Summary: Assisted and retirement living is becoming a big problem for governments around the world. There has been a bed shortage for years. Technology today, especially in building construction should help speed up the building of facilities for seniors. Local and provincial governments need to work together on zoning changes as part of managing vacant property and/or vacant spaces. The emergent of online shopping has change the retail and distribution model, especially in areas like commercial and industrial property. OAS payments need to rise as part of addressing income issues with seniors GIS needs to adjust its threshold from 19K to 40K as part of expanding assistance to seniors Rent subsidies to seniors need to increase Provincial government need to review their rent approval process as part ensuring affordable rents Mandatory audits and reporting of all LTC and Assisted Living facilities. More money needs to be spent on adding more auditors as well as looking at Data and AI as part of automating risk and compliance programs. Healthcare needs to move to homecare model. All levels of government need to focus on eliminating waste including the LHINs More funding for health and wellness programs for seniors

1. RETIREMENT
AND ASSISTED
LIVING
• Paul Young CPA CGA
• August 25, 2022

2. PAUL YOUNG - BIO
• CPA, CGA
• Academia (PF1, FA4, FN2, MU1. and MS2)
• SME – Risk Management
• SME – Close, Consolidate and Reporting
• SME – Public Policy
• SME – Emerging Technology
• SME – Business Process Change
• SME – Financial Solutions
• SME – Macro/Micro Indicators
• SME – Supply Chain Management
• SME – Data, AI, Security, and Platform
• SME – Internal Controls and Auditing
Contact information email: Paul_Young_CGA@hotmail.com
LinkedIn: https://www.linkedin.com/in/paul-young-055632b/
SlideShare - https://www.slideshare.net/paulyoungcga
Twitter: https://twitter.com/paulyoungcpa

3. AGENDA
• Retirement home break down
• Homecare / Canada
• National Standards
• Mortality rate / Canada
• Audit Reports – Retirement Homes – Diet
• Audit Reports – Patient Care
• Audit Reports – Quality
• OECD
• Revera
• Seniors / Poverty
• Analytics
• Medical Equipment and Supplies
• What’s needs to be done
• Training/Professional Development Courses
Assisted and Long-term Care
3
3

4. RETIREMENT HOME BREAKDOWN
Source - https://www.bcmj.org/news/statistics-canada-almost-5-seniors-long-term-care or
https://sba.ubc.ca/blog/industry-overview-home-care-providers-canada
4

5. HOMECARE IN CANADA
Source - https://sba.ubc.ca/blog/industry-overview-home-care-providers-canada
5

6. NATIONAL STANDARDS FOR HOMECARE
AND ASSISTED LIVING
• Assisted living and homecare fall under the provincial and territorial jurisdiction. There are
things that can be done
• Coordinated audits by Ministry of Public Health with all levels of government. This could be automated
through the use of analytics
• Better monitoring through the use of IoT - https://www.linkedin.com/pulse/blog-embracing-iiot-new-normal-
paul-young/?published=t
• Creating a new transfers that is tied to more funding for healthcare directly related to Assisted living
• New Transfer would have ties back to outcomes
• There are issues with the structural deficit as such model for healthcare would need to be revisited including the funding formula
- https://www2.slideshare.net/paulyoungcga/reforming-healthcare-with-countries-around-the-world
6

7. MORTALITY RATES / CANADA
7

8. AUDITOR GENERAL – ONTARIO – NURSING
HOMES - DIET
8

9. AUDITOR-GENERAL – ONTARIO –
PATIENT TREATMENT
Source - https://ipolitics.ca/2019/12/04/auditor-generals-report-paints-grim-
portrait-of-ontario-healthcare-system/
9

10. OECD / RETIREMENT LIVING
10

11. COVID19 – NURSING HOME
Source - https://www.cihi.ca/en/long-term-care-and-covid-19-the-first-6-months
11

12. COVID19 – NURSING HOME
Source - https://www.cihi.ca/en/long-term-care-and-covid-19-the-first-6-months
12

13. QUALITY / NURSING HOMES - ONTARIO
13
• Government implemented more quality
inspection at homes – so why are there still
issues with nursing home operations?
• Bruce Lea had issues that if there was
proper inspection would have been caught
sooner - https://london.ctvnews.ca/bruce-
county-fires-three-top-administrators-of-
long-term-care-home-issues-1.4592524
• Staffing and other issues have been a
concerns at long-term care facilities -
https://www.cbc.ca/news/canada/london/we
ttlaufer-inquiry-care-home-inspectors-
1.4777296
• Lack of inspection and oversight -
https://globalnews.ca/news/5202136/advoc
ates-cry-foul-after-ontario-officials-alter-
nursing-home-inspection-report-without-
explanation/
• LHIN has failed over the years to protect
seniors -
https://www.carp.ca/2015/12/14/131025/
• More oversight of nursing homes -
https://www.ncbi.nlm.nih.gov/pmc/articles/P

