ontario regulation 353/25

made under the

Fixing Long-Term Care Act, 2021

Made: December 11, 2025
Filed: December 15, 2025
Published on e-Laws: December 16, 2025
Published in The Ontario Gazette: January 3, 2026

Amending O. Reg. 246/22

(GENERAL)

1. (1) Section 1 of Ontario Regulation 246/22 is amended by adding the following definitions:

“dentist in the general class” means a member of the Royal College of Dental Surgeons who holds a certificate of registration in the general class or an out of province dentist in the general class; (“dentiste de la catégorie générale”)

“health profession Act” has the same meaning as in the Regulated Health Professions Act, 1991; (“loi sur une profession de la santé”)

“occupational therapist” means a member of the College of Occupational Therapists of Ontario or an out of province occupational therapist; (“ergothérapeute”)

“out of province dentist in the general class” means a person who is exempted from subsections 9 (1) and (2) of the Dentistry Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the general class of dentistry in Ontario; (“dentiste de la catégorie générale hors province”)

“out of province occupational therapist” means a person who is exempted from subsections 7 (1) and (2) of the Occupational Therapy Act, 1991 by a regulation made under that Act; (“ergothérapeute hors province”)

“out of province pharmacist” means a person who is exempted from subsections 10 (1) and (2) of the Pharmacy Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the pharmacist class in Ontario; (“pharmacien hors province”)

“out of province pharmacy technician” means a person who is exempted from subsections 10 (1) and (2) of the Pharmacy Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the pharmacy technician class in Ontario; (“technicien en pharmacie hors province”)

“out of province physiotherapist” means a person who is exempted from subsections 8 (1) and (2) of the Physiotherapy Act, 1991 by a regulation made under that Act; (“physiothérapeute hors province”)

“out of province registered dietitian” means a person who is exempted from subsections 7 (1) and (2) of the Dietetics Act, 1991 by a regulation made under that Act; (“diététiste agréé hors province”)

“out of province speech-language pathologist” means a person who is exempted from subsections 8 (1) and (2) of the Audiology and Speech-Language Pathology Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the general class of speech-language pathology in Ontario; (“orthophoniste hors province”)

“pharmacy technician” means a member of the Ontario College of Pharmacists who holds a certificate of registration as a pharmacy technician or an out of province pharmacy technician; (“technicien en pharmacie”)

“physiotherapist” means a member of the College of Physiotherapists of Ontario or an out of province physiotherapist; (“physiothérapeute”)

“speech-language pathologist” means a member of the College of Audiologists and Speech-Language Pathologists of Ontario who holds a certificate of registration as a speech-language pathologist or an out of province speech-language pathologist; (“orthophoniste”)

(2) The definitions of “exempted out of province health professional”, “out of province physician”, “out of province registered nurse in the extended class”, “out of province registered nurse in the general class”, “out of province registered practical nurse”, “pharmacist” and “registered dietitian” in section 1 of the Regulation are revoked and the following substituted:

“exempted out of province health professional” means any person who is exempted by a regulation made under a health profession Act from,

(a)  a provision in that Act that restricts the use of a title, and

(b)  a provision in that Act that prohibits the person from holding themselves out as qualified to practise in the applicable health profession; (“professionnel de la santé exempté hors province”)

“out of province physician” means a person who is exempted from subsections 9 (1) and (3) of the Medicine Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration authorizing independent practice in Ontario; (“médecin hors province”)

“out of province registered nurse in the extended class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the extended class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie supérieure hors province”)

“out of province registered nurse in the general class” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the general class for registered nurses in Ontario; (“infirmière autorisée ou infirmier autorisé de la catégorie générale hors province”)

“out of province registered practical nurse” means a person who is exempted from subsections 11 (1) and (5) of the Nursing Act, 1991 by a regulation made under that Act and who holds the equivalent of a certificate of registration in the general class for registered practical nurses in Ontario; (“infirmière auxiliaire autorisée ou infirmier auxiliaire autorisé hors province”)

“pharmacist” means a member of the Ontario College of Pharmacists who holds a certificate of registration as a pharmacist or an out of province pharmacist; (“pharmacien”)

“registered dietitian” means a member of the College of Dietitians of Ontario who holds a temporary or general certificate of registration under the Dietetics Act, 1991 or an out of province registered dietitian; (“diététiste agréé”)

2. (1) Paragraph 1 of subsection 55 (2.1) of the Regulation is revoked and the following substituted:

1.  If the skin assessment involves the performance of a controlled act under subsection 27 (2) of the Regulated Health Professions Act, 1991, a person who is,

i.  authorized to perform that act under a health profession Act, the Regulated Health Professions Act, 1991 or any relevant regulation, or

ii.  exempted from the prohibition on the performance of the controlled act by a regulation made under the Regulated Health Professions Act, 1991.

