Ministry of Health Long-Term Care Rules in Ontario vs the US: Which Duties Apply to Your Home?
A care home manager and a nursing director in two countries can read the same word, infection control, and still be planning two different sets of duties. Ontario and the United States both write infection prevention into care home law, but the named roles, reporting routes and review cycles do not line up. For a buyer, that gap decides what gets stocked, what gets logged and what evidence must exist on a shelf.
- Ontario: the Fixing Long-Term Care Act, 2021 and O. Reg. 246/22 set the program, the lead role and the review cycle.
- United States: 42 CFR 483.80 sets the program, the infection preventionist role and an annual influenza window.
- The two systems name different people, require different evidence and run on different clocks, so an order list built for one system misses one of the two cycles.
What does Ontario require of a long-term care home?
Ontario's requirements sit in two instruments. The Act, the Fixing Long-Term Care Act, 2021, creates the duty to run an infection prevention and control program. The detail lives in O. Reg. 246/22, and section 102 is the section to read first, because it turns a general duty into named roles, meeting intervals and records.
- s. 102 (5): the licensee designates a staff member as the infection prevention and control lead, with education and experience across ten named areas, including infectious diseases, cleaning and disinfection, data collection and trend analysis, outbreak management, asepsis and epidemiology.
- s. 102 (6): that lead must hold a current certification in infection control from the Certification Board of Infection Control and Epidemiology at designation, or obtain it within three years.
- s. 102 (4) (c): the interdisciplinary team, which includes the lead, the Medical Director, the Director of Nursing and Personal Care and the Administrator, meets at least quarterly, and more often during an outbreak.
- s. 102 (4) (e) and (f): the program is evaluated at least annually, with a written record of the date, participants and changes.
Reporting is provincial, not federal. Section 102 (4) (d) requires the local medical officer of health to be invited to those meetings, and section 102 (19) routes outbreak reporting to that officer and to the home's infection prevention and control hub.
Does a US nursing home have the same duties?
The US rule is one section of the federal nursing home requirements. 42 CFR 483.80 requires a program with four minimum elements: a system for preventing, identifying, reporting and controlling infections; written standards, policies and procedures; an antibiotic stewardship program with monitoring; and a system for recording incidents and corrective actions.
The role duty differs in shape. The facility must designate one or more infection preventionists with primary professional training in nursing, medical technology, microbiology, epidemiology or a related field, qualified by education, training, experience or certification, working at least part-time and holding specialised training. The US text names no certification body, but it adds a duty Ontario does not state: the role must sit on the quality assessment and assurance committee and report to it. It also requires influenza immunization to be offered each year from October 1 to March 31.
| Item | Ontario (FLTCA, O. Reg. 246/22) | United States (42 CFR 483.80) |
|---|---|---|
| Governing instrument | Act plus General regulation | single federal section |
| Named role | infection prevention and control lead | infection preventionist |
| Credential | certification in infection control from the named board, at designation or within three years | specialised training; qualified by training or certification |
| Team or committee | interdisciplinary team meets at least quarterly | infection preventionist sits on the quality assessment and assurance committee |
| Program review | at least annually, with a written record | written policies plus an incident recording system |
| Outbreak route | local medical officer of health and the home's IPAC hub | per the facility's own written policy |
| Resident immunisation | not set in this section | influenza offered annually, October 1 to March 31 |
Which supply duties come with the program?
Both systems push work onto consumables, but through different clauses. Ontario is explicit: the housekeeping clause names the supplies and ties them to the lead role.
| Ontario clause | Duty | Supplies it drives |
|---|---|---|
| s. 93 (2) (b) | clean and disinfect resident care equipment and contact surfaces with a low level disinfectant at minimum | disinfectant, wipes, gloves |
| s. 93 (4) | housekeeping equipment and cleaning supplies readily available to all staff | restocking at par, not on request |
| s. 95 (1) (b) | clean linen, face cloths and bath towels always available | washcloths and bed linen |
The word sufficient is a stocking standard rather than a product standard, which is why par levels are set by resident day. Our disposable washcloths and examination gloves sit in that recurring group, alongside isolation gowns and face masks for outbreak periods.
Which homes does each rule cover?
Coverage is the quiet difference. In Ontario, a long-term care home and a retirement home are two licensed categories with two rulebooks, while the US rule reaches the federally certified nursing facility. A retirement home is regulated under the Retirement Homes Act, 2010 and its General regulation, O. Reg. 166/11, a different instrument. A supply plan copied from a nursing home cannot simply be applied to a retirement home, even though the two look similar on the floor.
For a group running homes on both sides of the border, the result is one order list with two review clocks: a quarterly team meeting and an annual evaluation in Ontario, and an annual immunization window plus committee reporting in the US.
Ordering for a care home or a multi-site group? Wholesale and multi-site ordering covers case pricing and account setup, and the B2B wholesale collection lists the lines stocked for institutional buyers, including the long-term care supplies range.
References
- Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1 (checked 26 September 2026)
- Ontario Regulation 246/22, General, s. 93 and s. 102 (checked 26 September 2026)
- 42 CFR 483.80, Infection control (checked 26 September 2026)
- Ministry of Long-Term Care, Province of Ontario (checked 26 September 2026)
Related Reading
- LTC outbreak preparedness: an Ontario case review
- Isolation gowns for Ontario LTC homes: what inspectors look for
- Retirement home supplies in Ontario: RHRA compliance guide
Frequently Asked Questions
Which ministry regulates long-term care in Ontario?
Long-term care homes in Ontario are licensed under the Fixing Long-Term Care Act, 2021 and its General regulation, Ontario Regulation 246/22. The sector is administered by the Ministry of Long-Term Care, a separate ministry from the Ministry of Health; the medical officer of health role comes from the Health Protection and Promotion Act.
Does an Ontario care home need a certified infection control lead?
Yes. O. Reg. 246/22 s. 102 (6) requires the designated infection prevention and control lead to hold a current certification in infection control from the Certification Board of Infection Control and Epidemiology at designation, or obtain it within three years.
Is the US infection preventionist the same role as the Ontario lead?
No. 42 CFR 483.80 (b) requires an infection preventionist qualified by education, training, experience or certification, working at least part-time. The US text names no specific credential, and it adds a duty Ontario does not state: the role must sit on the quality assessment and assurance committee.
How often must the infection control program be evaluated?
Ontario sets an explicit cycle. O. Reg. 246/22 s. 102 (4) (c) requires the interdisciplinary team to meet at least quarterly, and more often during an outbreak, while s. 102 (4) (e) and (f) require an annual evaluation with a written record of the date, the participants, the changes made and the implementation date of each change.
Can an Ontario long-term care article about sterilizers cite this regulation?
No, and this is a common error. A search of O. Reg. 246/22 returns no occurrence of sterilization or reprocessing. The regulation works through the program and the supply duties in s. 93, so sterilization frequency must be sourced elsewhere.
Last updated: September 2026. CliniEco Medical is a licensed medical device establishment (MDEL #35334).
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