LTCcovid Country Profiles

Responses to 4.09. Reforms to improve care homes, including new standards and building regulations

The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It was compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project moderated the entries and edited as needed. It was updated regularly until the end of 2022.

The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.

To cite this report (please note the date in which it was consulted as the contents changes over time):

Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Patel D, Pharoah D (eds.) and LTCcovid contributors.  (2022) LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science.

Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.



Care home design and building regulations:

The pandemic has highlighted that the design of care homes has been an important factor in the risk of infections and deaths from COVID-19 experienced by care home residents. A study analysing associations between nursing home design and COVID-19 cases, deaths and transmissibility in 7,785 nursing homes the United States found that an increased share of private rooms, larger living area per bed and the presence of a ventilator-dependent unit were associated with fewer COVID-19 infections, deaths and transmissibility. (Zhu et al., 2021).


Zhu X., Lee H., Sang H. et al. (2021) Nursing Home Design and COVID-19: Implications of Guidelines and Regulation. JAMDA in press

The Fixing Long-Term Care Act, announced in 2021, would permit the Minister of Long-Term Care to develop a policy outlining how many beds are needed in the province and where these beds are most needed (source: Bill 37, Providing More Care, Protecting Seniors, and Building More Beds Act, 2021).

Last updated: December 10th, 2021

The Finnish government is currently proposing reforms to the Social Welfare Act that aim to promote diverse and flexible housing and care solutions, including communal housing and housing with 24-hour care. The communal housing would offer accessible and safe homes where people can live in apartments where they can participate in activities have support with any care needs. Both communal housing and housing with 24-hour care would be provided in the same building complex, also including ordinary apartments, with the aim that clients can get the services they need at home without having to move when their care needs change.

Long-term institutional care for older people is to be abolished by the end 2027, with a transition period to introduce and adapt the services.

Last updated: December 10th, 2021

Improving infrastructure for older people, and in particular the social care sector, was a key pillar of the French government’s plan to “relaunch the economy and make it more resilient” and intends to build a resilient care sector over a journey of 20-25 years. For care homes, 2.1 billion euros have been allocated over 5 years to invest in the transformation, renovation works, and digital upgrading of care and nursing homes. Examples of how this will be used include the renovation of 65,000 care home beds to adapt estates to the futures: buildings allowing for smaller structures with more convivial living opportunities, more rooms adapted to cognitive impairments, and future-proofing estates against climate change. The funds will also build new care homes.

1.5 billion euros have been allocated over 4 years to transform models of care homes, into more human, locally connected and medicalised settings. In addition, 125 million euros have been allocated to finance daily needs, such as buying new equipment, small changes and construction works.

Last updated: December 21st, 2021   Contributors: Camille Oung  |  Alis Sopadzhiyan  |  

Contributors to the LTCcovid Living International Report, so far:

Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Erica BreuerJorge Browne Salas, Jenni Burton, William Byrd, Sara CharlesworthAdelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin HämelNina Hemmings, David Henderson, Kathryn Hinsliff-Smith, Iva Holmerova, Stefania Ilinca, Hongsoo Kim, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’DonovanCamille Oung, Disha Patel, Martina Paulikova, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. SchmidtAgnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jae Yoon Yi, Jessica J. Yu

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.