Published plans and annual reports 2025–2026: Ministry of Long-Term Care
Ministry overview
Ministry’s vision
The foundation of every program the government funds is a strong economy which provides the necessary revenues to invest in long-term care. During a time of economic uncertainty – when there are threats against our economy – it is crucial that the government takes action to protect the long-term care system Ontario families depend on.
The vision for the Ministry of Long-Term Care (the “ministry”) is to continuously improve long-term care in Ontario so that every current and prospective long-term care resident receives the best possible care and quality of life, supported by highly trained professionals.
The ministry’s plan to protect long-term care is built on four pillars:
- create conditions to build homes
- fund system services and operations in long-term care and community
- increase staffing supply to support direct resident care
- improve accountability, enforcement and transparency
Ministry programs
All actions the ministry takes are designed to improve care or protect long-term care residents and are focused around the above pillars.
Pillar 1: Create conditions to build homes
As part of the Fixing Long-Term Care Act, 2021 the province committed to investing $6.4 billion to build 58,000 new or upgraded long-term care beds by 2028. Building net new beds will ultimately help reduce wait lists and alleviate hospital capacity pressures, while redeveloping and upgrading existing beds will ultimately help to maintain long-term care bed capacity and provide a safer and more comfortable home for residents.
Thanks to these investments, 147 long-term care projects, representing 23,977 new and redeveloped beds have been completed, are under construction or have ministry approval to begin construction as of March 31, 2025.
From April 1, 2024 to March 31, 2025, 322 net new beds and 811 upgraded beds have opened. This brings the cumulative total to 13,052 net new beds and 10,925 upgraded beds opened, under construction or approved to construct, since 2018.
One method the government supports building safe and modern long-term care homes is through initiatives like the Not-For-Profit Loan Guarantee Program. This program enables Infrastructure Ontario (IO) to issue larger loans to non-profit operators, facilitating the construction of 11 projects and over 1,900 long-term care beds.
In the Fall of 2023, the government announced the establishment of the Building Ontario Fund (BOF) – a new Agency to support the financing and building of critical infrastructure projects in Ontario. Long-term care homes are a priority area for the BOF. The first Loan Guarantee advanced through the newly established BOF supported the construction of the Rekai project at Cherry Place. Additional BOF financing has been provided for four homes operated by Arch Corporation in Amherstburg, Lancaster, Prescott and Tay Valley Township, resulting in over 900 beds being redeveloped or added.
Pillar 2: Fund system services and operations in long-term care and community
Meeting the needs of long-term care (LTC) residents and seniors in the community
A healthcare system that properly protects its residents is also one that meets the complex and diverse needs of its population, both those currently living in long-term care homes and those still living in the community.
Local priorities fund
First introduced in 2022-2023, the Local Priorities Fund was designed to simplify long-term care admissions and prevent unnecessary visits to hospital.
The fund provides specialized staffing, equipment and services that enable long-term care homes to admit new residents with specialized needs - including those who have been designated as needing alternate levels of care and support current residents with complex needs.
Increasing access to diagnostic testing
The government is investing in a mobile phlebotomy and a point-of-care-testing pilot program to bring diagnostic testing services to residents in the comfort of their long-term care home. By increasing access to on-site diagnostic testing for long-term care residents, we can reduce emergency department visits and hospitalizations.
Nurse-Led Outreach Teams
Nurse-Led Outreach Teams consist of specialized nurse practitioners and registered nurses (RNs) who work in partnership with hospital emergency departments and long-term care homes to provide integrated nursing and primary health care services, including clinical and diagnostic services, to residents in the comfort of their long-term care home. This helps avoid unnecessary emergency department visits and prevent hospital admissions.
Community Paramedicine for Long-Term Care and Community Paramedicine for Long-Term Care Plus
The Community Paramedicine for Long-Term Care program helps Ontarians remain safely at home by utilizing paramedics’ skills and training beyond emergency roles.
In 2024, the Community Paramedicine for Long-Term Care Plus program expanded services, enabling paramedics to provide diagnostics such as bloodwork, ultrasounds and urinalysis within long-term care homes to reduce emergency visits.
