jswizzle3737/ontario_laws_and_regs huggingface dataset:
Misuse of funding
 108. For the purposes of paragraph 5 of subsection 24 (1) and paragraph 6 of subsection 25 (1) of the Act, “misuse” of funding means the use of funding provided by the Ministry, the Agency or a local health integration network, (a) for a purpose other than a purpose that was specified as a condition of the funding; or (b) in a manner that is not permitted under a restriction that was specified as a condition of the funding.  O. Reg. 79/10, s. 108; O. Reg. 205/21, s. 1. Minimizing of Restraining
Policy to minimize restraining of residents, etc.
 109. Every licensee of a long-term care home shall ensure that the home’s written policy under section 29 of the Act deals with, (a) use of physical devices; (b) duties and responsibilities of staff, including, (i) who has the authority to apply a physical device to restrain a resident or release a resident from a physical device, (ii) ensuring that all appropriate staff are aware at all times of when a resident is being restrained by use of a physical device; (c) restraining under the common law duty pursuant to subsection 36 (1) of the Act when immediate action is necessary to prevent serious bodily harm to the person or others; (d) types of physical devices permitted to be used; (e) how consent to the use of physical devices as set out in section 31 of the Act and the use of PASDs as set out in section 33 of the Act is to be obtained and documented; (f) alternatives to the use of physical devices, including how these alternatives are planned, developed and implemented, using an interdisciplinary approach; and (g) how the use of restraining in the home will be evaluated to ensure minimizing of restraining and to ensure that any restraining that is necessary is done in accordance with the Act and this Regulation.  O. Reg. 79/10, s. 109.
Requirements relating to the use of a PASD
 111. (1) Every licensee of a long-term care home shall ensure that a PASD used under section 33 of the Act to assist a resident with a routine activity of living is removed as soon as it is no longer required to provide such assistance, unless the resident requests that it be retained.  O. Reg. 79/10, s. 111 (1). (2) Every licensee shall ensure that a PASD used under section 33 of the Act, (a) is well maintained; (b) is applied by staff in accordance with any manufacturer’s instructions; and (c) is not altered except for routine adjustments in accordance with any manufacturer’s instructions.  O. Reg. 79/10, s. 111 (2).
Prohibited devices that limit movement
 112. For the purposes of section 35 of the Act, every licensee of a long-term care home shall ensure that the following devices are not used in the home: 1. Roller bars on wheelchairs and commodes or toilets. 2. Vest or jacket restraints. 3. Any device with locks that can only be released by a separate device, such as a key or magnet. 4. Four point extremity restraints. 5. Any device used to restrain a resident to a commode or toilet. 6. Any device that cannot be immediately released by staff. 7. Sheets, wraps, tensors or other types of strips or bandages used other than for a therapeutic purpose.  O. Reg. 79/10, s. 112.
Evaluation
 113. Every licensee of a long-term care home shall ensure, (a) that an analysis of the restraining of residents by use of a physical device under section 31 of the Act or pursuant to the common law duty referred to in section 36 of the Act is undertaken on a monthly basis; (b) that at least once in every calendar year, an evaluation is made to determine the effectiveness of the licensee’s policy under section 29 of the Act, and what changes and improvements are required to minimize restraining and to ensure that any restraining that is necessary is done in accordance with the Act and this Regulation; (c) that the results of the analysis undertaken under clause (a) are considered in the evaluation; (d) that the changes or improvements under clause (b) are promptly implemented; and (e) that a written record of everything provided for in clauses (a), (b) and (d) and the date of the evaluation, the names of the persons who participated in the evaluation and the date that the changes were implemented is promptly prepared.  O. Reg. 79/10, s. 113. Drugs
Medication management system
 114. (1) Every licensee of a long-term care home shall develop an interdisciplinary medication management system that provides safe medication management and optimizes effective drug therapy outcomes for residents.  O. Reg. 79/10, s. 114 (1). (2) The licensee shall ensure that written policies and protocols are developed for the medication management system to ensure the accurate acquisition, dispensing, receipt, storage, administration, and destruction and disposal of all drugs used in the home.  O. Reg. 79/10, s. 114 (2). (3) The written policies and protocols must be, (a) developed, implemented, evaluated and updated in accordance with evidence-based practices and, if there are none, in accordance with prevailing practices; and (b) reviewed and approved by the Director of Nursing and Personal Care and the pharmacy service provider and, where appropriate, the Medical Director.  O. Reg. 79/10, s. 114 (3).
