RNAO endorses Bill 13: Time to Care Act and urges government to pass into law promptly

Oct. 30, 2020

The Registered Nurses’ Association of Ontario (RNAO) is praising members of provincial parliament for acting unanimously and in the best interests of residents in long-term care (LTC) homes by voting in favour of Bill 13 during a key vote in the Ontario legislature this week.

The private member’s bill, which was introduced by London-Fanshawe NDP MPP Teresa Armstrong in 2018, passed second reading on Oct. 29, and now goes to committee. It calls for amendments to the Long-Term Care Homes Act to establish a minimum of four hours of nursing and personal support services per resident, per day – in all nursing homes.

“We fully support Bill 13. For more than a decade, RNAO has been asking that care for residents be increased to four worked hours of nursing and personal care for each resident, each day, and in all nursing homes – including for-profit and not-for-profit. If passed, this bill will help improve quality of care for residents and will begin to address long-standing staffing deficiencies that these residents, their families and staff have experienced for decades,” says RNAO CEO Dr. Doris Grinspun.

Grinspun says nurses and other health providers dealing with the devastating effects of COVID-19 thank the government and all party leaders for putting aside partisan politics and supporting this bill. “We ask the government to move quickly so Bill 13 goes through the legislative process and that the provisions of the bill become law,” Grinspun says. In doing so, “the government will be acting in the best interests of Ontario seniors, their loved ones and staff.”

RNAO and other experts have insisted there is need for a minimum standard of care. “The evidence speaks for itself, in report after report that has called for such standards. We know this legislation isn’t final yet, however, there is reason to be hopeful. On behalf of the families of the more than 2,000 LTC residents and eight LTC health workers, including seven personal support workers (PSW) and an RN who died as a result of COVID-19, we have an obligation to ensure we provide safe, quality and compassionate care for residents in nursing homes. This is something we simply must deliver on,” says RNAO President Morgan Hoffarth.

The foundation to deliver four worked hours of care can be found in RNAO’s Nursing Home Basic Care Guarantee, which was released in July 2020. The guarantee stipulates that every LTC home – whether for-profit or not-for-profit – provide a minimum of four worked hours of direct nursing and personal care to each resident daily, and a skill mix that includes:

  • 0.8 hours (48 minutes) of RN care per resident, per 24 hours
  • 1 hour (60 minutes) of RPN care per resident, per 24 hours
  • 2.2 hours (132 minutes) of PSW care per resident, per 24 hours

On top of these basic but essential measures, RNAO is calling on the government to provide funding so each home is staffed with one nurse practitioner (or clinical nurse specialist if NPs are not available) for every 120 residents. A full-time nurse, preferably an RN, must also work in infection prevention and control and quality improvement, at each nursing home.  

“Almost 80,000 residents across Ontario call long-term care ‘home,’ and we owe it to them to ensure that during this second wave, not a moment is wasted. We are encouraged by this all-party show of support, however, we are in the middle of a crisis and the government must immediately act by moving on staffing, as well as ensuring this bill moves through committee and becomes law. Homes right across this province are in desperate need of more RNs, NPs, RPNs and PSWs. The government should act and make sure there is funding to hire the additional help that is desperately required,” urges Hoffarth.      

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit our website at or follow us on Facebook and Twitter.


For more information, or to arrange an interview with a nurse, please contact:

Contact info

Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)
Victoria Alarcon
Communications Officer/Writer
Registered Nurses' Association of Ontario (RNAO)