Presentation for Long-Term Care Homes September 2013 Ministry of - PowerPoint PPT Presentation

Fall 2013 Regulatory Amendments under the Long-Term Care Homes Act, 2007 Overview and Explanation of Key Components Presentation for Long-Term Care Homes – September 2013 Ministry of Health and Long-Term Care

Introduction • The purpose of this presentation is to provide an overview of the recent regulatory amendments under the Long-Term Care Homes Act, 2007 (LTCHA). Some of these amendments came into effect on September 15, 2013 and others will come into effect on November 1, 2013. • The presentation includes an overview of all of the regulatory amendments and will focus on the implications for long-term care (LTC) homes. • The amendments are now incorporated into Regulation 79/10 on the e-laws website at www.e-laws.gov.on.ca. 2

Table of Contents of the Regulatory Amendments Amendments that came into effect on September 15, 2013 A.Qualifications for LTC Home Staff slides 4 - 9 B.Critical Incident Reporting slides 10 - 15 C.Locking of Doors to Non-residential Areas slide 16 Amendments that will come into effect on November 1, 2013 D.Convalescent Care Program slides 17 - 19 E.Specialized Unit Admissions and Discharge slides 20 - 22 3

A. Qualifications for LTC Home Staff The amendments to the LTC home staff qualifications relate to the following topics: Expansion of existing ‘ grandparenting ’ provisions for staff who were employed in 1. a LTC home on July 1, 2010 (the date when the LTCHA and Regulation came into force); 2. Changes to the qualifications for cooks and food service workers; 3. A change to the qualifications for registered dietitians; and 4. A clarification of the existing requirements pertaining to nutrition managers. 4

A1. Expansion of ‘Grandparenting’ Provisions • The original grandparenting provisions included in Regulation 79/10 permitted (with certain exceptions) LTC home staff members who were working in LTC homes prior to July 1, 2010 to continue working in their LTC home in the same position without having to upgrade their qualifications to the new requirements. • With the exception of the administrator, they did not allow grandparented staff to work in a different home without upgrading their qualifications. • Generally, under the amended Regulation, as of September 15, 2013, identified positions will be able to be hired into the same position at a different LTC home without meeting the updated qualifications set out in the Regulation, on the condition that they: • were working or employed in the same capacity in a LTC home immediately before July 1, 2010 (i.e. when the LTCHA and Regulation came into force), and  have at least three years full-time experience in the position during the five years immediately before being hired at the different LTC home, or  have the equivalent of at least three years full-time experience working part-time in the position during the seven years immediately before being hired at the different LTC home. • in addition, administrators must have continued to work or be employed in that position since July 1, 2010. • Identified positions are the following: administrators, directors of nursing and personal care, leads for the recreational and social activities program, recreational and social activities staff, nutrition managers, cooks, food service workers, and leads for housekeeping, laundry and maintenance. 5

A1. Expansion of ‘Grandparenting’ Provisions: Selected Implications • The mobility of LTC home staff who were already employed in a LTC home at the time that the LTCHA came into effect is now improved. • The following slides set out a number of scenarios that clarify how the ‘grandparenting’ provisions will apply. • The licensee has the onus to ensure that employees meet the requirements relating to staff qualifications set out the Regulation. Licensees will need to consider what processes should be put in place to verify the qualifications of individuals being hired for these positions. 6

A1. Expansion of ‘Grandparenting’ Provisions: Scenarios Scenario Implication Full Time Staff (see specific implications with respect to administrators): Individual started working in a LTC home on January 1, Does NOT meet the grandfathering requirements i. 2009 and worked until December 31, 2011 in the same as the person would not have 3 years of full time position (3 years). Applying for the same position in a experience within the last five years when different LTC home in January 2016. applying in 2016. In addition, with respect to administrators, does not meet requirement for continuous service. Individual started working in a LTC home on July 1, 2007 Would meet the grandfathering requirements for ii. and worked until June 30, 2012 in the same position (5 staff, except for administrators (as does not meet years). Took a leave of absence from July 1, 2012 until requirement for continuous service). June 30, 2013 (1 year) and returned to work at the home in the same position. Applying for the same position in a different LTC home in October 2013. iii. Individual started working in a LTC home on January 1, Would meet the grandfathering requirements for 2009 and worked until December 31, 2018 in the same staff, except for administrators (as does not meet position (9 years). Applying for the same position in a requirement for continuous service). different LTC home in January 2020. 7

A2. Changes to Qualifications for Cooks & Food Service Workers • The qualifications for cooks have been amended to include Institutional Cooks. • The qualifications for food service workers have been amended to allow apprentice Cooks, Institutional Cooks, and Assistant Cooks as well as persons who have entered into registered training agreements in the trade of Cook, Institutional Cook or Assistant Cook to be hired as food service workers. • These changes harmonize the qualification requirements for cooks and food service workers under the LTCHA with existing training and development programs, thereby enhancing employment opportunities for prospective workers and improving recruitment opportunities for LTC homes. • LTC homes will have to cease to employ persons who have entered into registered training agreements in these trades if the agreement is cancelled, suspended or revoked or the person fails to complete the program within the specified time period of being hired. • The specified time periods are: • within three years of being hired, in the case of an apprenticeship program in the trade of Assistant Cook, and • within five years of being hired, in the case of an apprenticeship program in the trade of Cook or Institutional Cook. 8

A3. Changes to Qualifications for Registered Dietitians • The qualifications for registered dietitian have been amended to include a temporary certificate of registration under the Dietetics Act, 1991. A4. Clarification of Requirements Pertaining to Nutrition Managers • The Regulation has been amended to clarify that only registered dietitians or active members of the Canadian Society of Nutrition Management (CSNM) can be hired as a nutrition manager. • The CSNM has several classes of membership including Active Members and Student Members. The “Active” Membership is the most qualified class. • This clarification is consistent with the original intent of the Regulation. 9

B. Critical Incident Reporting • The amendments related to critical incident reporting pertain to two main topics: 1. environmental hazards; and 2. reporting of injuries that result in a person being taken to hospital. 10

B1. Changes to Provisions on Environmental Hazards • The Regulation has been amended to remove “loss of essential services” and “flooding” from the list of emergencies that must be reported immediately. • As a result, these incidents are now added to the list of environmental hazards that must instead be reported within one business day. • The reporting requirements for environmental hazards have also been clarified so that the reporting requirements apply to incidents that affect the provision of care or the safety, security or well-being of one or more residents of a LTC home for a period greater than six hours. 11

B2. Changes to Reporting of Injuries • The reporting requirements related to injuries have been amended so that reporting is only required when there is an incident that causes an injury to a resident for which the resident is taken to a hospital and that results in a significant change in the resident’s health condition. • The term “significant change” is defined as “a major change in the resident’s health condition that, will not resolve itself without further intervention, a) impacts on more than one aspect of the resident’s health condition, and b) requires an assessment by the interdisciplinary team or a revision to the resident’s plan c) of care.” • If the LTC home is unable within one business day to determine whether the injury has caused a significant change in the resident’s health condition, the LTC home must contact the hospital within three calendar days of the incident to determine whether the injury resulted in significant change. • If the injury has resulted in a significant change in the resident’s health condition or the LTC home remains unable to determine whether this is the case, the LTC home must inform the Ministry of the incident no later than three business days after the incident occurred. 12