Behavioural Supports Ontario
Behavioural Supports Ontario (BSO) provides personalized strategies and activities to address responsive behaviours stemming from cognitive impairments, mental health issues or neurological conditions. Through assessments, consultations and advice, BSO supports individuals at home or transitioning to long-term care.
Behavioural Specialized Units
Behavioural Specialized Units (BSU) help protect some of Ontario’s most vulnerable people. BSUs assist those with complex responsive behaviours that are associated with cognitive impairments such as dementia, with care provided by specialized staff in the comfort of a long-term care home rather than a hospital. These units are specially designed for individuals with increasingly complex behavioural needs that cannot be met in other healthcare environments due to the frequency, severity or level of risk the individual’s behavior poses to themselves or others.
Pillar 3: Increase staffing supply to support direct resident care
In 2020 the province released a long-term care staffing plan called “A better place to live, a better place to work: Ontario’s long-term care staffing plan”, which came to a close in March 2024. This staffing plan focused on six key areas of action:
- increasing staffing levels
- disrupting, accelerating and increasing education and training pathways
- supporting ongoing staff development
- improving working conditions
- providing effective and accountable leadership
- measuring success
The overarching goal of the staffing plan was the province’s commitment to increasing the direct hours of care long-term care home residents receive to a system level average of 4 hours of direct care per resident per day from nurses and personal support workers (PSW) and 36 minutes from allied health professionals.
To meet this goal, the province invested $4.9 billion between 2020-2021 and 2024-2025 to hire, retain and retrain thousands of long-term care staff. Since this commitment was made, Ontario has made significant progress in achieving its targets of four hours of direct care per long-term care resident per day.
Since 2020, Ontario has:
- Added an average of over an hour of total daily direct care per resident.
- Trained over 24,000 PSW, supported more than 12,600 PSW clinical placements and recruited over 2,000 new PSW to long-term care and home and community care, including 121 to rural, remote and northern communities.
- Launched new programs to train and recruit nurses to long-term care and implemented permanent wage increases for PSW.
As of September 2024, Ontario achieved 93% of its targets for nurses and PSW, surpassing goals for allied health professionals annually. Investments since 2021 have increased direct care in long-term care homes by 33%, adding over an hour of care per resident daily. The province allocated $342 million, upskilling over 5,000 registered nurses and registered practical nurses. By March 2025, more than 110,000 staff provided "hands-on" care to long-term care residents.
Pillar 4: Improve accountability, enforcement and transparency
The ministry’s highest priority is to ensure high-quality, safe care, that puts the well-being of long-term care residents first, which is why the ministry routinely inspects Ontario’s long-term care homes. The inspections branch ensures that long-term care home operators are compliant with the Fixing Long-Term Care Act, 2021 and its accompanying Regulations.
The Inspections Branch has implemented a multi-pronged compliance assistance initiative to enhance the sector’s performance and understanding of their requirements as set out in legislation. This includes the analysis of data and trends, in person support during inspections and increased communication and education for the long-term care sector. Another aspect of the initiative is a new inspection methodology that results in clearer, more concise reports. These reports are then shared at the end of the inspection which in turn reduces the overall time needed to complete an inspection. These efforts will ultimately improve resident experience in long-term care homes, promote consistency across the sector and foster collaboration between the ministry and long-term care homes.
The Fixing Long-Term Care Act, 2021 also requires all long-term care homes in Ontario to conduct continuous quality improvement initiatives and publicly report and post the improvements online. The reports must focus on the homes’ improvement priorities and provide the results of annual resident, family and caregivers surveys.
To improve transparency and accountability in Ontario’s long-term care homes, the ministry created the Homefinder website, a resource to help Ontarians find, compare and apply to long-term care homes while providing details like wait lists, bed counts and inspection reports.
2025-2026 Strategic plan
The province is projecting that the number of seniors living in Ontario will grow significantly from around 18% in 2023 to over 21% by 2051. This amounts to over 1.8 million new seniors. As the number of seniors increases, the province must prepare to respond to the care needs as people age.
That is why the government is continuing to improve long-term care in Ontario through carefully planned investments in program and services, staffing and more.
Pillar 1: Create conditions to build homes
Building modern, safe, long-term care homes is expensive and given the recent global economic uncertainty, it will be more costly and difficult in the future.
