1. Comprehensive inspections: aim to assess residents’ satisfaction and homes’ compliance with legislative requirements. On average, a comprehensive inspection involves three or four inspectors examining the home over an eight-day period.

2. Complaints: the MOHLTC centralized intake unit has responsibility for reviewing every complaint it receives and to decide whether an inspection is warranted. If it decides that an inspection is required, the unit assigns a risk level to each case: high, medium or low.

• High-risk cases involve alleged improper care, abuse, neglect, unlawful conduct, or retaliation by the homes’ staff—anything that places resident(s) in serious (or significant risk of serious) harm and in immediate jeopardy if the Ministry or the home fails to intervene.
• Medium-risk cases involve any alleged violation of the Act that result in moderate (or risk of moderate) harm to a resident(s).
• Low-risk cases involve minimal (or risk of minimal) harm. The Act stipulates that high risk complaints be inspected immediately, while the Ministry aims to inspect medium-risk complaints within 30 days and low risk complaints within 120 days.

3. Critical Incident: these include: fire, neglect or abuse of residents, improper care, misuse of residents’ money, unlawful conduct, unexpected or sudden death, residents missing for more than three hours, missing residents who return with an injury or adverse change in condition, outbreaks of reportable or communicable diseases, and contamination of the drinking water supply.

• The Ministry’s centralized intake unit reviews every critical incident reported to decide whether an inspection is warranted. The inspection process to address a critical incident is the same as the process for Complaint Inspections

4. Follow Up: if an inspection results in the home being issued with an order to comply with the legislation, there must be a follow-up inspection to ensure that the home has followed the order by the deadline given and that the issue has been rectified.

5. Resident Quality Inspections: the Resident Quality Inspections (RQI) are a comprehensive inspection conducted using methodology that was adapted from the Quality Indicator Survey (QIS), a nursing home inspection process, developed over 15 years for the Centres for Medicare and Medicaid and rolled out across the United States. The RQI was adapted to meet specific requirements of LTCHA and the characteristics of LTC home residents.

Next Chapter:

Preparing for inspections

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