An Overview Of Long Term Care In Canada 2024

What is Long-Term Care (LTC)?

Long-term care (LTC) provides 24/7 support to seniors or individuals with significant health needs that cannot be managed at home or in a retirement setting. LTC facilities offer comprehensive services, including medical care, personal support, and social activities. Unlike independent or assisted living in a retirement community, LTC primarily supports individuals who require consistent medical attention and help with Activities of Daily Living (ADL’s).
 

Key Questions to Ask When Considering LTC

Families evaluating LTC options should consider the following questions however, they need to be aware of the application/qualification process and how the location selection process works:

1. What medical services and therapies are available on-site?
2. How does the facility handle emergencies?
3. Are specialized care options like dementia support provided?
4. What are the daily routines, and are they flexible?
5. What is the staff-to-resident ratio, and what qualifications do staff have?
6. Can residents personalize their living spaces?
7. What social programs are available?
8. Are meals customized to dietary needs?
9. What are the visitation policies?
10. Are there any additional fees beyond the base cost?
    
     

How to Apply for LTC by Province

Application processes and agencies vary across Canada. Referrals for applications can be made by the person who needs/wants to go to LTC, their family members, professionals who care for them, or medical services connected to them. If the person the application referral is made for is competent, they must sign the forms and accept the bed themselves when one becomes available. If the person is incompetent, that right is awarded to whoever has their power of attorney for personal care.

LTC is provincially funded and each province's Ministry of Health ensures the legislation is followed, sets eligibility and costs, and manages applications and waiting lists.  As such, the agencies that manage the process are government-run organizations that are responsible specifically for home care and LTC in that province. 

• Ontario: Applications are managed by Ontario Health atHome or by contacting Home and Community Care Support Services at 310-2222 [2].
• British Columbia: Applications are coordinated by regional Health Authorities, and accessible through HealthLink BC.
• Quebec: Local CLSCs manage applications; further information is available via the Quebec Ministry of Health.
• Alberta: Managed by Alberta Health Services, with details on AHS Continuing Care.
• Manitoba: Contact Manitoba Health Long-Term Care for application guidance.
• Nova Scotia: Applications are through the Nova Scotia Health Authority.
• Saskatchewan: The Saskatchewan Health Authority oversees LTC placements.
   

Role of Hospitals and Retirement Homes in LTC Placement in Ontario

In Ontario, the More Beds, Better Care Act, 2022 (Bill 7) allows hospitals to place alternate level of care (ALC) patients in available LTC facilities without informed consent. Hospitals are authorized to charge patients up to $400 per day if they refuse a suitable placement. Furthermore, placements can be made within a 70-kilometer radius in urban areas or 150 kilometers in rural areas [4].

Retirement homes generally cannot evict residents solely for refusing an LTC placement; however, they can require a resident to move if their care needs exceed the services provided under the Retirement Homes Act, 2010. There are some retirement homes that are able to provide a comparable level of care to a LTC home however, in most cases, the resident would have to pay added costs for all added care. Retirement homes are all private and there is no government funding for them so, in some cases, the costs to remain in a retirement home if your care needs increase, becomes prohibitive and residents would be forced to consider moving to LTC where their care needs can be met at an affordable price.

Example of Ontario LTC application overview:
https://www.ontario.ca/page/apply-long-term-care#section-3
  “Wait times and placement offers:

Wait times for long-term care homes vary, but once you apply it’s important to start preparing for your move. When a spot becomes available you will receive a placement offer that includes a move-in date.

You will then have 24 hours to accept or reject the placement offer, and up to five days to move in.

You should also be aware that you will be expected to start paying on your move-in date, regardless of when you arrive.

If you are offered a place in a home that is not your first choice, you can:

• accept the placement offer
• move in, but choose to stay on the waiting list for a transfer into your first choice of home (understanding that this may take a long time)
• reject the placement offer

If you turn down the placement offer or fail to move into the home by your move-in date deadline, you will be removed from every waiting list you’re on. You will then be required to wait 12 weeks before you can reapply for long-term care unless there is a significant change in your condition or circumstances.

