CSA Group and HSO Publish National Long-Term Care Standards

Complementary standards address the need for high-quality services and safer environments

Toronto, ON/Ottawa, ON – January 31, 2023 – The COVID-19 pandemic highlighted long-standing issues in Canada’s long-term care (LTC) sector. In early 2021, Health Standards Organization (HSO) and the Canadian Standards Association (also known as CSA Group) were called upon by the Standards Council of Canada (SCC) to develop two complementary long-term care standards. HSO’s standard focuses on the delivery of high-quality long-term care services and CSA Group’s standard focuses on creating safer physical environments.

Today, HSO and CSA Group announce the publication of CAN/HSO 21001:2023 Long-Term Care Services and CSA Z8004:22 Long-Term Care Home Operations and Infection Prevention and Control. Building on previous work and the best available evidence, the standards reflect what Canadians want and expect long-term care to look like, capturing the vision and voices of over 20,000 long-term care home residents, members of the workforce, leaders, and other Canadians to work towards improving long-term care.

Published in January 2023, CAN/HSO 21001:2023 Long-Term Care Services provides guidance on the delivery of safe, reliable, and high-quality long-term care services, enabled by a healthy and competent workforce. The standard was developed by HSO’s Long-Term Care Services Technical Committee, chaired by Dr. Samir Sinha, Director of Geriatrics at Sinai Health and University Health Network in Toronto. The Technical Committee included balanced representation of people with lived experience, the workforce, researchers, and policy and decisions makers.

HSO’s new national LTC Services standard is divided into six sections that provide guidance on: promoting good governance, upholding resident-centred care, enabling a meaningful quality of life for residents, ensuring high-quality and safe care, fostering a healthy and competent workforce, and promoting a culture of quality improvement and learning across LTC homes. The LTC Services standard is intended to be used by LTC home teams (including residents, substitute decision makers, and essential care partners), leaders, governing bodies, policy makers, and external assessment bodies.

Published in December 2022, CSA Z8004:22 Long-Term Care Home Operations and Infection Prevention and Control is intended to provide guidance on safe operating practices and effective infection prevention and control (IPAC) practices in long-term care homes (LTCHs). Chaired by Dr. Alex Mihailidis, Scientific Director & CEO, AGE-WELL NCE, the standard was developed by CSA Group’s Technical Subcommittee on Long-Term Care Homes.

In addition to providing guidance on how to implement safe and effective care in appropriately designed settings, CSA Z8004:22 focuses on recommendations to help ensure person-centered care. The standard is divided into nine unique clauses, covering: organizational commitments, operations, quality improvement, infection prevention and control (IPAC), design, LTCH building systems, information and technology, catastrophic event management, and training and simulation. The intended end-users of CSA Z8004:22 include operational staff, infection prevention and control personnel, directors of care, architects, designers, engineers, governmental bodies, LTCH associations, residents, families, and caregivers.

Both standards were shaped by the needs and voices of long-term care residents, family members, caregivers, the workforce, leaders, and the general public. Public feedback was gathered through extensive public engagement activities including surveys and consultations, throughout the development of the standard.

The standards will work together with jurisdictional requirements, professional regulations, quality improvement initiatives, and other enablers to have a collective impact on long-term care as part of a quality ecosystem. HSO and CSA Group are having ongoing conversations with government decision makers, policy makers, and various industry stakeholders to help ensure that they have the information and tools needed to further implement CAN/HSO 21001:2023 and CSA Z8004:22. This could include the voluntary use of the standards and the standards potentially being incorporated by reference in legislation.

CAN/HSO 21001:2023 Long-Term Care Services will be included in Accreditation Canada’s Qmentum accreditation program to accredit at least 68% of Canada’s LTC homes on both a voluntary and mandated basis. For more information about HSO’s LTC Services standard, please visit https://longtermcarestandards.ca/.

In February 2023, CSA Group will host information sessions to raise awareness of CSA Z8004:22 and its impact on key audiences including frontline workers and operational staff; residents, families, and caregivers; and equity, diversity, and inclusion groups. Beginning in February 2023, CSA Group will also offer online self-directed and instructor-led courses to inform stakeholder groups about the details of the standard. For more information about these sessions and CSA Group’s work in long-term care, please visit the Standards for safer long-term care homes webpage.

Quote (s):

“HSO’s new national LTC Services standard raises the bar of accountability for access to high quality, evidence-informed, resident centered care in healthy and safe working conditions,” says Leslee Thompson, Chief Executive Officer, Health Standards Organization (HSO). “Over 18,800 Canadians participated in the standard development process, and with our partner Accreditation Canada we will strive to ensure the standard is adopted and upheld in every LTC home.”

“CSA Group is proud to be sharing this critically important standard on Long-Term Care Home Operations Infection Prevention and Control,” says Mary Cianchetti, President, Standards, CSA Group. “CSA Z8004 was the outcome of 21 months of dedicated work by our committee members comprised of leading experts, and guided by the input of thousands of Canadians with lived experience. Now that we have this standard in place, we will turn our attention to advocacy, education, and training, to ensure that decision-makers have the information needed to begin implementing the standard across Canada.”

“SCC is very proud of the incredible work that HSO and CSA Group undertook in response to the urgent needs of Canadians,” says Chantal Guay, Chief Executive Officer, Standards Council of Canada (SCC). “They delivered two National Standards of Canada using rigorous standards development processes based on consensus and input from a broad range of interested parties, including the public. We hope that all this work will help bring changes in long-term care, for the benefit of Canadians.”

Media contacts:

Health Standards Organization (HSO)
Brigitte Pellerin
[email protected]
+1 613-738-3800

CSA Group
Kimberly Gibson
[email protected]

Standards Council of Canada (SCC)
Annie Roy
[email protected]
+1 613-238-3222

About Health Standards Organization

Health Standards Organization (HSO) is a global non-profit organization dedicated to working with leading experts and people with lived experience to develop evidence-based standards, assessment programs, and quality improvement solutions. HSO is the only Standards Development Organization (SDO) solely dedicated to health and social services. Affiliated with Accreditation Canada (AC), HSO standards form the basis of AC’s accreditation programs and are used in over 15,000 locations and 38 countries.

About CSA Group
CSA Group is a global organization dedicated to safety, social good and sustainability. We are a leader in North American standards development and in product testing, inspection and certification around the world. Our mandate is to hold the future to a higher standard.

About the Standards Council of Canada

Since 1970, the Standards Council of Canada (SCC) has helped make life safer, healthier, more prosperous and sustainable for people, communities and businesses in Canada through the power of standardization. SCC works with a vast network of partners nationally and around the world, acting as Canada’s voice on standards and accreditation on the international stage, including as a member of the International Organization for Standardization (ISO) and International Electrotechnical Commission (IEC). As the country’s leading accreditation organization, SCC creates market confidence at home and abroad by ensuring conformity assessment bodies meet the highest expectations. In all these ways, SCC opens a world of possibilities.


January 31, 2023