To help build more long-term care homes faster, the ministry is working closely with the BOF and IO to create financing opportunities for large scale projects, such as long-term care homes. Under the Loan Guarantee Program, the ministry provides loan guarantees to the BOF and IO to unlock additional lending.
The province is also repurposing surplus lands to build long-term care homes through the Surplus Provincial Lands Program. Proceeds from sales of unused properties are funding 1,152 new beds in the Greater Toronto and Hamilton Area.
The government is enhancing long-term care homes by modernizing amenities like air conditioning and fire sprinklers, while merging funding for infection control, minor capital and falls prevention into the Ontario Comprehensive Minor Capital Fund to ease financial pressures and address key priorities.
| Indicator | Target value and date |
|---|---|
| Number of net new beds opened (target 30,000 by 2028) | 30,000 (December 31, 2028) |
| Indicator | Target value and date |
|---|---|
| Number of redeveloped beds opened (target 28,000 by 2028) | 28,000 (December 31, 2028) |
| Indicator | Target value and date |
|---|---|
| Percentage of long-term care beds classified as "new" by structural bed classification | 100% (December 31, 2028) |
Pillar 2: Fund system services and operations in long-term care and community
A properly organized healthcare system is one that meets the complex needs of its population. For Ontario, this means an interconnected, integrated, easy to navigate healthcare system, where Ontarians receive the care they need, where they need it, when they need it. By creating a truly interconnected system, Ontarians will receive appropriate care in the appropriate place while at the same time, preserving healthcare capacity in other areas.
This integrated, interconnected system is created through programs and services that meet the needs of seniors and Ontarians both in long-term care homes and in the community.
Programs and services that are part of this system include:
- expanded lab services for long-term care residents, including mobile and point-of-care testing
- Nurse-Led Outreach Teams supporting up to 161 long-term care homes
- Community Paramedicine for Long-Term Care program, which operates in 56 communities helping Ontarians age at home longer. Community Paramedicine for Long-Term Care Plus pilot for diagnostics in long-term care homes in 6 communities
- a two-year pilot called Community Access to Long-Term Care that enable seniors to use long-term care services while living at home
- emotion-based training through a three-year pilot program focused on dementia care
- increased capacity for BSU in LTC homes across the province
- increased support for BSO to assist residents with behavioural issues
- enhanced support for Resident and Family Councils
The Community Access to Long-Term Care (CALTC) pilot will leverage LTC home investments to support seniors in the community by giving seniors still living in their own homes access to certain services in LTC homes. Services such as personal care, clinical services and recreational and social programming.
CALTC will create an option for a less-intensive, non-residential LTC experience, with a goal to reduce and delay the need for resource-intensive care (including LTC, acute care, alternate levels of care), better support caregivers and support seniors in their setting of choice for longer.
The ministry will maintain the $1,500 fee-per-bed capitation rate for 2025-2026 to support pharmacy services in long-term care homes. It will also continue consulting with stakeholders to enhance service quality. Additionally, an agreement with the Institute for Safe Medication Practices Canada has been renewed to improve medication safety and address recommendations from the Gillese Inquiry.
Pillar 3: Increase staffing supply to support direct resident care
In the middle of the COVID-19 pandemic, the province released its staffing plan with a commitment to increase the average daily amount of direct care hours provided to each long-term care resident. This plan has led to significant improvements in long-term care staffing and resultant resident care. The government remains committed to meetings its direct hours of care targets while navigating the effects of economic uncertainty, global staffing shortages and inflation.
The government remains committed to increasing long-term care staffing supply to better support resident care though:
- $4.9 billion allocated from 2020–2025 to meet care hour targets under the Fixing Long-Term Care Act, 2021
- Annual Level of Care funding increased by $96.1 million (2.1%) for staffing, resident care and other supports:
- Program support services and global per diem raised by 2% or $0.26 and $0.15 per resident, per day respectively
- Nutritional support funding expanded by 2.8% or $0.37 per resident, per day.
