The regulatory changes to the three long-term care facility statutes are enabling, rather than compulsory, i.e. the changes will enable RN(EC)s as either employees or independent contractors to provide health services to residents in long-term care facilities. However, it is not mandatory for long-term care facilities to have RN(EC)s attend to the health care needs of residents. The regulatory changes will enable RN(EC)s to provide health services within their scope of practice in long-term care facilities that the regulations currently require a physician to do.

In addition to the regulatory changes that relate to RN(EC)s, some amendments are being made to allow registered practical nurses to practice within their scope of practice as well. The substantive wording in the regulations will basically remain the same but the role of the RN(EC) and/or RPN will be incorporated into the regulated functions.

Key amendments are as follows :

• Choosing an RN(EC) – The regulatory changes allow the resident to choose an RN(EC). The RN(EC) could be a RN(EC) for the home or could be a RN(EC) that has been treating the resident in the community, that the resident chooses to have follow him/her in the facility (references: s.51 of Regulation 832 under the Nursing Homes Act; s.15 of Regulation 69 under the Charitable Institutions Act; and s.28 of Regulation 637 under the Homes for the Aged and Rest Homes Act).
• RN(EC) to examine patient along with physician – The regulatory changes allow the RN(EC) to conduct physicals and examine residents within the scope of practice (references: ss.51(4) of Regulation 832 under the Nursing Homes Act; s.15 of Regulation 69 under the Charitable Institutions Act ;and s.26 of Regulation 637 under the Homes for the Aged and Rest Homes Act).
• RN(EC) employed as a RN(EC) for the home can authorize leave/ discharge of a resident as well as the physician (references: s.47.2 and s.48 of Regulation 832 under the Nursing Homes Act; s.20.1 and s.49 of Regulation 69 under the Charitable Institutions Act; and s.12.25 and s.47 of Regulation 637 under the Homes for the Aged and Rest Homes Act).
• The RN(EC) will take part in the quarterly review of the resident's plan of care. (references: s.127 of Regulation 832 under the Nursing Homes Act; s.58 of Regulation 69 under the Charitable Institutions Act; and s.68 of Regulation 637 under the Homes for the Aged and Rest Homes Act)
• The RN(EC) will have direct responsibility for the administration and storage of drugs along with the physician and pharmacist. In addition, this is an area where the registered practical nurses are able to practice to the full extent of their scope to administer drugs and have access to the same. (references: ss.63 to 68 of Regulation 832 under the Nursing Homes Act; s. 19 of Regulation 69 under the Charitable Institutions Act; and s.14 of Regulation 637 under the Homes for the Aged and Rest Homes Act.)
• The RN(EC) may be part of the on-call system for emergency services. (reference: s.53 of Regulation 832 under the Nursing Homes Act)

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