14. REVERA
• Lawsuits - https://www.ctvnews.ca/w5/groundbreaking-legal-action-alleges-nursing-home-
chains-put-profit-ahead-of-care-1.4155852
• Asset sale - https://business.financialpost.com/real-estate/property-post/revera-sells-big-stake-
in-canadian-senior-housing-to-health-care-reit-for-1-billion
• Pension Fund owns the company - https://www.thestar.com/business/2020/05/26/public-service-
union-calls-on-pension-fund-to-give-up-ownership-of-private-nursing-home-chain.html
14

15. SENIORS IN POVERTY
• “The median after-tax income of senior families (where the highest income earner was 65 years of age and
older) totaled $61,200 in 2017, up $2,500 from 2016. The median after-tax income of senior families has
trended up steadily since 2012, reflecting increases from wages and salaries income and private retirement
income. ”Source - https://www150.statcan.gc.ca/n1/daily-quotidien/190226/dq190226b-eng.htm
• “Senior families, where the highest income earner was 65 years of age or older, had a median after-tax income
of $57,500 in 2015, up 5.7% from 2012. After-tax income of these families has been climbing steadily since at
least the mid-1970s. In 1976, senior families received $33,100 in after-tax income. In 2015, unattached
individuals 65 years of age or older had a median after-tax income of $26,300, while their non-senior
counterparts reported $29,400. Both groups have seen little change in their median after-tax income
since 2012. ”Source – Stats Canada - https://www150.statcan.gc.ca/n1/daily-quotidien/170526/dq170526a-
eng.pdf or https://www150.statcan.gc.ca/n1/daily-quotidien/170526/dq170526a-eng.htm
• “Internal government documents say that many of the 57,000 seniors the Liberals say they have helped lift out
of poverty only moved above the poverty line when the government changed the measure. Last August, the
federal government adopted, for the first time, an official poverty line based on the income needed to afford a
basket of household necessities. ”Source - https://www.crestonvalleyadvance.ca/news/feds-lowered-poverty-
line-reducing-the-number-of-seniors-in-need-documents/
• Canada had 12.1% of the population in poverty in 2017 - Source – OECD -
https://www.statista.com/statistics/233910/poverty-rates-in-oecd-countries/ . Canada has done a decent job
with seniors. Canada was ranked very high with the G20 countries in terms of pension income -
https://www.forbes.com/sites/niallmccarthy/2015/12/02/which-countries-have-the-highest-levels-of-poverty-for-
pensioners-infographic/#2ee67be9216f
15

16. ANALYTICS / ASSISTED LIVING
Source -
16
• COVID-19 has increased pressure on the healthcare industry to identify data gaps, ensure
access to critical information, and manage uncertainty through scenario planning. Source -
https://www.canhealth.com/2020/09/30/covid-19-adopting-analytics-can-improve-patient-care-
and-resource-management/
• Managing clinical data - https://thejournalofmhealth.com/cegedim-to-collaborate-with-ibm-
watson-health-to-provide-access-to-real-world-clinical-data/
• AI and Medical Devices - https://www.ibm.com/blogs/internet-of-things/iot-ai-and-iot-help-an-
aging-population/ or https://www.medicalstartups.org/top/ai/
• Value for Money Audits / Performance Audits -
https://ibm.box.com/s/noi1j6ixzl6ralxkm4g0zzs911wf6s76

17. MEDICAL EQUIPMENT AND SUPPLIES
• Supporting local manufacturing of medical equipment and supplies -
https://ontarioconstructionnews.com/ontario-made-program-launched-to-support-canadian-
manufacturers-and-exporters-launch-of-2/
• Medical equipment and supplies is projected to grow at 6.2% clip -
https://www.ibisworld.com/canada/market-research-reports/medical-device-manufacturing-industry/
• Certification of medical equipment - https://www.newswire.ca/news-releases/health-canada-certifies-
winnipeg-ventilator-2-0-for-immediate-distribution-to-support-the-needs-of-covid-19-patients-
842116003.html
• Revisiting the manufacturing of medical equipment and supplies -
https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00006-eng.htm
• Better management of strategic supplies of medical equipment, devices, and supplies -
https://supplychaingamechanger.com/strategic-national-stockpiles-and-sourcing-for-the-national-
interest/
17

