Update on the Auditor General’s Recommendations and Summary of RHRA’s Recent Work

Established in 2011, the Retirement Homes Regulatory Authority (RHRA) is an independent, self-funded, not-for-profit regulator mandated by the government to protect and ensure the safety and well-being of seniors living in Ontario’s retirement homes under the Retirement Homes Act, 2010. RHRA welcomed the recommendations in the Auditor General’s report that acknowledge systemic opportunities and the need for retirement homes to the ensure the highest levels of protection and care for residents.  We also appreciate that the Auditor General recognized RHRA’s considerable progress to date and specified areas for continued focus on operational improvement in priority areas. The RHRA is committed to sharing information on our progress toward addressing the Auditor General’s recommendations.

The RHRA has developed a 5-point plan to address the Auditor General’s recommendations, which we have already started to implement. We will:

• Work with the Ministry for Seniors and Accessibility, the Ministry of Health, Local Health Integration Networks and/or Public Health to address systemic gaps, many of which are cited in the Report findings.
• Enhance public communication of retirement home current and past compliance history
• Strengthen our complaints processes.
• Continue using our risk model to evaluate licence applications based on comprehensive criteria
• Review our business model/fee structure to ensure sufficient resources to fulfill our mandate and address the Auditor General’s recommendations.

Retirement home resident safety and protection are our absolute top priority.  As an organization of 60 staff, including 14 inspectors, we are responsible for protecting more than 60,000 residents living in more than 770 retirement homes across the province. Since the beginning of the pandemic, we have conducted 429 inspections. Our inspectors have been working on the frontlines seven days per week and are available at all times so that when a home is in crisis, residents get the help they need through the expertise and oversight provided by RHRA, working in collaboration with our community partners.

We fulfill our mandate through a risk-based approach that ensures we are allocating our resources where they will have the greatest impact. This means that we inspect homes more frequently where we have found evidence of non-compliance with the law, and we prioritize following-up on any complaints related to neglect or reports of harm.  Our staff works closely with the management of any non-compliant home to ensure it is understood what action must be taken to meet the required standards and the timeline by which this must be completed.  And when appropriate, we will use our enforcement powers to take action when the safety of residents is at risk, up to and including the revocation of the facility’s licence to operate.

We have successfully prosecuted an unlicensed home operator in 2019 and in December 2020, the RHRA revoked the licences of several homes that could not demonstrate that they could reliably provide or facilitate care for residents. We understand that revoking a home’s licence can create significant stress and be very disruptive for residents who would be at risk of losing their homes, as well as potentially creating a significant housing problem for these communities, particularly in the midst of a pandemic. This is a balancing act we take very seriously and the best interest of residents is always the top consideration. While we are not a first responder, when a home in crisis needs help, we will work closely with our community partners (e.g. LHINS, public health units, fire department) or use our management order powers to place a professional manager in the home; the ultimate goal is to ensure as little disruption as possible to the care and wellbeing of residents while at the same time ensuring the home becomes compliant as soon as possible.

It is important to note that our work should not and cannot be done in isolation. We work closely with experts like Dr. Andrew Costa at McMaster University to ensure we have the right data and insights to make decisions that keep the resident at the center of all that we do, which is publicly available on our website. We’ve also worked with Dr. Nathan Stall, Sinai Health and Ontario COVID-19 Science Advisory Table and Dr. Samir Sinha, Sinai Health and National Seniors Strategy, among others.

We also have worked successfully with the Ontario Retirement Communities Association, AdvantAge Ontario and the Ontario PSW Association, among others, to communicate expectations, work collaboratively on solutions in crisis situations and to listen to feedback as to how we can collectively do more to protect seniors living in retirement homes.

Our unwavering focus on resident safety, keeping families informed and commitment to transparency never stops. In 2020 we sent more than 80 advisories to homes so that they are clear on how to comply with the Act and Regulation and have the most up-to-date information they need on the evolving COVID-19 guidance and directive from the Chief Medical Officer of Health and the Province to keep their retirement home in compliance. We also developed a robust communications campaign to raise awareness among residents and their loved ones about resident rights and how to report harm or submit a complaint to the RHRA.

Keeping seniors safe from harm is at the heart of everything we do, and we will not hesitate to use the tools and resources afforded to us to make that happen. This includes holding retirement homes accountable for any gaps in compliance. We are continually working to improve, always with resident safety front and centre, and we will continue to do so as we implement the Auditor General’s recommendations.