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Crisis in LTC: Worse Than We Imagined

On May 26, 2020 the most horrible report detailing conditions at several Long Term Care facilities written by the Canadian Armed Forces was released. The Army was asked to assist in the five LTCs in Ontario that had a very high death rate. They included: Orchard Villa (Pickering); Altamont (Scarborough); Eatonville (Etobicoke); Hawthorne (North York) and Holland Christian (Brampton).

The report detailed appalling conditions including suspected abuse, filth,  bug infestation,  lack of infection control and a disregard for resident’s health, safety and wellbeing. As I highlighted in last week’s blog, much of what was witnessed and reported was not entirely related to Covid concerns. The lack of PPE, guidelines and operating procedures only exacerbated many long standing problems.

While LTCs are licensed by the Ministry of Health and Long-Term Care they may not be accredited. and inspections of the homes are only required once per year.     I thought it would be helpful to clarify some terms and the following information is from the Ministry inspection website:

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.

“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:

  • Home, Community and Residential Care
    Home, Community and Residential Care providers are the local organizations established by the Ministry of Health and Long-Term Care that provide access to government-funded home and community services, including admission into LTC homes. Home, Community and Residential Care have Case Managers/Placement Coordinators who authorize admissions into LTC homes (for both permanent and short-stay admissions) and arrange for home care services. There is an application process that must be completed for placement into a LTC home.
  • Family Council
    An autonomous (self-led and self-determining) group made up of families and friends of the residents of a LTC home 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 the management and staff of a home.
  • Home Administrator
    The Administrator has overall responsibility for the day-to-day operations of a home.

In follow up to the 3 part series on Crisis in LTC, I wrote a fourth blog titled “Crisis in Long Term Care: Thinking About Tomorrow”.

In this blog I referenced the November 2017 publication ‘Aging with Confidence: Ontario’s Action Plan for Seniors’. Two plus years later,  things have only gotten worse.  Sadly, the title of this Ministry report couldn’t be further from the truth.






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About Audrey Miller
About: Audrey Miller, Managing Director of Elder Caring Inc. has over 30 years social work and rehabilitation experience working with older individuals and their families. She advises the financial, insurance, legal and business communities regarding elder care issues. Audrey is a recognized expert in her field. Email:


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