18. FUNDING
18
Long-Term and
Assisted Care - PBO.pdf

19. SPACES / LONG-TERM CARE
19
Housing and Seniors
- LTC.pdf
retirementsecurity-lo
ngtermcare-feb2018.pdf
Long-Term Care
fixes.pdf

20. FINANCIAL PERFORMANCE
20

21. FINANCIAL PERFORMANCE
21

22. WHAT’S NEXT
• LHIN need to set up better monitoring of long-term care facilities. This can be done through mandatory reporting to LHINs
including the use of analytics and data sciences
• Reforming healthcare - https://www.slideshare.net/paulyoungcga/how-does-the-world-reform-healthcare
• Notification tools
• Watson Assistant - https://www.youtube.com/watch?v=hitUOFNne14&t=43s
• Better use of data and AI as part of managing outbreaks
• https://www.ibm.com/blogs/watson-health/human-centered-contact-tracing/ or https://www.ibm.com/cloud/blog/announcements/ibm-and-
servicenow
• All long-term care facilities should have a performance audit done of their facilities as part of their funding -
https://www.slideshare.net/paulyoungcga/the-importance-of-value-for-money-and-perfomance-based-audits
• Nursing homes/Assisted living need to have a crisis management/risk management plan as part of managing any outbreak at
their facilities. These reports should be disclosed to various ministry of health across Canada
• All companies whether they are for profit or non-profit need to go through rigorous audits -
https://www.dementiacarecentral.com/memory-care/non-profit-vs-for-profit
• Staffing and wages – all homes need to review their staffing including wages, training, hours, benefits, etc.
• All homes need to have a crisis management, i.e. outbreaks
• Crisis Management - https://www.slideshare.net/paulyoungcga/how-to-implement-crisis-management-using-data-and-ai
22 Blog – Assisted Living and Long-Term Care – What is next – August 2022
Housing and Seniors
- LTC.pdf
retirementsecurity-lo
ngtermcare-feb2018.pdf
Long-Term Care
fixes.pdf
Zoning Changes.pdf LTC Care and 3D
housing.pdf
Rent Costs.pdf Homecare and
Devices.pdf
Long-Term Care
fixes.pdf
LTC Care and Bill
7.pdf
LTC and Hospitals.pdf LTC and healthcare
crisis.pdf
Seniors - Health and
Wellness.pdf
Real Estate and
Leasing.pdf
Summary:
Assisted and retirement living is becoming a big problem for governments around the world. There has
been a bed shortage for years. Technology today, especially in building construction should help speed
up the building of facilities for seniors.
Local and provincial governments need to work together on zoning changes as part of managing vacant
property and/or vacant spaces. The emergent of online shopping has change the retail and distribution
model, especially in areas like commercial and industrial property.
OAS payments need to rise as part of addressing income issues with seniors
GIS needs to adjust its threshold from 19K to 40K as part of expanding assistance to seniors
Rent subsidies to seniors need to increase
Provincial government need to review their rent approval process as part ensuring affordable rents
Mandatory audits and reporting of all LTC and Assisted Living facilities. More money needs to be spent
on adding more auditors as well as looking at Data and AI as part of automating risk and compliance
programs.
Healthcare needs to move to homecare model. All levels of government need to focus on eliminating
waste including the LHINs
More funding for health and wellness programs for seniors
1. Mandatory audits of all both public and private long-term care and assisted living facilities -
https://www.slideshare.net/paulyoungcga/why-are-value-for-money-and-performance-audits-
important-for-government-public-sector
2. Mandatory reporting into the government through FAO or a compliance group. The F/S would
include key metrics - https://www.slideshare.net/paulyoungcga/how-to-buld-a-governance-
model-for-the-public-sector-july-2022pptx

23. TRAINING AND DEVELOPMENT
• If you like to learn more
about trade and/or other
subjects as part of your
professional learning and
development then feel
free to review my material
on
https://www.udemy.com/
(search Paul Young CPA
CGA)
• These subjects address
how to fixed issues with
housing and/or systemic
issues related to economy
including government
policies