The Minister’s Directive: COVID‑19 response measures for long-term care homes was revoked effective April 19, 2024. The requirements in this directive no longer apply and are included below for reference only.

Effective August 30, 2022

Minister’s Directive: COVID-19 response measures for long-term care homes

This Minister’s Directive is issued pursuant to s. 184 (1) of the Fixing Long-Term Care Act, 2021 (Act), which authorizes the Minister of Long-Term Care to issue operational or policy directives respecting long-term care homes where the Minister considers it in the public interest to do so. Every licensee shall carry out every operational or policy directive that applies to the long-term care home. In case of a conflict between this directive and any applicable law (including a directive issued by the Chief Medical Officer of Health pursuant to s. 77.7 of the Health Protection and Promotion Act), the latter prevails.

This directive is effective as of August 30, 2022.

This directive relates to the safe operation of long-term care homes and specifically to reducing the risk of covid 19 while providing the greatest possible opportunities for maximizing resident quality of life. Additional measures apply in a covid 19 outbreak situation, including measures as per local public health direction and measures contained in the Ministry of Health covid 19 Guidance: Long-Term Care Homes and Retirement Homes for Public Health Units (PDF), or as amended.

Definitions

All terms in this directive have the same meaning as under the Act and Ontario Regulation (O. Reg.) 246/22 under the Act, unless otherwise defined.

The following definitions apply for the purpose of this directive.

  • Caregiver has the same meaning as under the Act.
  • Double room means a room with two beds that may be occupied (regardless of whether it is connected to another separate room by a door, hallway or a shared washroom).
  • Essential visitor has the same meaning as under O. Reg. 246/22.
  • General visitor means a person who is not an essential visitor and is visiting the home to provide non-essential services related to either the operations of the home or a particular resident or group of residents. This excludes children under the age of one year.
  • Isolation room is a room that may be occupied by one person only, and ideally has a contained bathroom for resident use. In some instances where single beds are not available for isolation, up to two residents requiring isolation may isolate in the same room with adequate spacing (two metres or six feet apart).
  • Licensee has the same meaning as under the Act.
  • Personal Protective Equipment (PPE) means equipment worn by staff, students, volunteers and caregivers to minimize exposure to hazards that may cause serious injuries and illnesses.
  • Resident has the same meaning as under the Act.
  • Single room means a room with only one bed that may be occupied (regardless of whether it is connected to another separate room by a door, hallway, or a shared washroom).
  • Staff has the same meaning as under the Act.
  • Student means a person working in the long-term care home as part of a placement requirement of an educational program of a college or university, or as part of a training program, who does not meet the definition of “staff” or “volunteer”.
  • Volunteer has the same meaning as under the Act.
  • Ward room means a room that has been structurally designed for three or more beds and would normally contain three or more licenced and operational beds available for admissions. Rooms structurally designed for one or two beds that are connected to each other by a door, hallway or shared washroom are not considered ward rooms.

I hereby issue the following directive with respect to every long-term care home:

  1. Infection prevention and control (IPAC) practices

    Licensees shall ensure that all staff, visitors, students, volunteers and residents practice the health and safety requirements contained in this directive while in the home. Licensees must ensure that the requirements in this directive are implemented and met at all times.

    1. covid 19 outbreak preparedness plan

      Licensees, in consultation with their joint health and safety committees or health and safety representatives if any, shall ensure measures are taken to prepare for and respond to a covid 19 outbreak, including ensuring the development and implementation of a covid 19 Outbreak Preparedness Plan. This plan must include at a minimum:

