Purpose of the Site

This website provides information on the key areas in which long-term care (LTC) homes are measuring quality. The site aims to be a resource for potential residents of long-term care and their families and for LTC homes to support quality improvement. (Click here for suggested questions that residents and families can ask staff at their homes.)

When searching for information about a home, keep in mind that not all homes are able to report their results at this time. Check back regularly, as more homes will be added over time. With the release of the next LTC Public Report in March 2012, we anticipate that all homes will be publicly reporting on key quality indicators. Families should also consider other sources of information when making a decision about a home (see Tips & Resources).
 
How the Data Were Collected

Most of the data were collected using the RAI-MDS (Resident Assessment Instrument – Minimum Data Set). This standardized tool is now used in most Canadian provinces and in many countries around the world. The Ministry of Health and Long-Term Care is currently working with homes to implement RAI-MDS across the province. Under this system, every resident will undergo a detailed health assessment at least once every three months. This assessment will be conducted by a staff member at the home. Staff will be specially trained to collect this information.

We also use provincial databases that cover access, emergency department visits and drug use, and data taken from a resident satisfaction survey of 30 homes that was conducted by researchers at the University of Toronto. For this study, in-person interviews were conducted with 60 randomly selected eligible residents (who were willing to participate and had no severe dementia) by trained interviewers who did not work at the long-term care home. Plans are underway to implement resident and family satisfaction surveys for all homes over the next two years.

Public Reporting Indicators

The public reporting indicators for long-term care used  were selected following a rigorous and evidence-based process that included:

• an environmental scan of long-term care indicators in use in Ontario and other jurisdictions, and public reporting mechanisms;
• consultations with academic experts (a Scientific Expert Panel); and
• consultations with representatives from the People Caring for People Implementation Team, led by Shirlee Sharkey, President and CEO of Saint Elizabeth Health Care and author of “People Caring for People: A Report of the Independent Review of Staffing and Care Standards for Long-Term Care Homes in Ontario.”

These groups chose indicators that can be accurately measured and influenced by homes. Click here to read the scientific panel’s report, “Long-Term Care in Ontario: A Report on Quality.”

Indicators are organized under HQO’s nine attributes: accessible, effective, safe, patient- (resident-) centred, equitable, efficient, appropriately resourced, integrated, and population health. Currently, this site reports on just four attributes: accessible, effective, safe, patient- (resident-) centred, and appropriately resourced. We will build on this as the site develops. For more information about HQO attributes, go to www.ohqc.ca/en/framework.php.

Limitations of the Data

Provincial results are based on data from 377 eligible long-term care homes (i.e., homes using the RAI-MDS system). Towards the end of fiscal year 2011/12, we anticipate that all homes will be able to report on their quality. At that time, we will be publicly launching the site.

Homes Participating in Public Reporting

This site includes long-term care homes that are funded and regulated by the Ministry of Health and Long-Term Care. These homes care for people who are no longer able to live independently or who require onsite nursing care, 24-hour supervision or personal support. They include:

• Licensed long-term care homes owned by for-profit corporations;
• Approved long-term care homes run by municipalities; and
• Licensed long-term care homes owned by charities and not-for-profit corporations, such as faith, community or cultural groups.

Retirement homes are not regulated or funded by the Ministry of Health and Long-Term Care and are not being publicly reported.

Participation in public reporting by long-term care homes is voluntary at present, and only those homes that have been using RAI-MDS  for at least a year were invited to post their results. Most homes in the province do not have enough data yet to qualify. More homes will be added over time. With the release of the next LTC Public Report in March 2012, we anticipate that all homes will be publicly reporting on key quality indicators.

Acknowledgements

HQO thanks the Canadian Institute for Health Information (CIHI) for providing the data for public reporting and the following organizations for their input into the design and testing of this website:

• Concerned Friends of Ontario Citizens in Care Facilities
• Ontario Association of Residents’ Health Quality Ontarios (OARC)
• Ontario Family Health Quality Ontarios’ Program
• Ontario Long Term Care Association (OLTCA)
• Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS)
• Ontario Municipal Benchmarking Initiative (OMBI)

We would also like to thank the following members of the HQO Long-Term Care Reporting Scientific Expert Panel and members of the People Caring for People Implementation Team, for their guidance in identifying and developing measures of quality.

Scientific Expert Panel

Geoff Anderson, MMD, PhD, University of Toronto
Andrea Baumann, MScN, PhD, McMaster University
Katherine Berg, MSc, PhD, , University of Toronto
Arlene Bierman, MD, MS, FRCPC, University of Toronto
Larry Chambers, PhD, PACE, Hon FFPH, University of Ottawa
Ben Chan, MD, MPH, MPA, Panel Chair and CEO, Health Quality Ontario
John Hirdes, MA, PhD, University of Waterloo
Vince Mor, PhD, MED, Brown University John Morris, PhD, Harvard University
Gary Naglie, MD, MSc, University of Toronto
Dorothy Pringle, RNMS, PhD, University of Toronto
Paula Rochon, MD, MPH, FRCPC, Women’s College Research Institute
Gary Teare, MSc, PhD, DVM, Saskatchewan Health Quality
Walter Wodchis, MA, MAE, PhD, University of Toronto

People Caring for People Implementation Team

Shirlee Sharkey, Chair
Maureen Hutchinson, Ontario Association of Residents’ Health Quality Ontarios
Robert Gadsby, Family Health Quality Ontarios' Program
Sheldon Wolfson, Ontario Association of Non-Profit Homes and Services for Seniors
Candace Chartier, Ontario Long Term Care Association
Candace Rennick, Canadian Association of Public Employees
Beverly Mathers, Ontario Nurses’ Association
Deborah Hammons, Local Health Integration Networks (LHINs)
Pat Stoddart, LHINs
Debra Bell, Ministry of Health and Long-Term Care