A Sector Transformed by Crisis 

Canada’s long-term care sector did not break during the COVID-19 pandemic. It simply cracked along the fault lines that had always been there. The crisis didn’t create the systemic issues of underfunding, inconsistent standards, and workforce strain; it merely brought them into painful focus. 

Today, long-term care is at an inflection point. Quality professionals are being asked to do more than maintain baseline safety. They are being called to lead transformation and one that prioritizes not only care, but quality of life, and not only residents, but the teams who serve them. 

As Nelea Lungu, Executive Vice-President at Health Standards Organization (HSO) and Accreditation Canada, emphasized during a keynote session, “It is not about accreditation. It is about the quality and safety of care and services we provide to this population.” 

That reframe, one that centers people over process, has become the philosophical backbone of a new era in Canadian long-term care.

Redesigning Standards with Purpose and Participation 

To understand where we’re going, we need to consider how the latest national long-term care standards were built. HSO, alongside the Canadian Standards Association and in partnership with Health Canada, co-developed a modernized framework designed to guide LTC organizations across the country toward safer, more equitable, and resident-centered care. 

But this wasn’t a closed-door process. Over 18,000 Canadians contributed to its development—including residents, families, caregivers, policy experts, and Indigenous voices. 

Lungu emphasized that this was a deliberate and defining choice. 

Six foundational principles emerged from the process:

• Commitment to resident-centered care 

• Workforce support and well-being 

• Cultural safety and trauma-informed practices 

• Team-based accountability 

• Continuous data-informed quality improvement 

• Alignment with jurisdictional legislation 

These principles are no longer abstract ideals, and instead, embedded in every operational expectation of the standard. 

Elevating Quality of Life as a Measurable Outcome 

One of the most significant philosophical shifts in the new framework is the inclusion of quality of life, not just quality of care, as a central objective. Historically, clinical outcomes and compliance indicators dominated accreditation efforts. But in long-term care, where residents often spend the final chapters of their lives, safety is not enough. 

“For this sector specifically,” said Lungu, “the most important piece is quality of life. We are talking about people’s homes. The question isn’t just whether we keep them safe—it’s whether we help them live well.” 

That means attention to emotional well-being, autonomy, community belonging, and human connection. In practice, this could mean more purposeful engagement with families and volunteers, more flexible approaches to risk, and greater emphasis on programs that bring joy such as music, arts, intergenerational connections, and culturally rooted care. 

It’s also a shift in how success is measured. LTC homes are encouraged to develop their own locally relevant indicators tied to quality of life goals, using these as part of their continuous improvement efforts.

From Episodic Inspection to Continuous Improvement 

Under the previous model, LTC homes typically prepared for accreditation like a high-stakes exam which is intense, infrequent, and often disconnected from everyday care. The updated Centum Global Long-Term Care Accreditation Program changes that entirely. 

This means that instead of preparing once every few years for an on-site survey, organizations are engaged in year-round assessment activities, including: 

• Staff-led self-assessments 

• Leadership attestations 

• Dynamic quality improvement plans 

These are designed to be practical, actionable, and integrated into existing workflows. The effect is cultural as much as operational. When quality becomes a daily habit rather than a rare performance, staff feel more ownership, and most importantly, less pressure. 

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