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Canadian Network for the Prevention of Elder Abuse ~~~~~ Réseau canadien pour la prévention des mauvais traitements envers les aîné(e)s
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Mandatory Reporting Requirements Across Canada for Abuse and Neglect in Institutions
Several provinces and territories in Canada require people to report suspected abuse or neglect of residents that occurs in a facility such as a nursing home, personal care home, or residential care facility.
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There are four main ways this can occur.
1. Special legislation: Alberta and Manitoba have special legislation for abuse or neglect occurring in institutions (see below).
2. Other general legislation: Other jurisdictions may place a special duty on the operator to protect residents from abuse or neglect and will require people to report suspected abuse or neglect situations to an outside authority.
3. Regulations, standards and guidelines for care: Some provinces and territories may include abuse or neglect as one of the special kinds of "incidents" which the care facility operators are required to report. A health authority or other funding body may require a publicly funded operator to respect certain standards and guidelines, as part of the funding contract. This is often the case for licensed facilities.
In many instances, the reporting is only required where there has been an injury, hospitalization, or death, and it does not necessarily have to be caused by abuse or neglect of the resident.
4. Internal or external policies: These focus on reporting and responding to abuse or neglect situations internally.
Provinces and territories vary in the types of abuse or neglect they cover in their reporting requirements, and may use more than one approach.
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The table below identifies where there are legal responsibilities to report abuse or neglect of older adults in institutions, as well as whether there are any specific legal protections for people making reports.
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* The Criminal Code of Canada (Bill C-13) was amended in 2004 to make it illegal for an employer to threaten or take disciplinary or retaliatory action against an employee who believes that a provincial law is being violated and who then reports that potential violation to an authority who is responsible for enforcing the law. This "whistleblower" protection law would apply in all provinces and territories to staff of long term care facilities when they are making reports to licensing or other designated authorities about violations affecting the health and safety of the residents.
In addition, labour standards and occupational health standards in some provinces provide protections from reprisals to staff who are reporting health of safety violations related to their working conditions. (1)
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| Province or Territory | Mandatory reporting for abuse in institutions? | Types of harms covered by the law or regulations on institutions to be reported | Any protection for reporting * | Any penalty for not reporting? | ||||||||||||||||||||
| Alberta | Yes (Protections for Persons in Care Act)* but only if it is a publicly funded facility. |
Intentional harms...
(See Note 15) and only if it is a publicly funded facility
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Yes, s. 4 (1), no action against reporter unless the report is made "maliciously or without
reasonable and probable cause" s. 4(2) no action against employee making report s.4(3) no reprisal against person in care
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Yes, under PPCA.
Can be fined. |
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| British Columbia (2) | Community Care and Assisted Living Act -Operator required to report "reportable incidents" in licensed community care facilities (complex care). Reports of the incident are to be made to
[see note 7] -No similar reporting requirement for abuse or neglect occurring assisted living facilities.
~~~ - Part 3 of Adult Guardianship Act, covers community and institutions. -Has voluntary reporting in general. - But duty on designated agencies to report crimes occurring in community or institution to the police. (s. 50)
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Community Care and Assisted Living Act covers
for community care facilities only.
~~~ AGA covers
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Community Care and Assisted Living Act, s. 22 (1)
protection from lawsuits for reporting abuse or neglect in licensed long
term care facility as long as made in good faith;
s. 22 (3) protection for person in care- protection from reprisals
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Adult Guardianship Act, Part 3, s. 46 (3) & (4) --reporter has protection from lawsuit for damages; protection in employment
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None noted for failure to report under the
Community Care and Assisted Living Act
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No, reporting is voluntary under Adult Guardianship Act. |
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| Manitoba | Yes (Protections for Persons in Care Act) (PPCA) Applies to hospitals, personal care homes and other health facilities as determined by regulation.
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[See Note 16] |
Immunity from proceeding or other action, if reporting abuse of vulnerable person in good faith ~~~
Protection from lawsuit or other action (s. 10); and protection in employment for reports made in good faith (s.11(1)); s. 11 (2) no retaliation against resident or person making report |
Under PPCA Yes, up to $2,000 fine for individual, $30,000 for corporation.
$2,000 fine for false report. |
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| New Brunswick (3) | No specific provision for abuse or neglect. However, under Nursing Home Act, s.19, the operator has duty to report "major incident or accident affecting health or safety of residents or staff."
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not defined | na | Class H Offense Operator may be fined $500 to $10,250 for failure to report major incident in nursing home; or imprisonment up to 180 days |
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| Newfoundland & Labrador | Nothing mentioned in homes for special care act or private homes for special care act. | na | Nothing specifically stated | na | ||||||||||||||||||||
| Northwest Territories | na | na | na | na | ||||||||||||||||||||
| Nova Scotia (4) | Homes for Special Care Act.