- Nursing and personal care funding increased by 2% or $2.22 per resident, per day for care supports and wage adjustments
- Other accommodations funding raised by 2% or $1.29 per resident, per day for cost pressures
- $300 million over three years, including $98 million this year, for PSW student incentives and grants up to $35,400 for underserved areas
- training 600 new PSW through the Humber College accelerated program
- the Preceptor Resource and Education Program for Long-Term Care (PREP LTC) program supports 3,000 preceptors and 31,000 clinical placements by 2027
- Expanding living classrooms and training 1,300 PSW by 2026
- strengthening nursing education initiatives like Bridging Education Grant In Nursing Initiative (BEGIN) and the Nursing Program Transformation Initiative (NPTI) and fast-tracking internationally trained nurses through supervised practical experience programs
- over 40,000 PSW benefiting through Ontario Centres for Learning since 2017
The government has also recently launched new PSW Career Navigator and launched a marketing campaign to assist prospective students in connecting with training opportunities and supports, while learning about future career opportunities in long-term care.
| Indicator | Target value and date |
|---|---|
| Legislated provincewide average hours of direct care (PSW & nurses) provided per long-term care home resident, per day across Ontario | 4.00 hours (March 31, 2025) |
| Indicator | Target value and date |
|---|---|
| Legislated provincewide average minutes of direct care (Allied Health Professionals) per long-term care home resident, per day across Ontario | 36 mins (March 31, 2023). Target to remain at or above 36 mins for subsequent years. |
Pillar 4: Improve accountability, enforcement and transparency
The Ontario government aims to protect vulnerable Ontarians by enhancing accountability and enforcement in long-term care by investing $70 million in the Integrated Technology Solutions Program which helps reduce medical errors through advanced safety and clinical tools.
The government is also committed to standardizing long-term care resident assessment measurements and reports by requiring all long-term care homes to transition to the new InterRAI reporting system by April 2026.
The government is committed to protecting long-term care residents through the Compliance Assistance and Regulatory Enforcement System (CARES) program, an IT system used by inspectors to ensure compliance with regulations and safeguard residents' rights and quality of life. The upcoming modernization of CARES, starting this summer, will also update LTCHomes.net for improved communication and reporting.
The compliance assistance initiative will enhance the sector’s performance and understanding of their requirements as set out in legislation. This initiative includes the analysis of data and trends, in person support during inspections and increased communication and education for the long-term care sector.
| Indicator | Target value and date |
|---|---|
| The target percentage to reduce the number of homes found not to be in compliance with a follow-up order | 5.5% (December 31, 2024) |
| Indicator | Target value and date |
|---|---|
| Percentage of all provincial long-term care homes that received a proactive compliance inspection | 100% (December 31, 2025) |
| Category | Amount ($M) |
|---|---|
| Other operating | 9,292.7 |
| Other capital | 0.0 |
| Ministry (pre-consolidation) | 9,292.7 |
| Consolidation adjustments | (5,758.5) |
| Total | 3,534.2 |
Detailed financial information
Combined operating and capital summary by vote
| Votes/programs | Estimates 2025–2026 $ | Change from estimates 2024–2025 $ | % | Estimates 2024–2025 $ | Interim actuals 2024–2025 $ | Actuals 2023–2024 $ |
|---|---|---|---|---|---|---|
| Ministry administration program | 13,109,400 | 1,891,300 | 16.9 | 11,218,100 | 13,109,500 | 9,664,473 |
| Long-term care homes program | 9,279,277,500 | (144,720,900) | (1.5) | 9,423,998,400 | 8,687,569,100 | 7,971,260,807 |
| Total operating expense to be voted | 9,292,386,900 | (142,829,600) | (1.5) | 9,435,216,500 | 8,700,678,600 | 7,980,925,280 |
| Statutory appropriations | 314,014 | N/A | N/A | 314,014 | 314,014 | 45,015 |
