Long-Term Care Services

Health Standards Organization (HSO) is developing a National Standard of Canada (NSC) for the co-design and delivery of integrated, resident-and-family-centred long-term care (LTC) services across Canada. The HSO National Long-Term Care Services Standard (CAN/HSO 21001:2022— Long-Term Care Services) is a revision of the HSO 21001:2020 – Long-Term Care Services standard and will provide LTC homes across Canada with evidence-informed practices that define how LTC homes and LTC teams can work collaboratively to keep people safe, provide safe, reliable, and high quality care, and demonstrate positive, outcomes-focused change.

The new standard will focus on:

• Resident-and-family-centred care practices that value the importance of respect, dignity, trust, and quality of life,
• Safe, reliable, and high quality care based on evidence-informed practices, 
• A healthy and competent workforce to ensure sustainable, team-based, compassionate care, and,
• An organizational culture that is outcome focused and strives towards the safety and well-being of residents, families, and the LTC workforce.

The CAN/HSO 21001:2022 – Long-Term Care Services standard will also:

• Adopt a “whole person,” holistic approach to the provision of LTC services that are delivered collaboratively with residents and families by LTC care providers in a licensed, congregate care setting;
• Present how LTC homes and LTC teams can improve quality of care and quality of life for residents and families by moving towards an integrated, resident-and-family-centred delivery of care model that enables LTC services to be delivered at the right time, by the right people and in the right setting;
• Present the requirements for the coordinated delivery of resident-and-family-centred LTC services, as defined by the needs of residents and their families;
• Determine how LTC services can be coordinated across the health system, and particularly integration at the level of local community services (e.g., timely access to primary and acute health services);
• Provide clear, standardized, evidence-informed practices to deliver direct care and services expected for a vulnerable population of Canadians with complex care needs;
• Outline how LTC homes can support and maintain a healthy LTC workforce, ensuring that staff receive the training they require, that they are provided with decent and safe working conditions, and that they are supported in their day-to-day interactions so they are able to provide the highest quality of mindful and purposeful LTC services to residents and families;
• Adopt a culturally safe, culturally appropriate and mindful approach to care and service delivery across all LTC interactions;
• Adopt a health equity lens and abide by the principles of equity, diversity and inclusion, advocating for the needs of all residents and families, particularly those relevant to underserved, racialized and/or marginalized communities such as 2SLGBTQ+ peoples, Black, Indigenous, and other People of Colour (BIPOC), refugee, immigrant and other ethno-cultural communities;
• Promote a higher quality of life for residents and their families by developing safe and age-friendly environments that foster autonomy and engagement while valuing the importance of respect, dignity and trust; and,
• Provide guidance to leadership and policy-makers about how they can support safe, reliable, and high quality LTC services through, for example, policy, regulation and legislation that are informed by the needs of people and communities.

For the purposes of this standard, LTC homes are defined as a facility formally recognized by jurisdiction (i.e., are licensed and/or permitted to formally operate as such) that provide a wide range of personal (e.g., assistance with everyday activities) and medical services 24 hours, 7 days a week. The LTC home is considered the person's formal 'home' address.

Overarching principles of both resident-and-family-centred care as well as integrated LTC service delivery as a continuum of care are foundational to the development of this standard. While the standard will focus exclusively on the delivery of evidence-informed, resident-and-family-centred LTC services within the context of formal LTC homes, principles of high quality, resident-and-family-centred LTC service delivery transcend setting and space and can be applied in any care environment where LTC services are delivered and received.

Out of scope in this revision is content related to the planning, designing and construction of LTC homes, as well as content related to infection prevention and control (IPAC) best practices used when planning, designing and building LTC homes.

The standard is not intended to duplicate or replicate existing HSO National Standards of Canada, but rather to supplement and complement current standards, guidelines and recommendations used across HSO’s suite of services.