This 101-page research paper documents the access and quality problems in residential long-term care, and their causes, urges governments and employers to improve seniors’ care and offers proven solutions.

CUPE represents 67,000 people who work in long-term care facilities across Canada, caring for the 200,000 people who live in these facilities.

Our working conditions are residents’ caring conditions.

The research shows:

  • there are enormous variations across provinces in the availability of services, level of public funding, eligibility criteria, and out-of-pocket costs borne by residents
  • residential long-term care in Canada is a two-tiered system
  • the long term care system faces increased pressure, with an aging population, yet most provinces have narrowed access
  • quality of care is jeopardized by chronically low staffing and poor working and living conditions
  • for-profits have, on average, lower staffing and worse conditions

To solve the inequities, lack of access and uneven standards of care, CUPE recommends that governments and employers:

  • Extend medicare to residential long-term care, with increased federal funding tied to legislated standards, including Canada Health Act criteria (public administration, universality, comprehensiveness, accessibility, and portability) and conditions (no user fees or extra billing). Quebec should have the right to opt out without penalty.
  • Expand residential long-term care, home and community care services to meet the needs of Canadian seniors, as part of a comprehensive and integrated system.
  • Establish non-profit ownership and operation of long-term care facilities by phasing out public funding to for-profit providers and ending contracting out.
  • Establish provincially-legislated quality of care standards for residential long-term care facilities, including minimum staffing levels.
  • Increase staffing (direct care and support staff) in residential long-term care facilities.
  • Provide safe and healthy work environments that support high quality care.
  • Support education and professional development of residential long-term care workers.