Thousands join call for the Nursing Home Basic Care Guarantee

July 27, 2020

Close to 6,000 nurses, nursing students, other health professionals and members of the public have joined the call by the Registered Nurses’ Association of Ontario (RNAO) for immediate implementation of the Nursing Home Basic Care Guarantee to protect Ontario’s seniors who make their home in a long-term care (LTC) facility. They made their demand for change and urgent action clear by signing RNAO’s Action Alert. 

There’s no question the unsafe staffing that nursing homes had going into the pandemic made COVID-19 as deadly as it has been in Ontario – the most poorly-staffed jurisdiction in Canada. For 21 years, one government after another has failed to protect LTC residents. This week – July 31 – will allow Premier Doug Ford to launch a new era for seniors living in nursing homes by guaranteeing their basic care needs, shoring up staffing levels for regulated and personal support staff, and adjusting the staff mix so residents can count on consistently safe care and quality of life. “Nursing home residents deserve this basic care guarantee, enabled by the required minimum staffing hours and the knowledge, competencies and skills demanded by the complexity and acuity of their care needs,” says RNAO CEO Dr. Doris Grinspun. “Seniors need this basic care guarantee starting July 31, 2020 – four days from now.”

This need for immediate action is outlined in RNAO’s Nursing Home Basic Care Guarantee (NHBCG) submission to the government’s Long-Term Care Staffing Study Advisory Group, which was struck by LTC Minister Merrilee Fullerton in response to the public inquiry on LTC homes that issued its recommendations on July 31, 2019. Justice Eileen Gillese gave the government a deadline of July 31, 2020 to table in the legislature a staffing plan for regulated staffing in LTC. 

RNAO’s NHBCG plan has been discussed with Minister Fullerton and Premier Ford on numerous occasions. The written plan issued months ago provides detailed, evidence-based analysis supporting the NHBCG and staffing formula. It calls for implementing and funding recommendations from past inquiries and commissions, rather than engaging in more study and deliberation. RNAO calls on Premier Ford and Minister Fullerton to table their staffing plan and related funding in the legislature on July 31, 2020.

“RNAO’s submission is to honour close to 2,000 residents in LTC who have lost their lives over the past four months, in part, because of years of government neglect. While governments have been paying lip service to this sector, the acuity and dependency needs of persons living in nursing homes has increased exponentially, and the shortfall of nurse practitioners (NP), registered nurses (RN), registered practical nurses (RPN) and personal support workers (PSW) required to provide safe care and quality of life has been given little consideration. Frankly, governments have relegated LTC to the backburner, treating residents as second-class citizens,” says Grinspun. 

The Nursing Home Basic Care Guarantee will ensure that no nursing home – whether for-profit or not-for-profit – can go below four hours of direct nursing and personal care per resident, per 24 hours. The guarantee also ensures the proper skill mix with a minimum of:

  • 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

In addition, RNAO wants the government to provide funding for each home to hire a full-time RN to focus on infection prevention and control, and quality improvement, and one NP for every 120 residents in LTC homes to provide day-to-day clinical oversight.  

These staffing improvements must be accompanied by full-time employment with benefits to advance care continuity and lower the transmission of infections. RNAO is also calling for salaries that are consistent with those of hospital staff, as residents in nursing homes are no less important. 

RNAO says all of these measures are mandatory to address systemic shortfalls that have existed in the nursing home sector for decades, and to urgently prepare for a second wave of the pandemic.

“The 79,000 older adults living in Ontario’s long-term care homes, along with their families and the staff who care for them, can’t wait any longer for change,” says Morgan Hoffarth, RNAO’s president. “The government has a deadline of July 31 – as set by Justice Gillese, who led the inquiry into the safety of residents in LTC homes. On July 31, Premier Ford has an opportunity to make good on his promise to fix long-term care for residents to whom we owe a debt of gratitude for the contributions they have made during their lives.”  

RNAO urges everyone to continue to sign the action alert asking Premier Ford to implement the Nursing Home Basic Care Guarantee. This is how people across Ontario, who are appalled and deeply concerned about the state of long-term care, can ensure their voice is heard. “We call on the public to immediately sign the Action Alert and ask friends and family to do the same,” says 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. 

Contact info

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