Homes for the Aged and Rest Homes Act
Loi sur les foyers pour personnes âgées et les maisons de repos

R.R.O. 1990, REGULATION 637

GENERAL

Historical version for theperiod December 27, 2007 to May 20, 2008.

Last amendment: O.Reg. 591/07.

This Regulation is made in English only.

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CONTENTS

Sections
Interpretation / 1-2.1
Nursing and Other Staff / 3-3.3
Staff Training / 4
Powers and Duties of Administrators / 5-6
Information / 6.1
Eligibility for Admission / 7-11.1
Application for Determination of Eligibility / 12
Application for Authorization of Admission / 12.1-12.2
Approval by Committee or Board / 12.3-12.4.1
Keeping of Waiting List / 12.5-12.7.1
Placement into Categories on Waiting List / 12.8-12.14.4
Ranking of Categories / 12.15
Ranking Within Categories / 12.16-12.18
Waiting List For Interim Beds / 12.19
Change of Category / 12.20
Authorization of Admission / 12.21-12.23
Transfer List / 12.24
Discharge / 12.25-12.26
Closing of a Home / 12.27
Restraint / 13
Medications / 14
Rules Governing Homes / 15-17.2
Fire Protection and Fire Duties / 18
Forms and Records / 19-25.1
Medical and Related Services / 26-29
Manner of Computing the Proportion of the Cost of Construction Allocated to Unorganized Parts of Districts / 30-31
Classification / 32
Payments under Subsection 28 (1) of the Act / 33-37
Reconciliation / 38-39
Preferred Accommodation Maximum / 39.0.1
Resident Payments / 39.1-39.7
Payment for Day Following Discharge / 39.8
Capital Expenditures / 40-44
Absences / 45-52
Trust Accounts / 53-54
Purchase of Produce from Home Farm / 55
Bonding of Administrator / 56
District of Nipissing / 57
District of Parry Sound / 58
District of Algoma / 58.1
Boards of Management / 59
Chairs of Boards / 60
Committees of Management / 61
Posting / 62-64
Notice / 65-66
Plan of Care / 67-68
Nutritional Care / 68.1
Quality Management / 69
Table 1 / Subsidy calculation worksheet
Table 3 / Resident payments
Table 4 / Ranking of waiting list categories
Table 5 / Rules for ranking within categories
Schedule 1 / The board of management for the District of Algoma
Schedule 2 / The board of management for the District of Cochrane
Schedule 3 / The board of management for the District of Kenora
Schedule 4 / The board of management for the District of Manitoulin
Schedule 5 / The board of management for the District of Nipissing East
Schedule 6 / The board of management for the District of Nipissing West
Schedule 7 / The board of management for the District of Parry Sound East
Schedule 8 / The board of management for the District of Parry Sound West
Schedule 9 / The board of management for the District of Rainy River
Schedule 10 / The board of management for the District of Thunder Bay

Interpretation

1.(1)In this Regulation,

“accommodation”, in relation to a home, means basic accommodation in the home or preferred accommodation in the home;

“basic accommodation”, in relation to a home, means lodging in a standard room in the home, housekeeping services, maintenance and use of the home, dietary services, laundry and linen services, administrative services and raw food;

“board” means the board of management of a home established under section 5 or 6 of the Act;

“casual absence” means an absence of a resident from a home for a period not exceeding forty-eight hours for a purpose other than receiving medical or psychiatric care or undergoing medical or psychiatric assessment;

“continuum of care applicant”, in relation to a continuum of care home, means a person who resides in a project set out opposite the home in Column 2 of the Continuum of Care Facilities Table and has resided there as of a date earlier than July 1, 1994;

“Continuum of Care Facilities Table” means the table published by the Ministry of Health and Long-Term Care that is titled “Continuum of Care Facilities Table” and that is dated October 24, 1996;

“continuum of care home” means a home set out in Column 1 of the Continuum of Care Facilities Table;

“design manual” means the document entitled “Long-Term Care Facility Design Manual”, published by the Ministry of Health and Long-Term Care and dated May, 1999, and which is available from the Ministry of Health and Long-Term Care;

