Development of a federal Safe Long-Term Care Act: Discussion paper

On this page

The need for a Safe Long-Term Care Act

More than 200,000 older adults and persons living with a disability reside in long-term care homes.Footnote i Residents often receive help from family and friend caregivers.

The COVID-19 pandemic highlighted long-standing systemic challenges in long-term homes across Canada including:

These challenges had a larger impact on the older adults and persons with disabilities who live in these facilities. We recognized the undue hardship being faced by long-term care residents and their loved ones. As such, we took immediate action to support provinces and territories by:

Long-term care residents deserve to live in dignity, comfort and respect. That is why the Minister of Health and the Minister of Seniors were mandated to develop national long-term care standards and a Safe Long-Term Care Act. In January 2023, the Standards Council of Canada (SCC), Health Standards Organization (HSO) and the Canadian Standards Association (CSA) Group released 2 new complementary, independent long-term care standards. These standards provide guidance for delivering long-term care services that are safe, reliable and centred on residents' needs.

While provinces and territories are primarily responsible for delivering long-term care, we are working collaboratively with provinces and territories to improve the quality, safety, equity and availability of long-term care. Now that the standards have been released, we are turning our attention to developing the Safe Long-Term Care Act. This will build on past efforts to support long-term care throughout the COVID-19 pandemic.

Long-term care in Canada

Long-term care homes provide on-site delivery of 24 hours per day, 7 days per week, supervised care, including:

The complexity of care is growing as more residents have cognitive impairments or significant physical care needs. The sector is facing workforce challenges, such as:

Many homes are older constructions that are not designed and operated to provide safe, person-centred care. For example, many homes with older designs have shared rooms and shared bathrooms that compromise privacy and infection prevention and control.

We've heard that most people in Canada, including those with disabilities, would prefer to age at home or in their community, close to family and loved ones. Those who need long-term care and residents of long-term care homes, as well as their family members, are seeking safe, high-quality, home-like settings. They want long-term care homes where:

The Canadian Institute for Health Information (CIHI) reports that as of March 31, 2021, long-term care homes in Canada are:

Ownership type varies across provinces and territories. For example:

Responsibility for long-term care

Provinces and territories are primarily responsible for delivering health care including how:

CIHI reported that provinces and territories spent $28.5 billion on long-term care in 2022. To operate, long-term care homes must:

Additionally, some jurisdictions complement their legislation and regulation with voluntary or mandatory accreditation by an approved third-party accrediting body. According to HSO, across Canada:

This varies across provinces and territories. Accreditation is mandatory in 5 provinces:

Where accreditation is voluntary, the rate of accreditation varies from:

We can help support improvements in long-term care by having Health Canada:

However, some federal departments are responsible for providing or funding access to long-term care for specific groups, such as:

While the long-term care sector is outside the scope of the Canada Health Act , provinces and territories can choose to use Canada Health Transfer funding to help cover the cost of providing long-term care services.

Federal involvement in long-term care and related areas

We have made important investments in recent years to support long-term care and home care.

With the onset of the COVID-19 pandemic, and the recognized impacts on long-term care homes and their residents, we responded immediately with help by:

On February 7, 2023, we confirmed our commitment to provide $3 billion over 5 years to support provinces and territories in their efforts to improve long-term care in their jurisdictions (originally announced in Budget 2021). This funding will help support:

In addition, Budget 2023 included an investment of $1.7 billion over 5 years to support hourly wage increases for personal support workers and related professions, as federal, provincial, and territorial governments work together on how best to support recruitment and retention.

Recognizing that people in Canada, including those with disabilities, prefer to age at home, we are also advancing work in home care. For example, beginning in 2017, we provided $6 billion over 10 years to provinces and territories to improve access to home and community care services, including palliative care. After the first 5 years of this investment, provinces and territories have implemented new initiatives to:

In October 2022, we announced that the National Seniors Council would serve as an expert panel to examine measures, including a potential aging at home benefit, to support Canadians who wish to age at home.

National long-term care standards

Since March 2021, the SCC, HSO and CSA Group have been collaborating to develop 2 new complementary national standards for long-term care. They undertook the process at arm's length from the federal government. Over 20,000 people in Canada participated in the consultations on these standards to reflect what people expect from long-term care. Participants included:

While these standards are independent, we provided close to $850,000 in funding to HSO and CSA Group to support their engagement and consultation process. The consultations revealed the need to:

On December 1, 2022, CSA Group posted their standard, Long-term care home operations and infection prevention and control . This standard addresses the design, operation and infection prevention and control practises in long-term care homes.

On January 31, 2023, HSO released their standard, Long-Term Care Services , which addresses the delivery of safe, reliable and high-quality long-term care services. It focuses on:

These standards complement our ongoing work with provinces and territories to help support improvements in long-term care.

We recognize that provinces and territories are primarily responsible for managing the delivery and operation of long-term care facilities, including how and whether they adopt the standards.

Potential elements of a Safe Long-Term Care Act

The new act could outline a pan-Canadian vision and principles for the safe operation and delivery of care in long-term care homes to:

The vision could describe:

The principles could include ideas about long-term care that are important to people in Canada such as:

Examples of actions that could be supported by the Act:

We are committed to working collaboratively with provinces and territories to improve the quality, safety and availability of care in long-term care homes. A Safe Long-Term Care Act will:

Legislation will be respectful of provincial-territorial jurisdiction. That is, it won't mandate standards or regulate long-term care delivery.

While federal authority can be used to develop federal legislation to promote improvements in the quality, safety and accessibility of long-term care, any federal legislation must respect the:

Public input on the future of long-term care

To help to ensure long-term care residents get the care they deserve, we are interested in hearing from people in Canada about:

In particular, we want to hear from:

We hope you can take the time to share your thoughts by participating in the safe long-term care consultation. The online questionnaire closes on September 21, 2023.

Footnote i

The Canadian Institute for Health Information describes Long Term Care Homes as:

long-term care homes, also called nursing homes, continuing care facilities and residential care homes, provide a wide range of health and personal care services for Canadians with medical or physical needs who require access to 24-hour nursing care, personal care and other therapeutic and support services.

Return to footnote i referrer

Page details

Date modified: