TORONTO - Ontario's proposed legislation to regulate retirement homes for the first time could lead to expensive, for-profit facilities that encroach on services provided by publicly funded nursing homes, but with less operational oversight, critics warn.

The Liberal government has been promising for years to create regulations for the approximately 700 retirement homes in the province, and the bill is now at the committee stage -- the last stop before third and final reading.

New regulations will be developed to enforce care and safety standards, mandate emergency plans and infection-control programs and police background checks for staff.

The bill defines a retirement home as one where at least six unrelated residents, primarily aged 65 and over, purchase accommodation and care. About 43,000 Ontario seniors live in retirement homes, which charge between $1,500 and $5,000 a month, even more in some cases.

Unlike nursing homes, which receive government funding to provide medical care to elderly patients, retirement homes are privately operated and unregulated.

Groups including the Registered Nurses Association of Ontario, the Ontario Health Coalition and CUPE have raised concerns about several aspects of the bill. Their biggest issue appears to be the self-regulating model the province has chosen.

Many of the retirement homes are owed by multinational real estate chains that will be allowed to dominate the new board of the Retirement Homes Regulatory Authority, warned Natalie Mehra of the health coalition.

"The approach in this bill, including a registrar and the authority to investigate complaints, issue licences, impose orders and terms and conditions, inspect and cancel licences, follows along the lines of the self-regulating colleges model," Mehra told the social policy committee.

"The difference is that the allied health professionals, nurses and physicians covered by the colleges, are not generally large, for-profit multinational corporations with all of the sophistication of approach to deregulation and profit-taking that this entails."

Judith Wahl of the Advocacy Centre for the Elderly, a legal clinic, called the bill a major step backwards.

"It will give too much control to the retirement home industry (and) it will do little to protect retirement home tenants," said Wahl.

"It will create two-tier medicine, requiring seniors to pay for their own health care and services that otherwise are publicly funded."

The Canadian Union of Public Employees, which represents several thousand workers in Ontario retirement homes, compared the self-regulation of retirement homes to "putting the fox in charge of the hen house" because the regulator will be dominated by the industry.

The nurses association said there was nothing in the bill to prevent a private retirement home from offering the same services that are provided by a regulated long-term care home.

"The RNAO is profoundly concerned that the regulation must not result in a slippery slope to two-tier health care for older persons in Ontario," said executive director Doris Grinspun.

"This concern stems mainly from the vague and ambiguous definition of retirement home."

Mehra agreed the definition of a retirement home needed to be clarified before the bill becomes law.

"The bill needs to be amended to clearly define what care services retirements can and cannot do within the legislation itself, not in the regulations," she said.

"The role of retirement homes should be limited so they cannot become de facto long-term care homes or chronic care hospitals that are privately owned and operated and subject to much less legislation and regulation."

The New Democrats said the retirement home industry should not have the majority of seats on the new regulatory board.

"We would like to see more public representation from various walks of life, as well as some physicians," said NDP critic Paul Miller.

"We don't want to leave it up to just the people that are running the homes."

The government won't even order retirement homes built before 1990 to be retrofitted with sprinkler systems in case of fires, complained Miller. "If it was my Mom, I'd certainly want to know there was a sprinkler system," he said.

The advocacy groups are also worried that no one ministry is in charge of the legislation to regulate retirement homes. They say the senior's secretariat is not a real ministry and doesn't have the capacity to oversee the homes.