(2) Subparagraph 2 i of subsection 55 (2.1) of the Regulation is revoked and the following substituted:

i.  A member of a regulated health profession, or an exempted out of province health professional, acting within their scope of practice.

3. Section 67 of the Regulation is revoked and the following substituted:

Therapy services staff qualifications

67. (1) Subject to subsection (2), every licensee of a long-term care home shall ensure that the therapy services referred to in section 65 and that the licensee arranges or provides under section 13 of the Act are only provided by therapists who have,

(a)  a current certificate of registration with the appropriate college of a regulated health profession; or

(b)  in the case of an out of province health professional, a current certificate of registration with the governing body of their health profession.

(2) Therapy services provided by the licensee may be provided by support personnel who,

(a)  are members of the staff of the home who work under,

(i)  the direction of a member of the appropriate regulated health profession or the appropriate exempted out of province health professional, and

(ii)  the supervision of the designated lead required under section 70; and

(b)  either,

(i)  have successfully completed a training program in restorative care,

(ii)  are currently enrolled in a training program in restorative care, or

(iii)  have successfully completed a relevant training course provided by the licensee that is designed and supervised by,

(A)  a qualified therapist who is a member of the appropriate college of a regulated health profession, or

(B)  a qualified therapist who is an appropriate exempted out of province health professional.

(3) Therapy services arranged by the licensee may be provided by support personnel of a regulated health professional or an exempted out of province health professional referred to in subsection (1) working under the direction and supervision of that health professional.

4. Clause 70 (2) (a) of the Regulation is revoked and the following substituted:

(a)  must have a current general certificate of registration with a college of a regulated health profession or with the Ontario College of Social Workers and Social Service Workers or must be an exempted out of province health professional; or

5. (1) Clause 80 (5) (c) of the Regulation is revoked and the following substituted:

(c)  where the licensee determines that it is necessary, a member of a regulated health profession, or an exempted out of province health professional, working within their scope of practice is on site to collaborate with the registered dietitian when the registered dietitian is providing the clinical and nutritional care by telephone or by means of video conferencing.

(2) Clause 80 (6) (b) of the Regulation is revoked and the following substituted:

(b)  the reasons for the licensee’s decision to have, or not to have, a member of a regulated health profession or an exempted out of province health professional on site to collaborate with the registered dietitian.

6. The Regulation is amended by adding the following section:

Additional persons who may approve the use of a PASD

120.1 Out of province occupational therapists and out of province physiotherapists are prescribed for the purposes of subparagraph 3 vi of subsection 36 (4) of the Act.

7. (1) Clause 140 (3) (a) of the Regulation is revoked and the following substituted:

(a)  where the administration involves the performance of a controlled act under subsection 27 (2) of the Regulated Health Professions Act, 1991, the person is,

(i)  authorized to perform that act under a health profession Act, the Regulated Health Professions Act, 1991 or any relevant regulation, or

(ii)  exempted from the prohibition on the performance of the controlled act by a regulation made under the Regulated Health Professions Act, 1991; or

(2) Subclause 140 (3) (b) (i) of the Regulation is revoked and the following substituted:

(i)  a member of a regulated health profession, or an exempted out of province health professional, who is acting within their scope of practice,

8. Sub-subclauses 148 (3) (a) (ii) (D) to (F) of the Regulation are revoked and the following substituted:

(D)  a registered nurse in the extended class,

(E)  a pharmacy technician, or

(F)  a dentist in the general class; and

9. Subclauses 177 (1) (d) (iii) to (v) of the Regulation are revoked and the following substituted:

(iii)  a physiotherapist,

(iv)  an occupational therapist,

(v)  a speech-language pathologist, or

10. Paragraph 3 of subsection 255 (2) of the Regulation is revoked and the following substituted:

3.  An act of misconduct under any other scheme in Ontario or in another jurisdiction that governs a profession, occupation or commercial activity, including a scheme a person is not required to participate in in order to practice or engage in the profession, occupation or activity.

11. Paragraph 2.1 of subsection 278 (1) of the Regulation is revoked and the following substituted:

2.1  In the case of an exempted out of province health professional, verification that the professional meets all of the criteria for being exempted, by a regulation made under the applicable health profession Act, from,

i.  the provision in that Act that restricts the use of a title, and

ii.  the provision in that Act that prohibits people from holding themselves out as qualified to practise in the health profession.

Commencement

12. This Regulation comes into force on the later of January 1, 2026 and the day this Regulation is filed.