Ontario Maximizing Critical Care Capacity to Support Hospitals
April 28, 2021
TORONTO — In response to the recent and rapid rise in hospitalizations, ICU admissions and the threat to the province’s critical care capacity, the Ontario government, in consultation with the Chief Medical Officer of Health, is taking further action to ensure hospital beds are available for COVID-19 patients in need of urgent care. To do so, the province is amending O. Reg. 272/21 under the Emergency Management and Civil Protection Act (EMCPA) to ensure patients receive quality care in the most appropriate setting during the third wave of the pandemic, driven by variants of concern. This temporary emergency order will provide hospitals with the flexibility to transfer patients whose doctors have determined no longer require hospital care to long-term care or retirement homes without obtaining the consent of the patient or, where the patient is incapable, their substitute decision maker. The amended order can only be used during major surge events where the demand for critical care threatens to overwhelm a hospital and compromise care. Hundreds of individuals in hospital are waiting to be discharged to a long-term care home or another more appropriate care setting and first priority will be given to patients with less complex care needs and those who are able to be moved close to their preferred choice. “The spread of COVID-19 variants continues to pose a significant threat to our health system’s critical care capacity and the lives of Ontarians,” said Christine Elliott, Deputy Premier and Minister of Health. “While this is an extremely difficult decision to make, the consequences of not doing so could be devastating if we don’t have the hospital beds we urgently need to care for the growing number of COVID-19 patients. Building on the more than 3,400 beds that have been added to the system since the beginning of the pandemic, our government will continue to take all necessary actions to ensure Ontarians have a safe place to be cared for in our hospitals.” Hospitals may rely upon this order only when necessary to respond to a major surge event, when the attending physician is satisfied that the patient will receive the care they require at the long-term care or retirement home. Transfers will only be made when medical professionals are confident they will not compromise the patient's medical condition, and where all of the other conditions specified within the order have been met including agreement by the home that they can meet the patient’s needs. Every effort will be made to ensure these patients are fully immunized from COVID-19 before moving. Patients who are not placed in their first choice of long-term care or who are transferred to a retirement home will retain their priority on the long-term care waitlist for their first-choice home. On April 23, 2021, the government waived the co-payment for hospital patients with a destination of long-term care who are transferred to a long-term care home that is not their first choice until they transfer to their first-choice home or decide to stay in their current home. Similarly, the retirement home’s care and accommodation costs to the individual will be waived until they receive a placement offer from their first-choice long-term care home. Funding will be provided to the retirement home from the government. “Ontario’s retirement homes can provide a safe and welcoming environment with the vast majority of residents being fully vaccinated during Phase One of the province’s rollout,” said Minster for Seniors and Accessibility, Raymond Cho. “As we work together to support Ontario’s health network, retirement homes are well positioned to assist by providing the appropriate level of care to patients in need.” Quick Facts
Since the onset of the pandemic, the government has made significant investments to build capacity and maintain the integrity of Ontario’s health system, including investing $5.1 billion to support hospitals and create over 3,100 more hospital beds.
Based on the latest modelling data, COVID-19 cases, hospitalizations and ICU occupancy are continuing to increase rapidly and are now at their highest levels since the start of the pandemic in March 2020. The Science Advisory Table projects that the number of COVID-19 patients in ICU will reach 1,100 and around 1,200 acute care COVID admissions by May.
As of April 22, there are 4,288 patients in hospitals who physicians have determined no longer require acute hospital care, of which 1,854 are waiting for a long-term care home (LTCH) bed. As of April 14, there are 5,401 LTCH vacant beds available for new residents.
As of April 27, 2021, over 4.7 million vaccine doses have been administered across the province, this includes 64,000 long-term care residents and 56,000 retirement home residents who have been fully vaccinated.
On April 20, 2021, the province updated Directive 2 for health care providers, instructing hospitals to cease all non-emergent and non-urgent surgeries and procedures in order to preserve critical care and human resource capacity.
On April 9, 2021, the province issued an emergency order authorizing hospitals to transfer patients between hospital sites without the consent of the patient or their substitute decision maker – in order to maximize system capacity. These additional measures will support building capacity of up to 1,000 critical care beds in Ontario for patients requiring more complex health care.