Quarterly evaluation
 115. (1) Every licensee of a long-term care home shall ensure that an interdisciplinary team, which must include the Medical Director, the Administrator, the Director of Nursing and Personal Care and the pharmacy service provider, meets at least quarterly to evaluate the effectiveness of the medication management system in the home and to recommend any changes necessary to improve the system.  O. Reg. 79/10, s. 115 (1). (2) Where the pharmacy service provider is a corporation, the licensee shall ensure that a pharmacist from the pharmacy service provider participates in the quarterly evaluation.  O. Reg. 79/10, s. 115 (2). (3) The quarterly evaluation of the medication management system must include at least, (a) reviewing drug utilization trends and drug utilization patterns in the home, including the use of any drug or combination of drugs, including psychotropic drugs, that could potentially place residents at risk; (b) reviewing reports of any medication incidents and adverse drug reactions referred to in subsections 135 (2) and (3) and all instances of the restraining of residents by the administration of a drug when immediate action is necessary to prevent serious bodily harm to a resident or to others pursuant to the common law duty referred to in section 36 of the Act; and (c) identifying changes to improve the system in accordance with evidence-based practices and, if there are none, in accordance with prevailing practices.  O. Reg. 79/10, s. 115 (3). (4) The licensee shall ensure that the changes identified in the quarterly evaluation are implemented.  O. Reg. 79/10, s. 115 (4). (5) The licensee shall ensure that a written record is kept of the results of the quarterly evaluation and of any changes that were implemented.  O. Reg. 79/10, s. 115 (5).
Annual evaluation
 116. (1) Every licensee of a long-term care home shall ensure that an interdisciplinary team, which must include the Medical Director, the Administrator, the Director of Nursing and Personal Care, the pharmacy service provider and a registered dietitian who is a member of the staff of the home, meets annually to evaluate the effectiveness of the medication management system in the home and to recommend any changes necessary to improve the system.  O. Reg. 79/10, s. 116 (1). (2) Where the pharmacy service provider is a corporation, the licensee shall ensure that a pharmacist from the pharmacy service provider participates in the annual evaluation.  O. Reg. 79/10, s. 116 (2). (3) The annual evaluation of the medication management system must, (a) include a review of the quarterly evaluations in the previous year as referred to in section 115; (b) be undertaken using an assessment instrument designed specifically for this purpose; and (c) identify changes to improve the system in accordance with evidence-based practices and, if there are none, in accordance with prevailing practices.  O. Reg. 79/10, s. 116 (3). (4) The licensee shall ensure that the changes identified in the annual evaluation are implemented.  O. Reg. 79/10, s. 116 (4). (5) The licensee shall ensure that a written record is kept of the results of the annual evaluation and of any changes that were implemented.  O. Reg. 79/10, s. 116 (5).
Medical directives and orders — drugs
 117. Every licensee of a long-term care home shall ensure that, (a) all medical directives or orders for the administration of a drug to a resident are reviewed at any time when the resident’s condition is assessed or reassessed in developing or revising the resident’s plan of care as required under section 6 of the Act; and (b) no medical directive or order for the administration of a drug to a resident is used unless it is individualized to the resident’s condition and needs.  O. Reg. 79/10, s. 117.
Information in every resident home area or unit
 118. Every licensee of a long-term care home shall ensure that the following are available in every resident home area or unit in the home: 1. Recent and relevant drug reference materials. 2. The pharmacy service provider’s contact information. 3. The contact information for at least one poison control centre or similar body.  O. Reg. 79/10, s. 118. Pharmacy Service Provider
Retaining of pharmacy service provider
 119. (1) Every licensee of a long-term care home shall retain a pharmacy service provider for the home.  O. Reg. 79/10, s. 119 (1). (2) The pharmacy service provider must be the holder of a certificate of accreditation for the operation of a pharmacy under section 139 of the Drug and Pharmacies Regulation Act.  O. Reg. 79/10, s. 119 (2). (3) There must be a written contract between the licensee and the pharmacy service provider setting out the responsibilities of the pharmacy service provider.  O. Reg. 79/10, s. 119 (3). (4) The written contract must provide that the pharmacy service provider shall, (a) provide drugs to the home on a 24-hour basis, seven days a week, or arrange for their provision by another holder of a certificate of accreditation for the operation of a pharmacy under section 139 of the Drug and Pharmacies Regulation Act; and (b) perform all the other responsibilities of the pharmacy service provider under this Regulation.  O. Reg. 79/10, s. 119 (4). (5) If, on the day this section comes into force, a licensee’s pharmacy service provider does not meet the requirement in subsection (2), the licensee shall retain a pharmacy service provider that meets the requirement within three months of the coming into force of this section.  O. Reg. 79/10, s. 119 (5).
Responsibilities of pharmacy service provider
 120. Every licensee of a long-term care home shall ensure that the pharmacy service provider participates in the following activities: 1. For each resident of the home, the development of medication assessments, medication administration records and records for medication reassessment, and the maintenance of medication profiles. 2. Evaluation of therapeutic outcomes of drugs for residents. 3. Risk management and quality improvement activities, including review of medication incidents, adverse drug reactions and drug utilization. 4. Developing audit protocols for the pharmacy service provider to evaluate the medication management system. 5. Educational support to the staff of the home in relation to drugs. 6. Drug destruction and disposal under clause 136 (3) (a) if required by the licensee’s policy.  O. Reg. 79/10, s. 120.