| Ministry total operating expense | 9,292,700,914 | (142,829,600) | (1.5) | 9,435,530,514 | 8,700,992,614 | 7,980,970,295 |
| Votes/programs | Estimates 2025–2026 $ | Change from estimates 2024–2025 $ | % | Estimates 2024–2025 $ | Interim actuals 2024–2025 $ | Actuals 2023–2024 $ |
|---|---|---|---|---|---|---|
| Colleges | (4,942,300) | 7,278,000 | (59.6) | (12,220,300) | (25,270,500) | (6,552,772) |
| Ontario Health | (5,495,626,900) | (482,149,300) | 9.6 | (5,013,477,600) | (5,197,941,400) | (5,070,327,501) |
| Other adjustments - Bill 124 | N/A | N/A | N/A | N/A | N/A | (1,389,470) |
| Hospitals | (249,403,600) | (61,386,300) | 32.6 | (188,017,300) | (227,004,100) | (214,200,336) |
| Ontario Infrastructure and Lands Corporation | (3,000,000) | N/A | N/A | (3,000,000) | (1,845,000) | (2,229,077) |
| School Boards | (5,500,000) | (5,500,000) | N/A | N/A | (5,500,000) | (4,997,871) |
| General real estate portfolio | N/A | N/A | N/A | N/A | N/A | (1,474,205) |
| Total including consolidation & other adjustments | 3,534,228,114 | (684,587,200) | (16.2) | 4,218,815,314 | 3,243,431,614 | 2,679,799,063 |
| Votes/programs | Estimates 2025–2026 $ | Change from estimates 2024–2025 $ | % | Estimates 2024–2025 $ | Interim actuals 2024–2025 $ | Actuals 2023–2024 $ |
|---|---|---|---|---|---|---|
| Long-term care homes program | 20,430,000 | N/A | N/A | 20,430,000 | 20,430,000 | 20,429,959 |
| Total operating assets to be voted | 20,430,000 | N/A | N/A | 20,430,000 | 20,430,000 | 20,429,959 |
| Ministry total operating assets | 20,430,000 | N/A | N/A | 20,430,000 | 20,430,000 | 20,429,959 |
| Votes/programs | Estimates 2025–2026 $ | Change from estimates 2024–2025 $ | % | Estimates 2024–2025 $ | Interim actuals 2024–2025 $ | Actuals 2023–2024 $ |
|---|---|---|---|---|---|---|
| Long-term care homes program | 1,000 | N/A | N/A | 1,000 | 1,000 | 28,997,700 |
| Total capital expense to be voted | 1,000 | N/A | N/A | 1,000 | 1,000 | 28,997,700 |
| Consolidation adjustment - Hospitals | N/A | N/A | N/A | N/A | N/A | (28,997,700) |
| Total including consolidation and other adjustments | 1,000 | N/A | N/A | 1,000 | 1,000 | N/A |
| Ministry total operating and capital including consolidation and other adjustments (not including assets) | 3,534,229,114 | (684,587,200) | (16.2) | 4,218,816,314 | 3,243,432,614 | 2,679,799,063 |
| Historic trend analysis data | Actuals 2022–2023 $ | Actuals 2023–2024 $ | Estimates 2024–2025 $ | Estimates 2025–2026 $ |
|---|---|---|---|---|
| Ministry operating and capital pre-consolidation | 7,318,993,588 | 8,009,967,995 | 9,435,531,514 | 9,292,701,914 |
| Year-over-year change | N/A | 9.4% | 17.8% | -1.5% |
| Consolidation and other adjustments (operating and capital) | (4,753,421,198) | (5,330,168,932) | (5,216,715,200) | (5,758,472,800) |
| Ministry total operating and capital including consolidation and other adjustments (not including assets) | 2,565,572,390 | 2,679,799,063 | 4,218,816,314 | 3,534,229,114 |
Ministry organization chart
- Natalia Kusendova-Bashta, Minister
- John Jordan, Parliamentary Assistant
- Dawn Gallagher Murphy, Parliamentary Assistant
- Peter Kaftarian, Interim Deputy Minister
- Peter Spencer, Director, Legal Services
- Peter Spadoni, Director, Communications
- Stephanie Soo, Executive Assistant and Strategic Advisor
- Gillian Steeve, Assistant Deputy Minister, System Planning & Partnerships
- Emily Cohen-Henry, Director, System Planning & Partnerships
- Kelci Gershon, Director, Long-Term Care Policy and Modernization
- Kelly McAslan, Assistant Deputy Minister, Long-Term Care Operations
- Brad Robinson, Director, Long-Term Care Inspections
- Nadine Rhodd, Director, Operational Policy and Implementation
- Ifeolu Ogunyankin, Director, Funding and Programs
- Christine Loureiro, Director, Performance and Operational Issues
- Sean Court, Assistant Deputy Minister, Long-Term Care Policy
- Adriana Ibarguchi, Director, Strategic Initiatives
- Lori Coleman, Director, Long-Term Care Response
- Carol Strachan, Director, Long-Term Care Staffing Supply
- Amanda Baine, Director, Strategic Initiatives
- James Stewart, Assistant Deputy Minister, Long-Term Care Capital Development
- Gary Thompson, Director, Capital Planning
- Hindy Ross, Director, Capital Program Management
- Sharmila Sukhdeo, Director, Capital Lending and Development Strategies
