Reports re critical incidents
 107. (1) Every licensee of a long-term care home shall ensure that the Director is immediately informed, in as much detail as is possible in the circumstances, of each of the following incidents in the home, followed by the report required under subsection (4): 1. An emergency, including fire, unplanned evacuation or intake of evacuees. 2. An unexpected or sudden death, including a death resulting from an accident or suicide. 3. A resident who is missing for three hours or more. 4. Any missing resident who returns to the home with an injury or any adverse change in condition regardless of the length of time the resident was missing. 5. An outbreak of a disease of public health significance or communicable disease as defined in the Health Protection and Promotion Act. 6. Contamination of the drinking water supply.  O. Reg. 79/10, s. 107 (1); O. Reg. 246/13, s. 9 (1); O. Reg. 148/18, s. 1. (2) Where a licensee is required to make a report immediately under subsection (1) and it is after normal business hours, the licensee shall make the report using the Ministry’s method for after hours emergency contact.  O. Reg. 79/10, s. 107 (2). (3) The licensee shall ensure that the Director is informed of the following incidents in the home no later than one business day after the occurrence of the incident, followed by the report required under subsection (4): 1. A resident who is missing for less than three hours and who returns to the home with no injury or adverse change in condition. 2. An environmental hazard that affects the provision of care or the safety, security or well-being of one or more residents for a period greater than six hours, including, i. a breakdown or failure of the security system, ii. a breakdown of major equipment or a system in the home, iii. a loss of essential services, or iv. flooding. 3. A missing or unaccounted for controlled substance. 4. Subject to subsection (3.1), 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. 5. A medication incident or adverse drug reaction in respect of which a resident is taken to hospital.  O. Reg. 79/10, s. 107 (3); O. Reg. 363/11, s. 8; O. Reg. 246/13, s. 9 (2). (3.1) Where an incident occurs that causes an injury to a resident for which the resident is taken to a hospital, but the licensee is unable to determine within one business day whether the injury has resulted in a significant change in the resident’s health condition, the licensee shall, (a) contact the hospital within three calendar days after the occurrence of the incident to determine whether the injury has resulted in a significant change in the resident’s health condition; and (b) where the licensee determines that the injury has resulted in a significant change in the resident’s health condition or remains unable to determine whether the injury has resulted in a significant change in the resident’s health condition, inform the Director of the incident no later than three business days after the occurrence of the incident, and follow with the report required under subsection (4). O. Reg. 246/13, s. 9 (3). (4) A licensee who is required to inform the Director of an incident under subsection (1), (3) or (3.1) shall, within 10 days of becoming aware of the incident, or sooner if required by the Director, make a report in writing to the Director setting out the following with respect to the incident: 1. A description of the incident, including the type of incident, the area or location of the incident, the date and time of the incident and the events leading up to the incident. 2. A description of the individuals involved in the incident, including, i. names of any residents involved in the incident, ii. names of any staff members or other persons who were present at or discovered the incident, and iii. names of staff members who responded or are responding to the incident. 3. Actions taken in response to the incident, including, i. what care was given or action taken as a result of the incident, and by whom, ii. whether a physician or registered nurse in the extended class was contacted, iii. what other authorities were contacted about the incident, if any, iv. for incidents involving a resident, whether a family member, person of importance or a substitute decision-maker of the resident was contacted and the name of such person or persons, and v. the outcome or current status of the individual or individuals who were involved in the incident. 4. Analysis and follow-up action, including, i. the immediate actions that have been taken to prevent recurrence, and ii. the long-term actions planned to correct the situation and prevent recurrence. 5. The name and title of the person who made the initial report to the Director under subsection (1) or (3), the date of the report and whether an inspector has been contacted and, if so, the date of the contact and the name of the inspector.  O. Reg. 79/10, s. 107 (4); O. Reg. 246/13, s. 9 (4). (5) The licensee shall ensure that the resident’s substitute decision-maker, if any, or any person designated by the substitute decision-maker and any other person designated by the resident are promptly notified of a serious injury or serious illness of the resident, in accordance with any instructions provided by the person or persons who are to be so notified.  O. Reg. 79/10, s. 107 (5). (6) Where a matter occurred before the coming into force of this section and the matter was required to be reported to the Director as an occurrence or unusual occurrence under any of the following, the licensee shall report the matter to the Director in accordance with the requirements that existed at the time the matter occurred: 1. Section 96 of Regulation 832 of the Revised Regulations of Ontario, 1990 (General) made under the Nursing Homes Act. 2. Section 31.1 of Regulation 69 of the Revised Regulations of Ontario, 1990 (General) made under the Charitable Institutions Act. 3. Section 25.1 of Regulation 637 of the Revised Regulations of Ontario, 1990 (General) made under the Homes for the Aged and Rest Homes Act. 4. An agreement made under an Act mentioned in paragraphs 1 to 3.  O. Reg. 79/10, s. 107 (6). (7) In this section, “significant change” means a major change in the resident’s health condition that, (a) will not resolve itself without further intervention, (b) impacts on more than one aspect of the resident’s health condition, and (c) requires an assessment by the interdisciplinary team or a revision to the resident’s plan of care. O. Reg. 246/13, s. 9 (5). Misuse of Funding