“dietitian” means a member of the College of Dietitians of Ontario who holds a general certificate of registration under the Dietetics Act, 1991;

“interim bed” means a bed that exists in a home for a temporary period of time under the terms of a service agreement for interim beds;

“long-stay resident” means a resident who is not a short-stay resident;

“medical absence” means an absence of a resident from a home for the purpose of receiving medical care other than psychiatric care or for the purpose of undergoing medical assessment other than psychiatric assessment;

“medical director” means the legally qualified medical practitioner appointed as physician for the home or joint home under subsection 12(4) of the Act;

“municipal auditor” means an auditor licensed and appointed in accordance with the Municipal Act for one or more of the municipalities maintaining the home or for the board, as the case may be, or, where the home is established under section 5 of the Act, means a public accountant licensed under the Public Accountancy Act;

“preferred accommodation”, in relation to a home, means private accommodation in the home or semi-private accommodation in the home;

“private accommodation”, in relation to a home, means lodging in a private room in the home, housekeeping services, maintenance and use of the home, dietary services, laundry and linen services, administrative services and raw food;

“private room” means,

(a)in the case of a home to which the design manual or the part of the retrofit manual concerning resident bedrooms and headed “Option A” applies, a room with one bed that has a private ensuite washroom, other than a room that is designated by the municipality, municipalities or board maintaining and operating the home as a standard room,

(b)in the case of a home to which the part of the retrofit manual concerning resident bedrooms and headed “Option B” applies, a room with one bed that has an ensuite washroom, other than a room that is designated by the municipality, municipalities or board maintaining and operating the home as a standard room, or

(c)in the case of all other homes, a room with one bed, other than a room that is designated by the municipality, municipalities or board maintaining and operating the home as a standard room;

“psychiatric absence” means an absence of a resident from a home for the purpose of receiving psychiatric care or undergoing psychiatric assessment;

“red-circled”, in relation to a year, means determined to be red-circled in accordance with the subsidy calculation worksheet for the year;

“registered nurse” means a member of the College of Nurses of Ontario who holds a certificate of registration as a registered nurse under the Nursing Act, 1991;

“registered nurse in the extended class” means a member of the College of Nurses of Ontario who is a registered nurse and who holds an extended certificate of registration under the Nursing Act, 1991;

“registered nursing staff” means those members of the nursing staff who are registered nurses including registered nurses in the extended class or registered practical nurses;

“registered practical nurse” means a member of the College of Nurses of Ontario who holds a certificate of registration as a registered practical nurse under the Nursing Act, 1991;

“related temporary approved charitable home for the aged” has the same meaning as in Regulation 69 of the Revised Regulations of Ontario, 1990 made under the Charitable Institutions Act;

“related temporary home” means, where all or some of the beds in a home are to be temporarily or permanently closed, another home, if any, that is operated by the same municipality, municipalities or board and is to provide beds to residents of the original home on a temporary basis until beds in the re-opened home or replacement home are available for those residents;

“related temporary nursing home” has the same meaning as in Regulation 832 of the Revised Regulations of Ontario, 1990 made under the Nursing Homes Act;

“re-opened approved charitable home for the aged” has the same meaning as in Regulation 69 of the Revised Regulations of Ontario, 1990 made under the Charitable Institutions Act;

“re-opened home” means, where all or some of the beds in a home are to be temporarily closed, the same home once those beds are re-opened;

“re-opened nursing home” has the same meaning as in Regulation 832 of the Revised Regulations of Ontario, 1990 made under the Nursing Homes Act;

“replacement approved charitable home for the aged” has the same meaning as in Regulation 69 of the Revised Regulations of Ontario, 1990 made under the Charitable Institutions Act;

“replacement home” means, where all or some of the beds in a home are to be permanently closed, the new home, if any, to be operated by the same municipality, municipalities or board and to serve as a replacement for the beds being closed in the original home;

“replacement nursing home” has the same meaning as in Regulation 832 of the Revised Regulations of Ontario, 1990 made under the Nursing Homes Act;

“resident classification form” means a form that contains questions designed to measure the functional abilities and care requirements of a resident and that is approved by the Minister for use in the classification process described in section 32;

