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Long-Term Care in Ontario

Province: ON

If your care needs can no longer be met in the community or retirement home level does not appear to provide adequate care, you/your loved one may require a long-term care home. Long-term care homes (formerly called Nursing Homes) are licensed, regulated and funded by provincial government. Eligibility for placement in long-term care is determined by your Local Health Integration Network (LHIN). Long-term care homes provide 24-hour/day supervision and/or assistance with personal care, eating, bathing, medications, and medical/nursing needs for medically stable individuals in a secure, supervised environment. They tend to offer more care than is usually available in a seniors’ building, retirement residence and even most assisted living settings and can manage special needs such as dementia. Standard room furnishings are provided, as are linens, meals, laundry services, hygiene and medical supplies. Availability of private, semi-private or basic accommodation varies from home to home and depends on when the home was built and renovated.

Long-term care homes have a dining room, lounge/common areas and activities/programs for residents. There is a doctor available for residents with regular on-site office hours. The government pays the “care portion” of the cost directly to the home. The resident is responsible for the co-payment which covers room and board costs. The “co-payment” amount is standardized across the province and set by the government.[1]

A co-payment reduction may be available for individuals who have chosen basic accommodation. If you wish to apply for a rate reduction, the LHIN will provide you with the Rate Reduction package most suitable to your circumstances. The package contains detailed instructions on the required list of documents and completion of the application, as well as phone numbers for assistance (note: eligibility is based on annual income, not personal assets).

If both spouses are receiving OAS, an application for Involuntary Separation can be made through the Income Securities Program of Human Resources Development Canada, which would effectively give each of them the benefit of receiving pensions – including Old Age Security (OAS), Guaranteed Income Supplement (GIS) & Guaranteed Annual Income System (GAINS) as if they were single individuals.

All nursing home applications are submitted to and through your Local Health Integration Network. There is no application fee. You must be over 18, have a valid Ontario Health Card and have care needs (eligibility criteria is set by the government) that can be met in a long-term care home to be eligible for placement in one[2]. Most long-term care homes have waiting lists and you may have to wait for an available bed in your chosen residence(s), depending on bed availability, length of waiting list, level of care required and other factors.

You can choose up to five long-term care homes. If you turn down a bed offer from one of your chosen homes, all your applications will be withdrawn and your application for placement will be closed for 3 months. Should your circumstances or situation change within that 3-month period, you will need to contact your LHIN Care Coordinator for reassessment. It is highly recommended that you take the time to research and visit the homes that you are considering. Once you choose the homes you want to see, call the long-term care homes to schedule a tour. Virtual tours of long-term care homes in your region may be available on the websites of homes you are interested in and/or on your LHIN’s website (visit www.lhins.on.ca, select your region, the tab ‘Home and Community Care’ on their homepage, the tab ‘Getting Care’ and then, Long-Term Care from the drop-down menu).

For those who do not require permanent accommodation in a long-term care home, short stay respite and convalescent care is available. Application for any of these programs is managed by the LHIN. Short stay respite is designed to provide relief for caregivers. The maximum length of stay is 60 days at a time, up to a total of 90 days in a calendar year. Short stay convalescent care provides supportive and restorative services for people who are recovering from an illness or injury in hospital or in the community. The maximum length of stay is up to a total of 90 days in a calendar year.

The Ministry of Long-Term Care conducts inspections of long-term care homes and creates reports that are posted on site of the home. For detailed information (and any noted concerns by inspectors) visit the webpage entitled Public Reporting on Long-Term Care Homes at: http://publicreporting.ltchomes.net/en-ca/Search_Selection.aspx. To report any concerns about specific long-term care homes, you can call the Long-Term Care Homes ACTION Line at 1 (866) 434-0144[3]



[1]As of July 1, 2019, the monthly room rate for residents in Ontario long-term care homes are as follows: Basic (depending on when a home was built or renovated this can mean up to 4 residents in a room, in newer homes it is usually 2 people per room) – $62.18/day ($1,891.31/month). Semi-private (usually 2 people per room) - $70.70/day ($2,150.46/month) in an older bed or in a newer bed if admitted prior to July 1, 2012; $71.75/day ($2,182.40/month) if resident was admitted to a newer bed on or after July 1, 2012 but before July 1, 2013; $72.83/day ($2,215.25/month) in a newer bed if admitted July 1, 2013 but before September 1, 2014; $73.89/day ($2,247.49/month) if admitted to a newer bed on or after September 1, 2014 but before July 1, 2015; $74.96/day ($2,280.04/month) if admitted to a newer bed on or after July 1, 2015. Private (one person per room) - $81.35/day ($2,474.40) in an older bed or if admitted before July 1, 2012; $83.22/day ($2,531.28/month) if resident was admitted to a newer bed on or after July 1, 2012 but before July 1, 2013; $85.08/day ($2,587.85/month) in a newer bed if admitted July 1, 2013 but before September 1, 2014; $86.96/day ($2,645.04/month) if admitted to a newer bed on or after September 1, 2014 but before July 1, 2015; $88.82/day ($2,701.61/month) if admitted to a newer bed on or after July 1, 2015. Short Stay Rate – (for Respite/Caregiver Relief: the maximum is 60 continuous days or 90 accumulated days in a calendar year; for Convalescent Care the maximum stay is 90 days in a calendar year) - $40.24/day. Note: fees are increased periodically so please check with your local LHIN for up-to-date rates. These fees do not include optional services like cable, phone, transportation and hairstylist visits. Please see section 245 of the Long-Term Care Homes Act for ‘non-allowable resident charges’.

[2] If you are looking at placement for a couple who may require different levels of care, it may be best to look at residences which will accommodate both or are connected to alternate homes offering different levels of care. Even if both people are currently at the same level, you may want to explore residences that would continue to manage both, if one’s health declines before the others’.

[3] Information reviewed and edited by Central LHIN staff (July 2019).

Esther Goldstein, B.Sc., B.S.W., RSW

connect@seniorcareaccess.com

 

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