- Jeffrey Graham, Assistant Deputy Minister and Chief Administrative Officer, Corporate Services
- Jonathan Riddell, Director, Business Planning and Finance
- Cathy Cheng, Director, Strategic Human Resources and Corporate Management
- Sean Twyford, Assistant Deputy Minister, Strategic Policy, Planning and French Language Services
- Michael Hillmer, Assistant Deputy Minister, Digital and Analytics Strategy
Appendix - Part I
Annual report
Improving long-term care and protecting those living in long-term care homes remains the top priority for the Ontario government. In 2021, the government passed The Fixing Long-Term Care Act, 2021 and Ontario Regulation 246/22, helping to guide the province’s investments in the sector and ensuring safe, high-quality care. Since then, the government has made unprecedented investments to make access to health care easier for long-term residents by increasing staffing and direct hours of resident care, building new and upgraded long-term care beds and improving protections and accountability in the sector.
Pillar 1: Create conditions to build homes
The government has continued to invest and innovate to build the new and upgraded long-term care beds the province needs—in both urban and rural communities—to ensure the province has the capacity to meet Ontario’s need for long-term care spaces now and in the future. The government continues to make progress towards its commitment of building 58,000 new and upgraded beds to modern design standards across the province by 2028, with 23,977 beds that are either open, under construction or have approval to start construction.
To get more long-term care homes built faster, Ontario extended the Construction Funding Subsidy (CFS) Top-Up to support the government’s commitment to build 58,000 new and redeveloped long-term care beds by 2028. Eligible projects received an additional CFS of up to $35 per bed, per day, for 25 years. Eligible not-for-profit operators were able to convert up to $15 of the supplemental increase to a construction grant to assist in securing project financing.
From April 1, 2024 to March 31, 2025, 322 net new beds and 811 upgraded beds have opened. This brings the cumulative total to 13,052 net new beds and 10,925 upgraded beds opened, under construction and approved to construct since 2018.
As of May 2025, the ministry has 147 projects open, under construction or approved to construct for a total of 23,977 beds.
Pillar 2: Fund system services and operations in long-term care and community
The government continues to integrate care across the health system so that every Ontarian receives the right care in the right place — whether in a long-term care home, a hospital or at home. This interconnected approach helps improve the quality-of-care Ontarians receive as well as preserves hospital and emergency department capacity.
Additional strategies implemented under this pillar include:
- $21.36M: To improve access to clinical and diagnostic services, prevent emergency transfers and support innovative programs like Point-of-Care Testing and Community Paramedicine pilots.
- $27M: For continued operation of 284 BSU beds, including 65 new beds, contributing to a total of 466 BSU beds across 21 long-term care homes.
- $95M: Base funding for hiring additional specialized BSO staff to grow investment from $84M.
- $0.93M: Funding for BSO Provincial Coordinating Office (PCO) to centralize program supports, improve accountability and standardize practices.
- $34.9M: Local Priorities Fund to aid Specialized Services, Equipment, Minor Capital and Outreach Teams for better transitions and reduced hospitalizations.
- $87M: Continued funding for Community Paramedicine for Long-Term Care (CPLTC) program to help seniors remain safely at home with non-emergency medical supports.
Pillar 3: Increase staffing supply to support direct resident care
The Fixing Long-Term Care Act, 2021 Strategic actions the government enacted for 2024-2025 under this pillar include:
- Allocated $1.82 billion to enhance direct care to align with system-level targets, with a $571 million increase over last year.
- Raised $353.1 million for Level of Care (LOC) funding in 2024-2025, marking a 6.6% per diem increase from 2023-2024.