System for notifying pharmacy service provider
 121. Every licensee of a long-term care home shall ensure that a system is developed for notifying the pharmacy service provider within 24 hours of the admission, medical absence, psychiatric absence, discharge, and death of a resident.  O. Reg. 79/10, s. 121. Obtaining and Keeping Drugs
Purchasing and handling of drugs
 122. (1) Every licensee of a long-term care home shall ensure that no drug is acquired, received or stored by or in the home or kept by a resident under subsection 131 (7) unless the drug, (a) has been prescribed for a resident or obtained for the purposes of the emergency drug supply referred to in section 123; and (b) has been provided by, or through an arrangement made by, the pharmacy service provider or the Government of Ontario.  O. Reg. 79/10, s. 122 (1). (2) Subsection (1) does not apply where exceptional circumstances exist such that a drug prescribed for a resident cannot be provided by, or through an arrangement made by, the pharmacy service provider.  O. Reg. 79/10, s. 122 (2).
Emergency drug supply
 123. Every licensee of a long-term care home who maintains an emergency drug supply for the home shall ensure, (a) that only drugs approved for this purpose by the Medical Director in collaboration with the pharmacy service provider, the Director of Nursing and Personal Care and the Administrator are kept; (b) that a written policy is in place to address the location of the supply, procedures and timing for reordering drugs, access to the supply, use of drugs in the supply and tracking and documentation with respect to the drugs maintained in the supply; (c) that, at least annually, there is an evaluation done by the persons referred to in clause (a) of the utilization of drugs kept in the emergency drug supply in order to determine the need for the drugs; and (d) that any recommended changes resulting from the evaluation are implemented.  O. Reg. 79/10, s. 123.
Drug supply
 124. Every licensee of a long-term care home shall ensure that drugs obtained for use in the home, except drugs obtained for any emergency drug supply, are obtained based on resident usage, and that no more than a three-month supply is kept in the home at any time.  O. Reg. 79/10, s. 124.
Monitored dosage system
 125. (1) Every licensee of a long-term care home shall ensure that a monitored dosage system is used in the home for the administration of drugs.  O. Reg. 79/10, s. 125 (1). (2) The monitored dosage system must promote the ease and accuracy of the administration of drugs to residents and support monitoring and drug verification activities.  O. Reg. 79/10, s. 125 (2).
Packaging of drugs
 126. Every licensee of a long-term care home shall ensure that drugs remain in the original labelled container or package provided by the pharmacy service provider or the Government of Ontario until administered to a resident or destroyed.  O. Reg. 79/10, s. 126.
Changes in directions for administration
 127. Every licensee of a long-term care home shall ensure that a policy is developed and approved by the Director of Nursing and Personal Care and the pharmacy service provider and, where appropriate, the Medical Director, to govern changes in the administration of a drug due to modifications of directions for use made by a prescriber, including temporary discontinuation.  O. Reg. 79/10, s. 127.
Sending of drugs with a resident
 128. Every licensee of a long-term care home shall ensure that a policy is developed and approved by the Director of Nursing and Personal Care and the pharmacy service provider and, where appropriate, the Medical Director, to govern the sending of a drug that has been prescribed for a resident with him or her when he or she leaves the home on a temporary basis or is discharged.  O. Reg. 79/10, s. 128.
Safe storage of drugs
 129. (1) Every licensee of a long-term care home shall ensure that, (a) drugs are stored in an area or a medication cart, (i) that is used exclusively for drugs and drug-related supplies, (ii) that is secure and locked, (iii) that protects the drugs from heat, light, humidity or other environmental conditions in order to maintain efficacy, and (iv) that complies with manufacturer’s instructions for the storage of the drugs; and (b) controlled substances are stored in a separate, double-locked stationary cupboard in the locked area or stored in a separate locked area within the locked medication cart.  O. Reg. 79/10, s. 129 (1). (2) Subsection (1) does not apply with respect to drugs that a resident is permitted to keep on his or her person or in his or her room in accordance with subsection 131 (7).  O. Reg. 79/10, s. 129 (2).
Security of drug supply
 130. Every licensee of a long-term care home shall ensure that steps are taken to ensure the security of the drug supply, including the following: 1. All areas where drugs are stored shall be kept locked at all times, when not in use. 2. Access to these areas shall be restricted to, i. persons who may dispense, prescribe or administer drugs in the home, and ii. the Administrator. 3. A monthly audit shall be undertaken of the daily count sheets of controlled substances to determine if there are any discrepancies and that immediate action is taken if any discrepancies are discovered.  O. Reg. 79/10, s. 130.
Natural health products
 132. (1) Every licensee of a long-term care home shall ensure that where a resident wishes to use a drug that is a natural health product and that has not been prescribed, there are written policies and procedures to govern the use, administration and storage of the natural health product.  O. Reg. 79/10, s. 132 (1). (2) Nothing in this Regulation prevents a resident from using, in accordance with the licensee’s policies and procedures as required by subsection (1), a natural health product that has not been prescribed.  O. Reg. 79/10, s. 132 (2). (3) Sections 114 to 131 and 133 to 137 do not apply with respect to a natural health product that has not been prescribed.  O. Reg. 79/10, s. 132 (3). (4) In this section, “natural health product” means natural health product, as that term is defined from time to time by the Natural Health Products Regulations under the Food and Drugs Act (Canada), other than a product that is a substance that has been identified in the regulations made under the Drug and Pharmacies Regulation Act as being a drug for the purposes of that Act despite clause (f) of the definition of “drug” in subsection 1 (1) of that Act.  O. Reg. 79/10, s. 132 (4).
Recreational cannabis
 132.1 (1) Every licensee of a long-term care home shall ensure that there are written policies and procedures to govern, with respect to residents, the cultivation, acquisition, consumption, administration, possession, storage and disposal of recreational cannabis in accordance with all applicable laws, including, without being limited to, the
Cannabis Act (Canada) and the Cannabis Regulations (Canada). O. Reg. 440/18, s. 2. (2) Nothing in this Regulation prevents a resident from cultivating, acquiring, consuming, administering, possessing, storing or disposing of recreational cannabis in accordance with the licensee’s policies and procedures as required by subsection (1). O. Reg. 440/18, s. 2. (3) Sections 114 to 132 and 132.2 to 137 do not apply with respect to recreational cannabis. O. Reg. 440/18, s. 2. (4) A licensee is not required to comply with subsection (1) until 90 days after the coming into force of this section. O. Reg. 440/18, s. 2.
Medical cannabis
 132.2 (1) Every licensee of a long-term care home shall ensure that there are written policies and procedures to govern, with respect to residents, the cultivation, acquisition, consumption, administration, possession, storage and disposal of medical cannabis in accordance with all applicable laws, including, without being limited to, the Cannabis Act (Canada) and the Cannabis Regulations (Canada). O. Reg. 440/18, s. 2. (2) Sections 122, 126, 129, 130, 131 and 136 do not apply with respect to medical cannabis. O. Reg. 440/18, s. 2. (3) A licensee is not required to comply with subsection (1) until 90 days after the coming into force of this section. O. Reg. 440/18, s. 2.
Industrial hemp and derivatives
 132.3 Sections 114 to 132.2 and 133 to 137 do not apply with respect to: (a) industrial hemp within the meaning of the Industrial Hemp Regulations (Canada); or (b) a derivative or a product made from a derivative that is exempt from the application of the Cannabis Act (Canada) under the Industrial Hemp Regulations (Canada) and that is not a natural health product within the meaning of section 132 of this Regulation. O. Reg. 440/18, s. 2.
Drug record (ordering and receiving)
 133. Every licensee of a long-term care home shall ensure that a drug record is established, maintained and kept in the home for at least two years,
in which is recorded the following information, in respect of every drug that is ordered and received in the home: 1. The date the drug is ordered. 2. The signature of the person placing the order. 3. The name, strength and quantity of the drug. 4. The name of the place from which the drug is ordered. 5. The name of the resident for whom the drug is prescribed, where applicable. 6. The prescription number, where applicable. 7. The date the drug is received in the home. 8. The signature of the person acknowledging receipt of the drug on behalf of the home. 9. Where applicable, the information required under subsection 136 (4).  O. Reg. 79/10, s. 133.
Residents’ drug regimes
 134. Every licensee of a long-term care home shall ensure that, (a) when a resident is taking any drug or combination of drugs, including psychotropic drugs, there is monitoring and documentation of the resident’s response and the effectiveness of the drugs appropriate to the risk level of the drugs; (b) appropriate actions are taken in response to any medication incident involving a resident and any adverse drug reaction to a drug or combination of drugs, including psychotropic drugs; and (c) there is, at least quarterly, a documented reassessment of each resident’s drug regime.  O. Reg. 79/10, s. 134.
Medication incidents and adverse drug reactions
 135. (1) Every licensee of a long-term care home shall ensure that every medication incident involving a resident and every adverse drug reaction is, (a) documented, together with a record of the immediate actions taken to assess and maintain the resident’s health; and (b) reported to the resident, the resident’s substitute decision-maker, if any, the Director of Nursing and Personal Care, the Medical Director, the prescriber of the drug, the resident’s attending physician or the registered nurse in the extended class attending the resident and the pharmacy service provider.  O. Reg. 79/10, s. 135 (1). (2) In addition to the requirement under clause (1) (a), the licensee shall ensure that, (a) all medication incidents and adverse drug reactions are documented, reviewed and analyzed; (b) corrective action is taken as necessary; and (c) a written record is kept of everything required under clauses (a) and (b).  O. Reg. 79/10, s. 135 (2). (3) Every licensee shall ensure that, (a) a quarterly review is undertaken of all medication incidents and adverse drug reactions that have occurred in the home since the time of the last review in order to reduce and prevent medication incidents and adverse drug reactions; (b) any changes and improvements identified in the review are implemented; and (c) a written record is kept of everything provided for in clauses (a) and (b).  O. Reg. 79/10, s. 135 (3).
Restraining by administration of drug, etc., under common law duty
 137. (1) A registered nurse may order the administration of a drug for the purposes of subsection 36 (3) of the Act.  O. Reg. 79/10, s. 137 (1). (2) Every licensee shall ensure that every administration of a drug to restrain a resident when immediate action is necessary to prevent serious bodily harm to the resident or to others pursuant to the common law duty described in section 36 of the Act is documented, and without limiting the generality of this requirement, the licensee shall ensure that the following are documented: 1. Circumstances precipitating the administration of the drug. 2. Who made the order, what drug was administered, the dosage given, by what means the drug was administered, the time or times when the drug was administered and who administered the drug. 3. The resident’s response to the drug. 4. All assessments, reassessments and monitoring of the resident. 5. Discussions with the resident or, where the resident is incapable, the resident’s substitute decision-maker, following the administration of the drug to explain the reasons for the use of the drug.  O. Reg. 79/10, s. 137 (2). Absences
Absent residents
 139. The requirements under this Regulation respecting the care and treatment of a resident do not apply with respect to a resident who is on a medical absence, a psychiatric absence, a casual absence or a vacation absence.  O. Reg. 79/10, s. 139.