“retrofit manual” means the document entitled “Long-Term Care ‘D’ Facility Retrofit Design Manual”, published by the Ministry of Health and Long-Term Care and dated January, 2002, and which is available from the Ministry of Health and Long-Term Care;

“semi-private accommodation”, in relation to a home, means lodging in a semi-private room in the home, housekeeping services, maintenance and use of the home, dietary services, laundry and linen services, administrative services and raw food;

“semi-private room” means,

(a)in the case of a home to which the design manual or the part of the retrofit manual concerning resident bedrooms and headed “Option A” applies, a room with one bed has an ensuite washroom, other than a room that is designated as a standard room by the municipality, municipalities or board maintaining and operating the home,

(b)in the case of a home to which the part of the retrofit manual concerning resident bedrooms and headed “Option B” applies, a room with two beds that affords privacy to each resident, and that has an ensuite washroom other than a room that is designated as a standard room by the municipality, municipalities or board maintaining and operating the home, or

(c)in the case of all other homes, a room with two beds, other than a room that is designated as a standard room by the municipality, municipalities or board maintaining and operating the home;

“short-stay program” means a program in which a person is admitted to a home for a definite number of days;

“short-stay resident” means a resident who has been admitted to a short-stay program;

“spouse” means a person,

(a)to whom the person is married, or

(b)with whom the person is living, or was living immediately before one of them was admitted to a home, in a conjugal relationship outside marriage, if the two persons,

(i)have cohabited for at least one year,

(ii)are together the parents of a child, or

(iii)have together entered into a cohabitation agreement under section 53 of the Family Law Act;

“standard room” means,

(a)in the case of a home to which the design manual or the retrofit manual applies, a room with one or two beds that affords privacy to each resident, that has an ensuite washroom, and that is designated as a standard room by the municipality, municipalities or board maintaining and operating the home, or

(b)in the case of all other homes,

(i) a room with three or more beds, or

(ii)a room with less than three beds that is designated by the municipality, municipalities or board maintaining and operating the home as a standard room;

“subsidy calculation worksheet” means,

(a)for the years 1993 to 1998, the documents published by the Ministry of Health that are set out opposite the year in Table 1, and

(b)for the years 1999 and following years, the forms approved by the Minister that are set out opposite the year in Table 1;

“vacation absence” means an absence of a resident from a home for a period exceeding forty-eight hours for a purpose other than receiving medical or psychiatric care or undergoing medical or psychiatric assessment;

“veteran” means a veteran as defined in subsection 2 (1) of the War Veterans’ Allowance Act (Canada).

“veterans’ priority access bed”, in relation to a home, means a bed that has been designated as a veteran’s priority access bed as required under the terms of the home’s service agreement. R.R.O. 1990, Reg. 637, s.1; O.Reg. 684/92, s.1; O.Reg. 371/93, s.1; O.Reg. 237/94, s.1; O.Reg. 372/94, s.1(1,2); O.Reg. 536/94, s.1; O.Reg. 342/96, s.1; O.Reg. 641/98, s.1; O.Reg. 65/00, s.1(1); O.Reg. 182/01, s.1; O.Reg. 120/02, s.1; O.Reg. 271/02, s.1; O.Reg. 60/03, s.1; O.Reg. 338/04, s.1; O.Reg. 330/05, s.1 (1, 2).

(2)Two persons are partners for the purpose of this Regulation if they have lived together for at least one year and have a close personal relationship that is of primary importance in both persons’ lives. O.Reg. 372/94, s.1(3).

(3)Revoked: O.Reg. 330/05, s.1 (3).

2., 2.1Revoked: O.Reg. 10/97, s.1.

Nursing and Other Staff

3.(1)Subject to subsection (2), the municipality, municipalities or board maintaining and operating a home shall ensure that there are nurses with nursing experience on the staff of the home and that at least one of those nurses is a registered nurse. O.Reg. 42/98, s.1.

(2)There shall be employed such staff to care for residents in addition to those required under subsection (1) including registered nurses, as may be required by the Director. R.R.O. 1990, Reg. 637, s.3(2).

