How enforcement shapes compliance with legal rules: the case of long-term care homes in Ontario

Abstract

This paper contributes to the legal and socio-legal literature on long-term care (LTC) facilities (also known as nursing homes) by drawing from the responsive regulation literature and empirical research conducted in 2021 and 2022. Enforcement is an under-explored aspect in the legal and socio-legal literature on LTC. This research asks how the regulator’s enforcement activities shape compliance of LTC homes in Ontario. This paper reports the results from eleven semi-structured key informant interviews with associations that represent LTC facilities, advocacy organizations, unions, and professionals, such as lawyers. The current enforcement activities do not appear to evoke responsiveness in at least some of the LTC homes because the regulator’s approach is not dynamic: the regulator does not change its mix of “persuasion” and “coercion” in order to respond to the motivations and behaviours of homes. Inspection and enforcement activities have had little impact on how homes respond to rules.