Recording of absences
 140. Every licensee of a long-term care home shall ensure that each medical absence, psychiatric absence, casual absence and vacation absence of a resident of the home is recorded.  O. Reg. 79/10, s. 140.
Licensee to stay in contact
 141. (1) Every licensee of a long-term care home shall maintain contact with a resident who is on a medical absence or psychiatric absence or with the resident’s health care provider in order to determine when the resident will be returning to the home.  O. Reg. 79/10, s. 141 (1). (2) Every licensee of a long-term care home shall be in contact with a long-stay resident of the home who is on a vacation absence in order to determine when the resident will be returning to the home.  O. Reg. 79/10, s. 141 (2).
Care during absence
 142. Every licensee of a long-term care home shall ensure that before a long-stay resident of the home leaves for a casual absence or a vacation absence and before a short-stay resident of the home leaves for a casual absence, (a) a physician or a registered nurse in the extended class attending the resident or a member of the registered nursing staff of the home sets out in writing the care required to be given to the resident during the absence; and (b) a member of the licensee’s staff communicates to the resident, or the resident’s substitute decision-maker, (i) the need to take all reasonable steps to ensure that the care required to be given to the resident is received by the resident during the absence, (ii) that the licensee will not be responsible for the care, safety and well-being of the resident during the absence and that the resident or the resident’s substitute decision-maker assumes full responsibility for the care, safety and well-being of the resident during the absence, and (iii) the need to notify the Administrator of the home if the resident is admitted to a hospital during the absence or if the date of the resident’s return changes.  O. Reg. 79/10, s. 142.
Where interim bed resident considered to be long-stay resident
 143. For the purposes of the following provisions of this Regulation, a resident in the interim bed short-stay program shall be considered to be a long-stay resident: 1. Section 138. 2. Subsection 141 (2). 3. Section 142.  O. Reg. 79/10, s. 143. Discharge
Restriction on discharge
 144. No licensee of a long-term care home shall discharge a resident from the long-term care home unless permitted or required to do so by this Regulation.  O. Reg. 79/10, s. 144.
When licensee may discharge
 145. (1) A licensee of a long-term care home may discharge a resident if the licensee is informed by someone permitted to do so under subsection (2) that the resident’s requirements for care have changed and that, as a result, the home cannot provide a sufficiently secure environment to ensure the safety of the resident or the safety of persons who come into contact with the resident.  O. Reg. 79/10, s. 145 (1). (2) For the purposes of subsection (1), the licensee shall be informed by, (a) in the case of a resident who is at the home, the Director of Nursing and Personal Care, the resident’s physician or a registered nurse in the extended class attending the resident, after consultation with the interdisciplinary team providing the resident’s care; or (b) in the case of a resident who is absent from the home, the resident’s physician or a registered nurse in the extended class attending the resident.  O. Reg. 79/10, s. 145 (2). (3) A licensee of a long-term care home may discharge a resident if, (a) the resident decides to leave the home and signs a request to be discharged; (b) the resident leaves the home and informs the Administrator that he or she will not be returning to the home; (c) the resident is absent from the home for a period exceeding seven days and the resident has not informed the Administrator of his or her whereabouts, and the Administrator has been unable to locate the resident; (d) in the case of a long-stay resident, the total length of the resident’s casual absences during the period between midnight on a Saturday and midnight on the following Saturday exceeds 48 hours and the resident does not have any remaining vacation absence days available in the calendar year; or (e) in the case of a short-stay resident, the total length of the resident’s casual absences during the period between midnight on Saturday and midnight on the following Saturday exceeds 48 hours.  O. Reg. 79/10, s. 145 (3). (4) Clause (3) (e) does not apply to a resident in the interim bed short-stay program and the resident shall be considered to be a long-stay resident for the purposes of clause (3) (d).  O. Reg. 79/10, s. 145 (4).
Discharge when beds closed
 147. (1) A licensee may discharge a resident whose bed is closed if it is not possible to transfer the resident to another bed in the home.  O. Reg. 79/10, s. 147 (1). (2) Subsection (1) does not apply if, (a) notice was required under section 306 but that section was not complied with; (b) the Director agreed, under subsection 306 (7), to a shorter notice period, or to dispensing with notice and, as a result, less than 16 weeks notice was given to the persons described in clause 306 (3) (a); or (c) section 307 applied when the resident was transferred to the bed but that section was not complied with.  O. Reg. 79/10, s. 147 (2).