      • identifying members of the Outbreak Management Team
      • identifying their local IPAC Hub and its contact information (where applicable)
      • conducting regular IPAC audits (PDF) in accordance with the covid 19 Guidance Document for Long-Term Care Homes in Ontario (PDF), or as amended
      • ensuring covid 19 testing kits are available and plans are in place for taking specimens
      • ensuring sufficient PPE is available
      • ensuring that all staff, students and volunteers are trained on IPAC policies and procedures including the proper use of PPE
      • developing policies to manage staff, students and volunteers who may have been exposed to covid 19
      • permitting an IPAC Hub associated organization completing an IPAC assessment to do so and to share any IPAC report or findings produced by the organization, in accordance with any applicable laws, with any or all of the following, as may be required to respond to covid 19 at the home:
        • the Ministry of Long-Term Care
        • public health units
        • local public hospitals
        • Ontario Health and Home and Community Care Support Services
      • keeping staff, students, volunteers, residents, and families informed about the status of covid 19 in the homes, including frequent and ongoing communication during outbreaks

    2. Masking

      Licensees are required to ensure that the masking requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

    3. Physical distancing

      Licensees are required to ensure that the physical distancing requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

    4. Environmental cleaning

      Licensees shall ensure that:

      • regular environmental cleaning of their facilities is maintained
      • enhanced environmental cleaning (PDF) and disinfection for frequently touched surfaces is performed

      See the Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control’s (PIDAC-IPC) Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition (PDF) for more details.

      Licensees are required to ensure that the environmental cleaning and disinfection requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  2. Personal protective equipment

    Licensees are required to ensure that the personal protective equipment requirements as set out in the covid 19 Guidance: Long-Term Care Homes and Retirement Homes for Public Health Units (PDF), or as amended, are followed.

  3. Cohorting for staff, students, volunteers and residents

    Licensees are required to ensure that the cohorting requirements for staff, students, volunteers and residents as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  4. Case and outbreak management

    Licensees are required to ensure that the requirements for case and outbreak management as set out in the  covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  5. Accommodations

    1. Admissions and transfers

      Licensees shall ensure that the detailed requirements and information related to admission and transfer into the home, including requirements for testing and isolation, are followed as set out in the covid 19 Guidance: Long-Term Care Homes and Retirement Homes for Public Health Units (PDF), or as amended.

    2. Areas for Isolation

      Licensees shall ensure that requirements for areas for isolation as set out in the COVID-19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

    3. General accommodations

      After completing all testing and isolation requirements as applicable, all new residents and other transfers into the home must be placed in a single room or double room. Where a double room is used, every effort must be made to allow for adequate space (minimum two metres) between beds. New residents include persons who were previously a resident at the home but were discharged (for example, persons who were discharged because they exceeded the permitted length of an absence).

    4. Ward rooms

      Where placement into a single or double room is not possible, a new admission may be placed in a ward room with no more than one other resident. That is, there cannot be more than two residents placed in a ward room and any additional bed in the room must be left vacant and not available for occupancy. Where ward rooms are used, every effort must be made to allow for adequate space (minimum two metres) between beds.

      A bed in a ward room must be left vacant, and not available for occupancy, if a resident who occupied a bed in the ward room is discharged from the long-term care home and there are two or more residents who continue to occupy beds in the ward room.

      Despite the requirements set out in this section, residents who are currently occupying beds in a ward room with two or more residents must be permitted to return to their bed following an authorized absence, including medical absences requiring an admission or a transfer to another health care facility, subject to applicable conditions, after completing their required testing and isolation requirements under the Ministry of Health covid 19 Guidance: Long-Term Care Homes and Retirement Homes for Public Health Units (PDF), or as amended, and  covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended.

  6. Absences

    Licensees are required to ensure that the resident absence requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  7. Visitors

    Licensees are required to ensure that the visitor requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  8. Asymptomatic screen testing

    Licensees are required to ensure that the covid 19 asymptomatic screen testing requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  9. COVID-19 screening

    Licensees are required to ensure that the covid 19 screening requirements as set out in the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended, are followed.

  10. Reporting

    Licensees are required to ensure that statistical information regarding covid 19 testing and covid 19 vaccination is collected, maintained, and disclosed in accordance with the covid 19 Guidance Document for Long-Term Care Homes in Ontario, or as amended.