 hours of direct care are currently provided to each resident on a daily basis. This means LTC residents in Ontario receive one third less nursing and care hours than the very conservative estimate government committed to, but hasn’t implemented since 2017.
Equally alarming is that current legislation in Ontario does not specify skill mix ratios for RNs, RPNs and PSWs. It only assigns one RN on-site per shift, which is grossly deficient. We estimate the current skill mix at 0.30 hours of RN care per resident, per day, 0.49 hours of RPN care and 1.92 hours of PSW care.
All three groups are below the recommended levels of nursing and care hours. For RNs, the shortfall is 63 per cent from the recommended level. For RPNs, there is a shortfall of 51 per cent. And for PSWs, the shortfall is 13 per cent. Added to these deficiencies is the reality that only a small number of nursing homes have NPs. Most homes must do without an NP.
The increase in staffing to meet the guarantee must be accompanied by immediate changes in human resources policies permitting staff to work in only one LTC facility; providing wage parity with hospitals; and ensuring that full-time employment with benefits is offered to staff who want full time work to enable continuity of care for residents, improve staff retention, and remove the need to work in multiple locations.
Action alert: Premier Ford has vowed to fix the LTC system. We urge you to demand the government implement with funding, the Nursing Home Basic Care Guarantee based on the minimum staffing formula. Let Minister Fullerton, Premier Ford, and the Staffing Study Advisory know that this is a necessary step to protecting Ontario’s older adults who call LTC their home. Ontario’s seniors deserve nothing less.
Please, add your voice today - sign the action alert here.