The facility Administrator must report "unusual occurrences" in a form once every three months. Reg. s. 23 (2) (b) & 4
Applies to nursing homes, homes for the aged, and residential care facilities.
~~~ In October, 2004, the Protection of Persons in Care Act was passed by the Nova Scotia Legislature. It is not in force yet. |
not identified
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None noted
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Yes, any contravention of the Act can carry fine of up to $100, or imprisonment up to 30 days.
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| Nunavut | na | na | na | |||||||||||||||||||||
| Ontario | Yes Nursing Homes Act, s. 25 (2) [See note 8] Charitable homes required to report to Director any assault or any injury where taken to hospital, or accidental/ unexplained death. (Regulation, s. 31.1) There is a similar requirement in the Nursing Home Act, Regulation, s.96. and a similar requirement under Homes for the Aged and Rest Homes Act. Regulation, s. 25.1 (1). R.R.O. 1990, Regulation 637.
These will be repealed when Ontario's Long Term Care Homes Act, 2007 comes into Force.
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Nursing Home Act: mental and physical abuse, violation of
certain rights, restraints. ~~~
No similar reference to abuse or neglect in Homes for Aged and Rest Homes Act or
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Yes, s. 24.3
(1) & (2) of
Nursing Home Act, protection from reprisals
when making disclosure to inspector s. 25 (2) & (3) protection of job if reporting, as long as not malicious or without reasonable grounds ~~~ s. 21.4 of Homes for Aged and Rest Homes Act protection from reprisals when making disclosure to inspector in good faith.
~~~ s.10.4(1) of Charitable Institutions Act protection from reprisals when making disclosure to inspector in good faith.
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Contravention of almost any section of the
Nursing Home Act by an individual is an offense. On conviction, may
carry fine up to $25,000 or jail up to one year for the 1st
offense. (s. 36.1). Fine on first offense is up to $50,000 for a
corporation.
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| Prince Edward Island (5) | No, not to outside authority. Nursing home operator only required to record injury, medication or treatment error on an incident report. [See note 9]
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not identified | Yes, s. 4 (3) Adult Protection
Act offers protection from lawsuit as long as report not made
maliciously or without reasonable and probable cause. [However, see Note 5 on whether APA in PEI applies to institutions] |
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| Quebec (6) | No [See note 10] |
na | na | na* | ||||||||||||||||||||
| Saskatchewan | Yes Under regulations to the Personal Care Home Act, operator must report all "serious incidents" to resident's supporter and health authority. Abuse and neglect are defined as "serious incidents". |
"Any harm or suspected harm suffered by a resident as a result of unlawful conduct, improper treatment or care, harassment or neglect on the part of any person" -"any occurrence, accident or injury that is potentially life threatening"; - deaths reportable to Corner- [See Note 17]
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None noted | s. 20 provides fine for
any violation of the Act.
The fine is up to $1000 for and an individual, and $5000 for a corporation, with additional $200 fine for the individual for each day the offence occurs, and $1000 a day in the case of a corporation. |
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| Yukon | [See Note 11] Relies on policy to report internally, not legislation or regulation. |
na | ||||||||||||||||||||||
(1) For example, Ontario's Occupational Health and Safety Act, R.S.O. 1990, c. O.1 prohibits employers from taking reprisals against a worker because the worker has complied with the Act, sought its enforcement, or given evidence in a proceeding brought under the Act. The focus is on workplace safety, not resident safety.
There are other areas that potentially overlap with resident safety. In 2003, Saskatchewan established mandatory reporting of medical errors. See, Canadian Medical Association Journal, (Jan 2, 2003). "Saskatchewan first province with mandatory reporting of medical errors": www.cmaj.ca/news/02_01_03.shtml
(2) Adult Guardianship Act R.S.B.C. 1996, c.6, Pt.3
(3) Family Services Act, S.N.B. 1980, c.F-22 (as amended)
(4) Homes for Special Care Regulations, made under Section 19 of the Homes for Special Care Act, R.S.N.S. 1989, c. 203. O.I.C. 77-1261 (October 11, 1977), N.S. Reg. 127/77, as amended up to and including O.I.C. 93-404, (April 20, 1993), N.S. Reg. 73/93.
Please note, Nova Scotia's Adult Protection Act (which has mandatory reporting) only applies to where the abuse is occurring in the person's home and does not apply to institutions. There is currently a review of the Act. One of the recommendations from that review may be that the Homes for Special Care Act and regulations are strengthened to deal more effectively with abuse or neglect in facilities.