(3)Despite subsections (1) and (2), the municipality, municipalities or board maintaining and operating a home shall ensure that at least one registered nurse who is a member of the regular nursing staff of the home is on duty and present in the home at all times. O.Reg. 338/04, s.2.

(4)Until August 1, 2005, subsection (3) does not apply to a municipality, municipalities or board with respect to a home having 80 beds or less. O.Reg. 413/04, s.1.

3.1(1)The municipality, municipalities or board maintaining and operating a home shall ensure that there is at least one food services supervisor on the staff of the home and that the minimum combined number of hours worked in a week by all of the home’s food services supervisors in their capacity as such is the number obtained by multiplying the number of meal days in the week by 4/105. O.Reg. 587/94, s.4.

(2)The municipality, municipalities or board maintaining and operating a home shall ensure that there is at least one food handler on the staff of the home and that the minimum combined number of hours worked in a week by all of the home’s food handlers in their capacity as such is the number obtained by multiplying the number of meal days in the week by 2/5. O.Reg. 587/94, s.4.

(3)For the purpose of subsections (1) and (2), the number of meal days in a week is the sum of the number of meal days in each day of the week. O.Reg. 587/94, s.4.

(4)For the purpose of subsection (3), the number of meal days in a day is the number obtained using the formula,

in which,

“A”is the number of residents the home has that day; and

“B”is the number of meals and snacks prepared in the home that day for persons who are not residents of the home.

O.Reg. 587/94, s.4.

(5)In this section,

“food handler” means an employee whose function it is to prepare or cook food or to clean kitchen equipment or utensils. O.Reg. 587/94, s.4.

3.2For the purpose of determining whether section 3.1 is being complied with, a person who holds more than one position at a home or who works at a home in more than one capacity shall be considered to be working in only one capacity at any one moment in time. O.Reg. 587/94, s.4; O.Reg. 10/97, s.2.

3.3The municipality, municipalities or board maintaining and operating a home shall ensure that there are sufficient qualified administrative staff to manage and administer the home. O.Reg. 10/97, s.3.

Staff Training

4.The municipality, municipalities or board maintaining and operating a home shall ensure,

(a)that when a person becomes a member of the staff of the home, the person is given in-service training to orient him or her to the home; and

(b)that in-service training programs for the purpose of continuing education are conducted for all of the staff of the home. O.Reg. 587/94, s.4.

Powers and Duties of Administrators

5.An administrator,

(a)is responsible to the council of the municipality that establishes and maintains the home, the councils of the municipalities that establish and maintain a joint home or to the board, as the case may be, for,

(i)the proper performance of his or her duties under the Act and this Regulation,

(ii)the efficient management and operation of the home,

(iii)keeping the records, completing the forms and making the returns required by the Act and this Regulation, and

(iv)maintaining the confidentiality of all records and protecting the privacy and rights of the residents;

(b), (c)Revoked: O.Reg. 372/94, s.3(2).

(d)shall, if possible, when making plans regarding the transfer, discharge or restraint of a resident, involve the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident’s personal care;

(e)shall ensure that a written record is kept of clothing, valuables and other personal effects brought by the applicant to the home upon admission or acquired by him or her from time to time after admission;

(f)shall ensure that a written record is kept of all illnesses, transfers, discharges and deaths of residents;

(g)is responsible for the receipt from, and the disbursement to, residents of money held for residents in the trust account established under section 53 and for keeping a written record of all those receipts and disbursements;

(h)shall organize a continuing program of varied and meaningful activities designed to stimulate the interests of residents including handicrafts, continuous learning, activation programs approved by the Director, recreation and entertainment to enhance the residents’ lifestyle within the home and, where appropriate, in the community;

(i)shall encourage the participation of volunteer groups and individuals from the community including a Home Auxiliary in the program of varied and meaningful activities for residents;

(j)shall allocate proper accommodation to residents taking into consideration the type of care needed;

(k)shall not relocate any resident without a planned program of counselling and orientation and, where possible, consultation with the person who is lawfully authorized to make a decision on behalf of the resident concerning the resident’s personal care;

(l)shall purchase provisions for the home;