Long-term care staffing issues have reached a crisis state. Pre-COVID-19 staffing shortages in long-term care were well-documented and a consistently pressing concern. Since COVID-19, staffing shortages have reached the breaking point. Staff in long-term care are often underpaid, may have to work several jobs with unpaid travel time, and often have to work in difficult and unsafe conditions.

In Ontario, 80% of nursing home administrators reported having difficulty scheduling shifts, which can impact their ability to meet regulatory requirements. They reported that of the positions to be filled, personal support worker positions were the most difficult to fill.

Recommendation #76: Staffing Ratios

• Establish staffing ratios and increase staffing numbers. Include both staff-to-resident ratios as well as establishing healthcare staffing ratios of doctors, registered nurses, licensed practical nurses, rehabilitation care providers, social workers, and personal support workers. Stop downloading healthcare to personal support workers in long-term care.

Recommendation #77: Living Wages, Benefits and Pensions

• Increase pay for staff, particularly personal support workers, to ensure living wages are achieved, including pensions and benefits. Encourage full-time work at one long-term care location. This will improve employee engagement, create stable staffing and care relationships while decreasing the potential of cross-home infection spread.

Recommendation #78: Pay Staff by Work Performed, Not Location

• The financial compensation of home and long-term care staff is half of what hospital staff receives, with the same qualifications. Financially compensate health and social care staff for the work they perform, not the place where they perform their work responsibilities. Pay equity should be established among long-term care, home care and hospital care settings.

Recommendation #79: National Strategy for the Health & Human Resources (HHR) Sector

• Care provision requirements for the aging population will increase. In order to adequately meet these requirements, as well as meet long-term care residence staffing needs while avoiding retrieving staff from other care sectors such as home care, Canada urgently requires a national strategy for the health and human resources necessary for current and future needs. Provinces and territories must work collaboratively with the federal government, on a F/P/T basis, to create and implement this strategy with key stakeholders in the sector.

Recommendation #80: Immigration Priority for the Aged Care Sector

• Establish home care and long-term care worker immigration as part of the skilled worker priority status. This should be integrated as part of a broader integrated health and human resources aged-care staffing strategy. Recruitment expertise should focus on aging and dementia care. Reinstate the Live-In Caregiver Immigration Program with updated care recruitment needs. Prioritize recruitment expertise in aging and dementia care.