Discharge during pandemic
 147.1 (1) During a pandemic a licensee of a long-term care home shall discharge a long-stay resident if the resident or the resident’s substitute decision-maker provides a written request to be discharged because of the pandemic. O. Reg. 83/20, s. 1. (2) Every licensee of a long-term care home shall ensure that before a long-stay resident leaves the home pursuant to a request under subsection (1), (a) a physician or a registered nurse in the extended class attending the resident or a member of the registered nursing staff of the home sets out in writing the care required to be given to the resident once the resident has left the home; and (b) a member of the licensee’s staff communicates to the resident, or the resident’s substitute decision-maker, (i) the need to take all reasonable steps to ensure that the care required to be given to the resident is received by the resident after the resident leaves the home, (ii) that the licensee will not be responsible for the care, safety and well-being of the resident once the resident is discharged, and the resident or the resident’s substitute decision-maker assumes full responsibility for the care, safety and well-being of the resident once the resident is discharged, and (iii) that when the resident is ready to return to the home, the resident, the resident’s substitute decision-maker or another person acting on behalf of the resident will need to contact the placement co-ordinator to arrange for re-admission. O. Reg. 83/20, s. 1. (3) A resident in the interim bed short-stay program shall be considered to be a long-stay resident for the purposes of this section. O. Reg. 83/20, s. 1.
Requirements on licensee before discharging a resident
 148. (1) Except in the case of a discharge due to a resident’s death, every licensee of a long-term care home shall ensure that, before a resident is discharged, notice of the discharge is given to the resident, the resident’s substitute decision-maker, if any, and to any other person either of them may direct, (a) as far in advance of the discharge as possible; or (b) if circumstances do not permit notice to be given before the discharge, as soon as possible after the discharge.  O. Reg. 79/10, s. 148 (1). (2) Before discharging a resident under subsection 145 (1), the licensee shall, (a) ensure that alternatives to discharge have been considered and, where appropriate, tried; (b) in collaboration with the appropriate placement co-ordinator and other health service organizations, make alternative arrangements for the accommodation, care and secure environment required by the resident; (c) ensure the resident and the resident’s substitute decision-maker, if any, and any person either of them may direct is kept informed and given an opportunity to participate in the discharge planning and that his or her wishes are taken into consideration; and (d) provide a written notice to the resident, the resident’s substitute decision-maker, if any, and any person either of them may direct, setting out a detailed explanation of the supporting facts, as they relate both to the home and to the resident’s condition and requirements for care, that justify the licensee’s decision to discharge the resident.  O. Reg. 79/10, s. 148 (2). (3) Before discharging a resident from the home under clause 145 (3) (a), (b) or (d) or subsection 147.1 (1), the licensee shall offer to, (a) assist the resident in planning for discharge by identifying alternative accommodation, health service organizations and other resources in the community; and (b) contact appropriate health service organizations and other resources in the community or refer the resident to such organizations and resources.  O. Reg. 79/10, s. 148 (3); O. Reg. 83/20, s. 2.
Responsibility of placement co-ordinator
 149. The appropriate placement co-ordinator shall, if a resident to whom subsection 145 (1) or clause 146 (7) (a) applies so desires, assist in arranging alternative accommodation, care or services for the resident.  O. Reg. 79/10, s. 149.
Licensee to assist with alternatives to long-term care home
 150. Every licensee of a long-term care home shall offer to contact the appropriate placement co-ordinator for the purpose of providing information about alternatives to living in a long-term care home to a resident whose condition has improved to the extent that he or she no longer requires the care and services provided by the long-term care home, as set out in the resident’s plan of care.  O. Reg. 79/10, s. 150.
Transitional, absences and discharges due to absences
 151. (1) Where, during the calendar year that this section comes into force, a resident of a home under the Nursing Homes Act, the Charitable Institutions Act or the Homes for the Aged and Rest Homes Act has taken vacation absences or casual absences in accordance with the regulations under those Acts before the coming into force of this section, the absences shall be counted as if they had been taken while this Regulation was in force.  O. Reg. 79/10, s. 151 (1). (2) Where a long-stay resident was on a psychiatric absence from a home in accordance with the regulations under the Nursing Homes Act, the Charitable Institutions Act or the Homes for the Aged and Rest Homes Act immediately before the coming into force of this section, (a) the duration of the absence before the coming into force of this section shall be counted for the purposes of the discharge provisions of this Regulation; and (b) no bed-holding amount is payable for the days of the absence after the coming into force of this section.  O. Reg. 79/10, s. 151 (2). (3) Where a long-stay resident was on a medical absence from a home in accordance with the regulations under the Nursing Homes Act, the Charitable Institutions Act or the Homes for the Aged and Rest Homes Act immediately before the coming into force of this section, (a) a licensee shall not discharge the resident under clause 146 (4) (a) until the absence exceeds 51 consecutive days; and (b) no bed-holding amount is payable for the days of the absence after the coming into force of this section.  O. Reg. 79/10, s. 151 (3). (4) Where a short-stay resident was on a medical absence from a home in accordance with the regulations under the Nursing Homes Act, the Charitable Institutions Act or the Homes for the Aged and Rest Homes Act immediately before the coming into force of this section, the days of the absence before the coming into force of this section shall be counted for the purposes of the discharge provisions of this Regulation.  O. Reg. 79/10, s. 151 (4). Part iii    Admission of residents
PART III ADMISSION OF RESIDENTS
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Definition
 152. In this Part, “partner” means either of two persons who have lived together for at least one year and who have a close personal relationship that is of primary importance in both persons’ lives.  O. Reg. 79/10, s. 152. 153. Revoked: O. Reg. 205/21, s. 2.
