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Ontario Auditor General Releases Special Report on Pandemic Readiness and Responsiveness in Long-Term Care

Ontario’s Auditor General Bonnie Lysyk released a Special Report on Pandemic Readiness and Response in Long-Term Care. In the report, the Auditor General highlighted the challenges homes were faced with before COVID-19 impacted homes last spring. The key finding include:

  • Actions were not taken to prepare for future outbreaks after the SARS outbreaks in the early 2000s.

  • Concerns regarding the delivery of care to seniors.

  • Lack of integration into the health care sector.

Once COVID-19 entered homes, the report notes that “unfortunately, neither the Ministry of Long-Term Care, nor the long-term-care sector was sufficiently positioned, prepared or equipped to respond to the issues created by the pandemic in an effective and expedient way.

The Auditor General also outlined 16 recommendations and 55 action items Ontario and the Ministry of Long-Term Care should take to improve and ensure quality care for seniors living in long-term care homes. These 16 recommendations are broken down by category.

System Planning

  • Reassess the long-term-care home licensing process to require home operators to renovate their facilities within a realistic, but shorter defined time frame to be in compliance with current standards, with the intent of preventing future disease outbreaks.

  • Reassess the plan to build or rebuild 45,000 long-term care beds to meet the current and future needs of Ontarians and re-evaluate the progress each year.


  • Develop and implement a staffing strategy so homes have consistent and sufficient staffing levels provide quality care to residents.

  • Establish a long-term plan to ensure personal support workers (PSWs) are properly trained and meet the staffing requirements of homes.

Infection Prevention and Control (IPAC) Measures 

  • Ensure proper IPAC measures are in place in homes by working with local public health units.

  • Develop a pandemic plan for the entire long-term care sector that clearly outlines roles and responsibilities, specific actions to be taken, and the timing of such actions in the event of a pandemic for homes, Ontario Health, Ministry of Long-Term Care and Local Health Integration Networks.

  • Review and revise the Ministry of Long-Term-Care’s inspection program and the Ministry of Health’s Inspection Prevention and Control Protocol.

Pandemic Planning

  • Require local public health units to assist long-term-care homes in preparing and reviewing their outbreak response plans, which is currently in the Ministry of Health’s Institutional/Facility Outbreak Management Protocol.

  • Develop a future pandemic plan that minimizes the spread of infectious diseases when long-term-care homes are at capacity.

Ministry of Long-Term Care Internal Process

  • Recommend that the Secretary of Cabinet include in the hiring criteria for this ministry that future Assistant Deputy Ministers and Deputy Ministers have knowledge and experience in the long-term care sector.

  • Develop and coordinate from the Health Table so operators can effectively implement the measures to control the spread of COVID-19 and other potential future infectious diseases in a timely manner.


  • Work with public health units to clarify roles and responsibilities and work in formal partnerships to conduct inspections of long-term-care homes for compliance with Directive #3.

  • Determine and conduct annual inspections that address the risks and instances of non-compliance before they result in more significant outcomes for residents.

  • Hold operators accountable in the event they are non-compliant.

  • Better utilize its inspection function in cases of infectious disease outbreaks and other types of emergencies.

The Ministry has responded to the recommendations and addressed several of them in their plans to improve long-term care for seniors in Ontario.

What’s Next?

This report comes only days before the Ontario Long-Term Care COVID-19 Commission will submit its final report to the Minister of Long-Term Care. The findings in today’s report should not come as a surprise to many in the long-term care sector as seniors were disproportionately affected by COVID-19.

The Government of Ontario has acknowledged the work that needs to be done to provide quality care for seniors in the province and have been addressing this through their commitments to increasing the number of hours of care a daymodernizing long-term care homes and through the implementation of the Long-Term Care Staffing Plan.

Read the Special Report on Pandemic Readiness and Response in Long-Term Care here.

Read Ontario’s response to the Special Report here.