- Invested $19.3 million in Humber College's Learn and Earn program, $3.8 million for Collège Boréal’s French equivalent and $4 million to develop the Personal Support Workforce.
- Dedicated $3.1 million to CLRIs for improving care quality, $1 million to end-of-life care skills and up to $5 million for dementia care planning.
- Pledged $94.5 million over three years for PREP LTC to support PSW and nursing placements.
- Launched a multilingual "Become a PSW" campaign to recruit and raise awareness of PSW careers.
- Committed $300 million over three years for PSW training, recruitment and incentives, resulting in over 2,000 recruits in LTC and Home and Community Care since November 2023.
Pillar 4: Improve accountability, enforcement and transparency
The government has strengthened inspections and enforcement in long-term care homes while introducing initiatives like the Integrated Technology Solutions program. This program, supported by a $70 million investment over two years, enhances medication safety, clinical decision support tools and technological solutions for these care homes.
As part of the 2025 provincial budget, the government remains committed to supporting the third phase of the CARES. This project involves a software system primarily used by long-term care Inspectors while examining long-term care homes to ensure compliance with the appropriate legislative and regulatory requirements and to safeguard resident rights, safety, security and quality of life.
In 2024-2025, the ministry implemented five releases that included over 350 enhancements to improve CARES and enable more effective and efficient delivery of the inspections program. Phase 3 is currently underway with a phased implementation starting in summer 2025. Phase 3 includes changes to the LTCHomes.net platform and the Critical Incident System used by homes for reporting purposes.
In 2024-2025, the ministry began supporting all long-term care homes through a phased transition to the new interRAI Long-Term Care Facility resident assessment instrument. Assessments are required for every resident before admittance to the home and every quarter thereafter. All homes will need to use the new standard by April 1, 2026.
The new standard will improve both the quality and efficiency of the assessment process, reduce the administrative burden on LTC homes and improve the quality of care for Ontario residents. Further improvements will include:
- improved data accuracy, reliability, timeliness and reporting capability
- alignment with federal and international standards in home care
Key performance indicators
The ministry is committed to improving long-term care in Ontario. A key part of this is measuring the province’s progress on key performance indicators. Below are some key performance indicators related to government-directed and ministry-identified priorities that the ministry is tracking and the most recent performance results of each measure.
Outcome Measure #1 – Legislated provincewide average hours of direct care (PSW and nurses) provided per long-term care home resident per day in Ontario
The Fixing Long-Term Care Act, 2021, set key targets for average daily direct hours of care (DHOC) for every resident, including four hours of care provided by nurses and PSW by March 31, 2025 and to sustain this level every year thereafter. The sector met the interim direct-hour-of-care targets for the first two years, including:
- Year 1 - achieving three hours of direct care provided by PSW and nurses.
- Year 2 - achieving three hours and 15 minutes of direct care provided by PSW and nurses.
As of September 2024, Ontario was 93% of the way toward its final Year 4 target of an average of four hours of direct nursing and personal support care per resident, per day. This represents a 33% increase in direct care hours since 2021.
Lingering impacts of the COVID-19 pandemic, inflation and a global shortage of qualified PSW and nurses have affected the sector’s ability to meet the Year 3 targets.
The ministry continues to invest in the sector to build LTC capacity and meet care targets. Ongoing investments are underway to build the health human resources (HHR) supply needed for ongoing progress towards direct care targets through training and education programs aimed at attracting, recruiting and retaining the long-term care workforce.
Outcome measure #2 - Legislated provincewide average minutes of direct care (Allied Health Professionals) per long-term care home resident, per day across Ontario
The Fixing Long-Term Care Act, 2021, set key targets for average daily direct hours of care (DHOC) for every resident, including 36 minutes by allied healthcare professionals (AHPs), such as resident support personnel, physiotherapists, recreational therapists and social activity staff by March 31, 2023 and to sustain this level every year thereafter.
The long-term care sector has met and exceeded the AHP DHOC targets in all three years to-date. This will ultimately ensure that residents are provided direct care through recreation and programs (for example physiotherapy) for the maintenance or improvement of functions related to activities of daily living, enhancing their overall quality of life.
