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O. Reg. 319/21: TRANSFER OF HOSPITAL PATIENTS

filed April 28, 2021 under Emergency Management and Civil Protection Act, R.S.O. 1990, c. E.9

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ontario regulation 319/21

made under the

Emergency Management and Civil Protection Act

Made: April 28, 2021 (8:30 a.m.)
Filed: April 28, 2021
Published on e-Laws: April 28, 2021
Printed in The Ontario Gazette: May 15, 2021

Amending O. Reg. 272/21

(TRANSFER OF HOSPITAL PATIENTS)

1. (1) Section 1 of Schedule 1 to Ontario Regulation 272/21 is amended by adding the following definitions:

“alternate level of care” means a designation that is given by an attending clinician to a patient indicating that the patient does not require the intensity of resources or services that are provided in a hospital; (“niveau de soins différent”)

“licensee” means,

(a) in relation to a long-term care home, a licensee within the meaning of the Long-Term Care Homes Act, 2007, and

(b) in relation to a retirement home, a licensee within the meaning of the Retirement Homes Act, 2010; (“titulaire de permis”)

“local health integration network” has the same meaning as in subsection 2 (1) of the Local Health System Integration Act, 2006; (“réseau local d’intégration des services de santé”)

“long-term care home” has the same meaning as in subsection 2 (1) of the Long-Term Care Homes Act, 2007; (“foyer de soins de longue durée”)

“placement co-ordinator” means a placement co-ordinator designated under subsection 40 (1) of the Long-Term Care Homes Act, 2007; (“coordonnateur des placements”)

“retirement home” has the same meaning as in subsection 2 (1) of the Retirement Homes Act, 2010; (“maison de retraite”)

(2) Schedule 1 of the Regulation is amended by adding the following sections:

Long-term care homes

2.1 (1) Subject to subsections (2) and (3), a hospital is authorized to transfer a patient to a long-term care home, a placement co-ordinator is authorized to approve the admission of the patient, and the licensee of the home is authorized to admit the patient to the home as a resident, whether or not the transfer has been consented to by the patient or, if the patient is incapable, the patient’s substitute decision-maker.

(2) A transfer under subsection (1) only applies to a patient who has been designated by their attending clinician as requiring an alternate level of care in a long-term care home.

(3) A hospital may not transfer a patient to a long-term care home under subsection (1) unless the following conditions are met:

1. The transfer is necessary to,

i. respond to a major surge event,

ii. enable the hospital to optimize the availability of its critical care and acute care resources, or assist another hospital in optimizing the availability of such resources, and

iii. reduce a foreseeable risk of serious bodily harm to a person.

2. Efforts have been made that are reasonable in the circumstances to obtain consent to the transfer and admission to the long-term care home from the patient or, if the patient is incapable, their substitute decision-maker.

3. The attending clinician is satisfied that the patient can receive the care that the patient requires at the long-term care home, and that the transfer can be effected without compromising the patient’s medical condition.

4. The placement co-ordinator and the licensee of the long-term care home have complied with the requirements set out in subsection 208.2 (2) of Ontario Regulation 79/10 (General) made under the Long-Term Care Homes Act, 2007, except for paragraph 11 of that subsection.

(4) For greater certainty, nothing in this section requires a licensee of a long-term care home to accept the patient other than under the admissions process in section 208.2 of Ontario Regulation 79/10 (General) made under the Long-Term Care Homes Act, 2007.

Retirement homes

2.2 (1) Subject to subsections (2) and (3), a hospital is authorized to transfer a patient to a retirement home, and the licensee of the home is authorized to accept the patient as a resident of the home, whether or not the transfer has been consented to by the patient or, if the patient is incapable, the patient’s substitute decision-maker.

(2) A transfer under subsection (1) only applies to a patient who has been designated by their attending clinician as requiring an alternate level of care in a long-term care home.

(3) A hospital may not transfer a patient to a retirement home under subsection (1) unless the following conditions are met:

1. The transfer is necessary to,

i. respond to a major surge event,

ii. enable the hospital to optimize the availability of its critical care and acute care resources, or assist another hospital in optimizing the availability of such resources, and

iii. reduce a foreseeable risk of serious bodily harm to a person.

2. Efforts have been made that are reasonable in the circumstances to obtain consent to the transfer to the retirement home from the patient or, if the patient is incapable, their substitute decision-maker.

3. The attending clinician is satisfied that the patient can receive the care that the patient requires while a resident at the retirement home, and that the transfer can be effected without compromising the patient’s medical condition.

4. It is confirmed by the licensee of the retirement home that a bed is available for the patient at that home.

5. The licensee of the retirement home ensures that an assessment of the resident to develop a plan of care is conducted pursuant to section 62 of the Retirement Homes Act, 2010.

6. The placement co-ordinator has determined the patient is eligible for admission to a long-term care home.

(4) For greater certainty, nothing in this section requires a licensee of a retirement home to accept the patient as a resident of the home.

(5) The following rules apply to a patient transferred to a retirement home pursuant to subsection (1):

1. Once the Minister makes a determination under subsection 208.3 (1) of Ontario Regulation 79/10 (General) made under the Long-Term Care Homes Act, 2007, the placement co-ordinator shall place the patient in category 1 of the waiting list referred to in section 171 of that Regulation for the patient’s first choice of home, and shall keep the patient in that category for as long as the patient is awaiting placement in that first choice, unless they would otherwise be placed in a higher ranking category.

2. If the patient is admitted to a long-term care home that is not the patient’s first choice, the patient shall be considered a resident admitted to the long-term care home under section 208.2 of Ontario Regulation 79/10 (General) made under the Long-Term Care Homes Act, 2007 for the purposes of section 247.4.1 of that Regulation.

(3) Section 3 of Schedule 1 to the Regulation is amended by adding the following subsections:

(2) Where a hospital transfers a patient to a long-term care home in accordance with subsection 2.1 (1), the hospital is authorized to disclose to the placement co-ordinator and to the licensee of the long-term care home any information, including personal health information, that is necessary to facilitate the provision of care to the patient as a resident of the home.

(3) Where a hospital transfers a patient to a retirement home in accordance with subsection 2.2 (1), the hospital is authorized to disclose to the licensee of the retirement home and, where necessary to co-ordinate the provision of community services to the patient while in the retirement home, to the responsible local health integration network, any information, including personal health information, that is necessary to facilitate the provision of care to the patient as a resident of the home.

(4) Section 4 of Schedule 1 to the Regulation is amended by striking out “As soon as” at the beginning and substituting “In the case of patients who have been transferred to an alternate hospital site, as soon as”.

(5) Section 5 of Schedule 1 to the Regulation is amended by adding “the Long-Term Care Homes Act, 2007, the Retirement Homes Act, 2010, the Residential Tenancies Act, 2006” after “Health Care Consent Act, 1996”.

(6) Section 5 of Schedule 1 to the Regulation is amended by adding the following subsection:

(2) To the extent that this Order conflicts with Ontario Regulation 95/20 (Streamlining Requirements for Long-Term Care Homes) made under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020, this Order prevails.

 

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