A downtown Toronto long-term care home is rebuilding with a new design that considers lessons learned from the COVID-19 pandemic, going beyond the province’s standards — but some say those standards are out of date.

Right down to the placement of garbage cans, the new design of the Rekai Centre’s Cherry Place aims to prevent the spread of viruses and prioritize residents’ emotional and social needs, according to the centre’s CEO, Sue Graham-Nutter.

“We never wanted our residents to go through this ever again,” she said.

Traditional long-term care homes saw over three times as many COVID-19 deaths and twice as many cases in 2020 than small care homes, according to data from a 2025 study by the National Institute on Aging (NIA).

Many of the planned updates at the 13-storey facility on Cherry Street were brainstormed during the pandemic as shortfalls were brought to light, said Graham-Nutter.

“I would go into the stairwell, in my full PPE, and I would text [the architect] with, ‘We need to think about this, we need to think about that,’ because I didn't want to forget the minor details,” she said.

The redesigned facility will have infection control zones with sealed doors, improved oxygen access and 348 beds.

Ontario requires facilities to have a maximum of two residents per room and patients must be divided into self-contained cohorts of 32 people maximum, called “resident home areas,” according to the latest Ontario long-term care home design manual from 2015.

The changes made by the Rekai Centre are a good start, according to Dr. Samir Sinha, a geriatrician, clinician scientist and the director of health Policy Research at NIA.

But Ontario's standards for long-term care homes are falling behind the latest best-practice research, he said.

A rendering of the street view of the 13-storey Cherry Place outlining the use of each of the building's floors.

In Ontario homes, long-term care patients are grouped into 'resident home areas' of up to 32 residents but,at Cherry Place, some groups will be half that, according to the project's architect, Dustin Hooper. (Submitted by the Rekai Centre)

“If you think about palliative care hospices, if you think about group homes for younger people … we often don't have them living in large institutional settings," Sinha said. “So why is it that in North America we only do this with frail, older people?”

Sinha said long-term care should be moving towards a “small care homes” model of 10 to 12 people, each with their own private bedroom and bathroom. Larger buildings can be broken up into multiple 12-person households and still follow the model, he said.