Information to be provided by placement co-ordinator
 154. (1) When a person who wishes to seek admission to a long-term care home contacts a placement co-ordinator, the placement co-ordinator shall provide the person with information about alternative services that the person may wish to consider.  O. Reg. 79/10, s. 154 (1). (2) The placement co-ordinator shall also provide the person with information about a resident’s responsibility for payment for charges for accommodation and the maximum amounts that may be charged by a licensee for accommodation.  O. Reg. 79/10, s. 154 (2). (3) The placement co-ordinator shall advise the person that a resident may apply to the Director for a reduction in the charge for basic accommodation and that a resident who makes such an application is required to provide supporting documentation including, (a) the resident’s Notice of Assessment issued under the Income Tax Act (Canada) for the resident’s most recent taxation year; (b) the resident’s proof of income statement (option “C” print) from the Canada Revenue Agency for the resident’s most recent taxation year; or (c) the resident’s written authorization to electronically obtain income information for the resident’s most recent taxation year from the Canada Revenue Agency. O. Reg. 128/18, s. 2. (4) When a person is determined eligible for admission, the placement co-ordinator shall provide the person with information about, (a) the length of waiting lists and approximate times to admission for long-term care homes; (b) vacancies in long-term care homes; and (c) how to obtain information from the Ministry about long-term care homes.  O. Reg. 79/10, s. 154 (4). Eligibility for Admission
Criteria for eligibility, long-stay
 155. (1) A placement co-ordinator shall determine a person to be eligible for long-term care home admission as a long-stay resident only if, (a) the person is at least 18 years old; (b) the person is an insured person under the Health Insurance Act; (c) the person, (i) requires that nursing care be available on site 24 hours a day, (ii) requires, at frequent intervals throughout the day, assistance with activities of daily living, or (iii) requires, at frequent intervals throughout the day, on-site supervision or on-site monitoring to ensure his or her safety or well-being; (d) the publicly-funded community-based services available to the person and the other caregiving, support or companionship arrangements available to the person are not sufficient, in any combination, to meet the person’s requirements; and (e) the person’s care requirements can be met in a long-term care home.  O. Reg. 79/10, s. 155 (1). (2) In this section, “nursing care” means nursing and other personal care given by or under the supervision of a registered nurse or a registered practical nurse.  O. Reg. 79/10, s. 155 (2).
Same, short-stay admission, respite care and convalescent care programs
 156. (1) A placement co-ordinator shall determine a person to be eligible for long-term care home admission as a short-stay resident in the respite care program only if, (a) the person, (i) has a caregiver who requires temporary relief from his or her caregiving duties, or (ii) requires temporary care in order to continue to reside in the community and is likely to benefit from a short stay in the home; (b) it is anticipated that the person will be returning to his or her residence within 60 days after admission to the long-term care home; and (c) the person meets the requirements of clauses 155 (1) (a), (b), (c) and (e).  O. Reg. 79/10, s. 156 (1). (2) A placement co-ordinator shall determine a person to be eligible for long-term care home admission as a short-stay resident in the convalescent care program only if, (a) the person requires a period of time in which to recover strength, endurance or functioning and is likely to benefit from a short stay in a long-term care home; (b) it is anticipated that the person will be returning to his or her residence within 90 days after admission to the long-term care home; and (c) the person meets the requirements of clauses 155 (1) (a), (b), (c) and (e).  O. Reg. 79/10, s. 156 (2).
Same, spouse or partner
 157. (1) Despite clauses 155 (1) (c) and (d), a placement co-ordinator shall determine a person to be eligible for long-term care home admission as a long-stay resident if, (a) the person’s spouse or partner is, (i) a long-stay resident, or (ii) a person who has been determined by a placement co-ordinator to be eligible for long-term care home admission as a long-stay resident; and (b) the person meets the requirements of clauses 155 (1) (a), (b) and (e).  O. Reg. 79/10, s. 157 (1). (2) Despite anything else in this Regulation, (a) a person described in subsection (1) may only be placed in a category set out in subsection 173 (3) or 174 (3); and (b) a placement co-ordinator may not authorize the admission to a long-term care home of a person described in subsection (1) before the admission of their spouse or partner is authorized to that home.  O. Reg. 79/10, s. 157 (2).
Same, veterans
 158. Despite clauses 155 (1) (c) and (d), a placement co-ordinator shall determine a person to be eligible for long-term care home admission as a long-stay resident if the person is a veteran and an insured person under the Health Insurance Act.  O. Reg. 79/10, s. 158.