Ontario is also now allowing the redeployment of Ontario Health and Home and Community Care Support Services staff to long-term care and retirement homes to support these transfers and ensure patients receive the level of care they need. The government is also exempting fully immunized long-term care home and retirement home employees from restrictions that prohibit them from working in more than one long-term care home, retirement home or other heath care settings. Quotes "With ongoing, high levels of hospitalization and almost 900 COVID patients now in intensive care units, Ontario’s hospitals are grappling with an enormous challenge to provide access to care for critically ill and other very sick COVID and non-COVID patients. Hospitals are doing everything they can to maintain and sustain capacity by transferring patients out of hotspot regions and redeploying staff and resources but the pressures are unrelenting. Thousands of people continue to wait in hospital for discharge to other more appropriate settings, including long-term care. Using temporary policy measures, it may be possible to safely and effectively increase the number of patients being discharged to a care setting more appropriate to their health needs. The Ontario Hospital Association recognizes that great sensitivity to the care needs of residents is required at all times, especially under today’s very challenging conditions. It is essential that hospitals work very closely with patients and families experiencing a transition in care during this difficult period." - Anthony Dale President and CEO of the Ontario Hospital Association "Retirement communities understand their important role in the continuum of care and their ability to help alleviate capacity pressures in the greater health system. Having done extraordinary work to keep their residents safe during the pandemic, ORCA’s regulated members will work with their health system partners to support those seniors, where their care needs can safely be met in a retirement residence, and to provide additional capacity in light of these urgent conditions." - Cathy Hecimovich CEO of the Ontario Retirement Communities Association "We are thankful to our long-term care partners as the current wave requires a system response. Facilitating the safe transfer of some long-term care patients to available long-term care beds, while they wait for their home of choice, will allow hospitals to use acute care beds and staff to care for the critically ill." - Barb Collins President and CEO of Humber River Hospital "Fortunately we have protected seniors residing in long-term care with access to full vaccination, as well as those who provide care for them. In order to meet the coming critical care demands we must create capacity in hospitals. To do this requires the relocation of those waiting for long-term care in hospitals to homes that have vacancies and can safely care for these citizens. I appreciate the government’s willingness to support this through an emergency order at this very difficult time." - Dr. Kevin Smith President and CEO of University Health Network "We are grateful for the decision by government today as it provides for the tools to effectively transfer patients waiting for long-term care (LTC) in hospital to the most appropriate safe setting in LTC, thereby relieving the pressure on hospitals in hotspot areas who are experiencing the impacts of the wave 3 surge." - Michelle DiEmanuele President and CEO of Trillium Health Partners "The third wave of the pandemic is placing incredible pressure on health care across Ontario. In response, Ontario’s hospitals are taking extraordinary efforts to work in partnership as one hospital system. Hospitals have also worked in close partnership with the long-term sector since the beginning of the pandemic and it is crucial to continue this partnership to ensure every Ontarian receives the best care in the most appropriate environment." - Dr. Gary Newton President and CEO of Sinai Health "Four months ago, the government prioritized vaccinations for long-term care residents, and then staff. The vaccines saved lives. Now, allowing fully vaccinated staff to work at more than one home, and ensuring home and community care staff are redeployed into long-term care, will help alleviate staffing shortages and allow more homes to take additional residents from overwhelmed hospitals." - Donna Duncan CEO of the Ontario Long-Term Care Association "As the pandemic rages on, long term care homes across Ontario are doing everything they can to assist during this challenging third wave. By opening their doors to as many hospital patients waiting for long term care as homes can safely accommodate, hospitals will be able to care for more COVID-19 patients. We continue to work together to care for Ontarians." - Lisa Levin CEO of AdvantAge Ontario Additional Resources
Visit Ontario’s COVID-19 vaccine web page to view the latest provincial data and information on COVID-19 vaccines.
Visit Ontario’s COVID-19 information website to learn more about how the province continues to protect the people of Ontario from the virus.
For public inquiries call ServiceOntario, INFOline at 1-866-532-3161 (Toll-free in Ontario only).