Outcome measure #3 – The percentage of unique long-term care homes who are found not to be in compliance with an order on follow-up
The Fixing Long-Term Care Act, 2021 included several changes designed to enhance operator accountability and give inspectors more effective tools to enhance enforcement and reduce the number of recurring compliance orders.
The target was to reduce the number of homes found not to be in compliance with a follow-up order to 5.5% of all long-term care homes. In 2023, the government met the target as 5.0% of homes in the province were found not to be in compliance with at least one order, on follow-up. This number rose slightly to 7.7% in 2024 due to policy changes that led to a moderate increase in the number of compliance orders issued overall.
Efforts are underway to improve performance on this metric—for example, the introduction of a comprehensive compliance assistance program has been initiated with the aim supporting homes to attain compliance more effectively. The ministry will continue to monitor and provide strong oversight of LTC homes to ensure residents are protected.
Outcome measure #4 – Percentage of all provincial long-term care homes that received a proactive compliance inspection
The government launched a new and improved proactive inspections program in long-term care homes. This program will support the ministry’s commitment to completing a proactive compliance inspection in 100% of homes by the end of 2025, by ensuring there are enough inspectors to visit each long-term care home, while continuing to inspect critical incident complains.
The ministry is on track to meet this goal. Monthly interim targets were exceeded in the last three quarters of 2024 and continue to be exceeded in the first quarter of 2025. As of April 24, 2025, 546 homes received a proactive compliance inspection—this represents 89% of all long-term care homes in Ontario.
Significant progress has also been made in the areas of recruitment and training ensuring that there are enough inspector resources to achieve the goal by end of calendar year 2025.
Outcome measure #5 - Number of net new beds opened (target 30,000 by 2028)
From April 1, 2024 to March 31, 2025, an additional 322 net new beds have opened, bringing the cumulative total to 13,052 net new beds since 2018. Building net new beds will ultimately help to reduce wait lists and alleviate hospital capacity pressures.
Outcome measure #6 - Number of redeveloped beds opened (target 28,000 by 2028)
From April 1, 2024 to March 31, 2025, an additional 811 upgraded beds have opened, bringing the cumulative total to 10,925 upgraded beds since 2018. Redeveloping and upgrading existing beds will ultimately help to keep beds available and provide a safer and more comfortable home for residents.
Outcome measure #7 - Percentage of long-term care beds classified as "new” by structural bed classification
Capital development remains a critical ministry priority. The government is committed to building 30,000 net new beds and redeveloping 28,000 older existing beds by 2028 to modern standards.
The ministry has been building and redeveloping beds at a high rate with significant recent construction activity. As of March 31, 2025, 57% (44,878 beds) of long-term care spaces were classified as “new”. This represents a 3% increase from February 2024. Through development and redevelopment projects, the target is for 100% of all class B or older long-term care beds in the province to be classified as "new".
Outcome measure #8 - Median wait time from long-term care application to placement in days (excluding transfers)
From December 2023 through December 2024, the median wait time increased by 25 days. Wait time for LTC placement is driven by multiple variables such as the growing aging population, supply and demand of LTC beds, etc.
The ministry is working to ensure Ontarians are receiving access to care. Innovative models and broader system solutions are being explored to address the growing demand, demographic shifts and keeping seniors safely at home for longer.
| Category | Amount ($M) |
|---|---|
| Other operating | 8,701.0 |
| Other capital | 0.0010 |
| Ministry (pre-consolidation) | 8,701.0 |
| Consolidation adjustments | (5,457.6) |
| Total | 3,243.4 |
| Staff strength (as of March 31, 2025) | 658.0 |
Footnotes
- footnote[1] Back to paragraph Estimates, interim actuals and actuals for prior fiscal years are re-stated to reflect any changes in ministry organization or program structure. Interim actuals reflect the numbers presented in the 2025 Ontario Budget.
- footnote[2] Back to paragraph Estimates and actuals for prior fiscal years are re-stated to reflect any changes in ministry organization or program structure.
- footnote[3] Back to paragraph Interim actuals reflect the numbers presented in the 2025 Ontario Budget.
- footnote[4] Back to paragraph Ontario Public Service Full-Time Equivalent positions.