Same, redevelopment transfers
 159. (1) Despite section 155, a placement co-ordinator shall determine a person to be eligible for long-term care home admission as a long-stay resident if the person is, (a) a long-stay resident of a long-term care home immediately before the closure of his or her bed in the home who is requesting a transfer to a related temporary long-term care home; (b) a long-stay resident who is requesting a transfer from a related temporary long-term care home to a replacement long-term care home or to a re-opened long-term care home operated by the same licensee as the related temporary long-term care home; or (c) a long-stay resident of a long-term care home immediately before the closure of his or her bed in the home who is requesting a transfer to a replacement long-term care home.  O. Reg. 79/10, s. 159 (1). (2) A placement co-ordinator acting under this section is exempt from complying with subsections 43 (4) and (6) and 44 (12) of the Act.  O. Reg. 79/10, s. 159 (2). (3) For the purposes of this section, a resident of the interim bed short-stay program shall be considered to be a long-stay resident.  O. Reg. 79/10, s. 159 (3). Application for Determination of Eligibility
Application for authorization of admission
 161. (1) To apply for authorization of his or her admission to a long-term care home under section 44 of the Act, an applicant shall provide to the placement co-ordinator, (a) a written request by the applicant for authorization of his or her admission to the home, made in the form provided by the placement co-ordinator; (b) such additional information and documentation as is necessary to enable the placement co-ordinator to determine the category in which to place the applicant under sections 170 to 180; (c) such additional information and documentation as is relevant in the opinion of the placement co-ordinator for the licensee to determine whether to give or withhold approval of the person’s admission; and (d) copies of the assessments and reassessments referred to in clause 44 (11) (a) of the Act.  O. Reg. 79/10, s. 161 (1). (2) Despite clause (1) (a), a person who is determined eligible for long-term care home admission under subsection 159 (1) is not required to provide a request for authorization of admission in writing.  O. Reg. 79/10, s. 161 (2). (3) The placement co-ordinator shall assist the applicant in obtaining anything that the applicant is required to provide to the placement co-ordinator under this section.  O. Reg. 79/10, s. 161 (3). Approval by Licensee
Approval by licensee
 162. (1) Subject to sections 163 and 164, when an applicant who has been determined by a placement co-ordinator to be eligible for long-term care home admission applies for authorization of his or her admission to a particular long-term care home, the appropriate placement co-ordinator shall, (a) give the licensee of the home, in addition to the material required under subsection 44 (7) of the Act, any other information possessed by the placement co-ordinator that in the placement co-ordinator’s opinion is relevant to the licensee’s determination of whether to give or withhold approval for the applicant’s admission to the home; and (b) request the licensee to determine whether to give or withhold approval for the applicant’s admission to the home.  O. Reg. 79/10, s. 162 (1). (2) The appropriate placement co-ordinator shall ensure that any assessment given to the licensee as part of the material mentioned in clause (1) (a) was made within the previous three months, and that if within the preceding three months there was a significant change in the applicant’s condition or circumstances, the assessment or reassessment that reflects those changes is included in the material.  O. Reg. 79/10, s. 162 (2). (3) Subject to subsections (4) and (5), the licensee shall, within five business days after receiving the request mentioned in clause (1) (b), do one of the following: 1. Give the appropriate placement co-ordinator the written notice required under subsection 44 (8) of the Act. 2. If the licensee is withholding approval for the applicant’s admission, give the written notice required under subsection 44 (9) of the Act to the persons mentioned in subsection 44 (10) of the Act.  O. Reg. 79/10, s. 162 (3). (4) Where, within the five business days referred to in subsection (3), the licensee makes a request in writing to the appropriate placement co-ordinator for additional information that in the placement co-ordinator’s opinion is relevant to the licensee’s determination of whether to give or withhold approval for the applicant’s admission to the home, the placement co-ordinator shall provide the information to the licensee.  O. Reg. 79/10, s. 162 (4). (5) The licensee shall give the appropriate notice under paragraph 1 or 2 of subsection (3) within three business days of receiving the additional information provided under subsection (4).  O. Reg. 79/10, s. 162 (5).
Exceptions
 163. Subsections 44 (7), (8) and (14) of the Act and sections 162 and 184 of this Regulation do not apply with respect to an applicant who is eligible for long-term care home admission under subsection 159 (1), and the licensee of a related temporary long-term care home, a re-opened long-term care home or a replacement long-term care home shall be deemed to approve the admission to the home of such an applicant.  O. Reg. 79/10, s. 163.
Limit on waiting lists
 164. (1) A placement co-ordinator shall not provide the information and request referred to in subsection 162 (1) to a licensee if the result would be, (a) that there are more than five requests outstanding relating to admission as a long-stay resident; or (b) that there are more than five requests outstanding relating to admission as a short-stay resident.  O. Reg. 79/10, s. 164 (1). (2) For the purposes of subsection (1), a request is outstanding if approval has been given or the licensee is still considering whether to give approval.  O. Reg. 79/10, s. 164 (2). (3) Subsection (1) does not apply with respect to a home that is not yet licensed or approved for the purposes of the Act and a request relating to such a home shall not be counted as a request that is outstanding.  O. Reg. 79/10, s. 164 (3). (4) This section does not apply to an applicant who will be placed in category 1 on the waiting list for the long-term care home if the licensee approves his or her admission to the home.  O. Reg. 79/10, s. 164 (4). Keeping of Waiting List