TORONTO - Health Minister George Smitherman resisted calls Tuesday for regulations that would require Ontario nursing homes to provide a minimum standard of care to its elderly residents, despite a new report calling on staff to spend more time with patients.

Smitherman, who once mused openly about wearing an adult diaper to satisfy himself that elderly residents were receiving appropriate care, promised to implement the recommendations of the report to improve conditions in long-term care facilities.

But right now, that doesn't include regulating the amount of time spent caring for elderly residents -- a measure long sought by nursing home groups who say seniors are forced to wallow in soiled diapers for hours on end because facilities are so short-staffed.

"We have that in reserve,'' Smitherman said.

"It's possible. We can go back to it. But our starting point here will be to try and give life to the report through an implementation team that is, I think, more powerful than a number acting alone.''

The 30-plus page, government-commissioned report on long-term care was released moments before Smitherman began to speak about its findings at a news conference, providing little time to digest its contents.

It called on the province to boost funding to nursing homes and raise the level of care to an average of four hours a day, up from the current average of 3.2 hours.

Smitherman said he couldn't immediately commit to making that happen, as there wasn't enough money in the ministry's budget. But getting there could cost ''several hundred million additional dollars,'' he said.

Even though many have called for minimum standards, the report concluded that wasn't enough to get the job done.

"When we spoke to residents and families, a lot of what they were looking for was more time for someone to sit and talk with them, for more time to have their issues of the day expressed,'' said the report's author Shirlee Sharkey, who is president of the Saint Elizabeth Health Care non-profit organization.

"So it's a much broader issue than simply, how many hours does someone have, but a whole approach to staffing and a whole approach that's focused on residents' needs.''

If standards aren't set, there's little to hold the government accountable if conditions in nursing homes don't improve, said NDP critic France Gelinas.

"It's kind of like a do-nothing ministry,'' added Progressive Conservative critic Elizabeth Witmer.

"Get these hot issues off the table and give them to someone else.''

The report also recommends that the province look at ways to improve the way care is delivered, including developing annual staffing plans at each home to meet the needs of its residents.

Sharkey will lead a team to help implement the recommendations and provide advice on key areas which require regulations, Smitherman said.

Nursing homes will also have to start reporting on the health of its residents and how satisfied they are with their care, which will be collected by the Ontario Health Quality Council and posted on a website, he said.

Currently, residents in nursing homes are receiving between 1.9 to 5.1 hours of daily care, Sharkey said.

Problems in nursing homes have dogged Smitherman for months, despite a budget promise to hire 2,500 personal support workers and 2,000 nurses over four years.

Last month, the province barred a Toronto nursing home from accepting new residents following the death of two residents. Critics said the deaths highlighted the chronic problems plaguing Ontario nursing homes, where caregivers have little time to attend or monitor elderly patients.