A discussion paper on adult protection in the province states that it would be cumbersome to apply the adult protection law to special care homes. It also suggests that "While cases of abuse/neglect may occur in these homes, they are the exception." (pg. 22) It should be noted that placement in special care homes is one of the commonly used interventions in Nova Scotia for abuse or neglect of older adults, particularly for situations involving self neglect.
Nova Scotia Dept. of Health. (September, 2004) Adult Protection Act: A Discussion Paper. www.gov.ns.ca/health/ccs/discussion_paper.pdf
(5) Adult Protection Act, R.S.P.E.I. 1998, c.A.5 Prince Edward Island's adult protection legislation does not specifically identify whether or not it only applies to abuse or neglect in the community. The definition of a "person in need of protection" could easily apply to abused or neglected older persons in institutional settings,. The Act is being used by adult protection services for harms occurring in long term care facilities.
The resources and types of assistance including respite services and institutional placement, identified under the Act, appear to assume that the abuse or neglect is occurring in the community, not an institutional setting such as a nursing home.
(6) Charte de droits et libertés de la personne L.R.Q. c.C-12, s. 48
www2.publicationsduquebec.gouv.qc.ca/home.php
(7) Includes neglect, emotional, physical, sexual and financial abuses, falls, emergency restraint.
(8) In Ontario, there are three Acts that regulate long-term care facilities (Nursing Homes Act, Homes for the Aged and Rest Homes Act and the Charitable Institutions Act). Each includes a Residents' Bill of Rights. The Residents' Bill of Rights spells out in detail residents' rights and the responsibilities of the facility to fully respect, promote and support these rights, as well as residents' autonomy and decision-making.
In response to the Commitment to Care report by Monique Smith, Ontario planned to consolidate the three Acts. See Nov, 3, 2004 news release. In 2007, Bill 140 Long Term Care Act (which among other things consolidated the three Acts) received royal assent, but is not yet in force.
(9) Nursing Home regulations under PEI Community Care Facilities and Nursing Home Act . Nursing home operator is required to inform next of kin, guardian or friend if resident "suffers an injury, a serious change in his condition, or dies" (s. 35 of Nursing Home Regulations).
(10) There is no legal obligation to report abuse in long term care facilities in Québec. However, people can report abuse to the institution's resident/users committee.
 | Or they can address a formal complaint (plainte) to the «commmissaire à la qualité» of the institution (Loi sur les services des santé et les services sociaux) or to the Commission des droits et libertés de la personne (Charte québécoise des droits et libertés de la personne). A few complaints regarding financial exploitation by operators of small care homes in Quebec have been investigated by Commission des droits et libertés de la personne (Quebec Human Rights Commission). |
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In their 1995 Health Canada report on abuse in institutions, Beaulieu and Tremblay note: |
"The 1991 reform of Quebec’s act concerning health and social services (loi sur la santé et les services sociaux) included three provisions aimed directly or indirectly at preventing or responding to abuse and neglect: each institution is required to adopt its own code of ethics, set up resident committees to give older adults and their families a say, and provide grievance committees to which older adults and their families can bring their complaints (Gouvernement du Quebec, 1993). This reform has improved protection for residents of institutions. However, caregivers sometimes face an ethical dilemma: they must protect older adults against all threats or mistreatment, but they must also respect the older adult’s right to act or not to act."
http://dsp-psd.pwgsc.gc.ca/Collection/H72-21-133-3-1995E.pdf
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On December 10, 2004, Quebec Health Minister Philippe Couillard stated the provincial officials were drafting standards for nursing homes, including private long term care homes. CBC News December 10, 2004. "Province to toughen nursing home standards". http://montreal.cbc.ca/regional/servlet/View?filename=qc-homes20041210 |
(11) Residential care facilities in the Yukon are governed by the Hospitals Act.
(12) Sexual abuse: (non-consensual sexual contact, activity or behaviour)
(13) Financial abuse: intentionally misappropriating or improperly or illegally converting money or other valuable possessions. Does not cover financial abuse by family members.
(14) Neglect: intentionally failing to provide adequate nutrition, adequate medical attention or other necessity of life without a valid consent.
(15) Alberta's Protection for Persons in Care Act does not cover psychological neglect, violation of rights, inappropriate physical restraints, financial abuse by family, not cover any systemic issues.
(16) Manitoba's Protection for Persons in Care Act does not cover inappropriate chemical or physical restraints, or violation of rights. Physical abuse is interpreted as including physical neglect.
(17) Includes deaths that occurred (a) as a result of an accident or violence or was self-inflicted; (b) from a cause other than disease or sickness; (c) as a result of negligence, misconduct or malpractice on the part of others; (d) suddenly and unexpectedly when the deceased appeared to be in good health.
(*) Not specifically identified in the legislation, but in practice, it has been interpreted as included.
Canadian Network for the Prevention of Elder Abuse. Page last updated Friday April 24, 2009
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