Rejection of your application

Homes are allowed to reject applications only for very specific reasons, such as not being able to meet your care needs. For example, a home can reject your application if you need a specific type of medical equipment and the home doesn’t have it or doesn’t have the staff to support it.”

Long-Term Care Costs and Subsidies by Province in Canada

LTC costs vary significantly across Canada, with subsidies available to assist low-income residents. Each province covers the cost of care for all residents however, the resident is responsible for a co-payment, deemed to be the cost of room and board. Because all adhere to the princleple that every citizen is entitled to care in a LTC home if they are assessed to require it, all provinces can subsidize the lowest price point for residents who do not have income to cover the minimum rate and allow for a small comfort allowance. 

Here’s a breakdown of the costs and subsidy options across the provinces:

1. Ontario: Basic accommodation ranges from $2,036 to $2,909/month. The Long-Term Care Home Rate Reduction Program is available to support low-income residents, helping cover basic room costs [2].
2. British Columbia: LTC fees can be as high as $3,974.10/month for private accommodations. Fees are income-tested, with subsidies reducing costs for residents with lower incomes [5].
3. Alberta: Charges for LTC increased by 3.8% in August 2024, with accommodation costs based on income. The cost ranges from $2,047 - $3,262/month however, Alberta offers subsidies for residents meeting financial criteria [4].
4. Saskatchewan: Residents pay about 20% of the LTC cost, with the province subsidizing the remaining 80%. Monthly fees vary depending on the type of accommodation and resident income [6]. Current costs range from $1,349 - $3,357/month.
5. Manitoba: LTC costs are also based on income, ranging from $1,271.56 to $3,075.46/month. Subsidies are available, with fees adjusted annually based on the resident’s income.
6. Nova Scotia: LTC costs are means-tested, with residents typically paying up to $3,361/month, though income-based subsidies significantly reduce fees for those in need.
7. Newfoundland and Labrador: LTC residents pay based on income, with costs varying but generally subsidized by the government to keep them affordable. The maximum cost a resident will pay is $2,990/month.
8. Quebec: Residents pay a portion of the cost based on income, with financial assistance available. Fees typically range between $1,333.20 and $2,142.30/month for standard accommodations.
9. New Brunswick and Prince Edward Island: LTC fees vary, with a cost-sharing model in place that considers the resident’s income and assets to determine their monthly contribution. The maximum cost in NB is $3,437.08/month and in PEI is $3,488.26.
10. Northwest Territories: Costs are generally lower, at approximately $976/month, due to higher government subsidies [3].
11. Nunavut: LTC is fully funded by the government so residents are not responsible for a co-payment.
12. Yukon: LTC is heavily subsidized and residents are only responsible for paying $1,217/month.

Provincial support ensures that seniors with a limited income have access to essential LTC services at reduced rates, enabling more equitable access across Canada.

Long-term care in Canada serves individuals with complex care needs, helping them live with dignity and support. Application processes, costs, and legislation vary, with each province tailoring policies to manage demand while prioritizing patient care and accessibility. Many families are unaware of the complexities of retirement options vs long-term care, and are advised to seek out information and tour homes before selecting them if you are seeking this type of care for a loved one. 

This overview, offered as a courtesy by SeniorCareAccess.com, provides essential information for families and professionals making decisions about senior care.  If you feel that you require assistance with an aging family member, retirement home placement or transitional management, we invite you to contact us about our consulting program designed to empower Canadian families.

Sources: ontario.ca - Paying for long-term care
statista.com - Cost of nursing homes by province Canada
alberta.ca - Continuing care – Resident accommodation charges
gov.bc.ca - Long-Term Care Services - Province of British Columbia
saskatchewan.ca - Special Care Homes
cbc.ca - Controversial law designed to free up hospital beds to be ...
ontario.ca - Fixing Long-Term Care Act, 2021, S.O. 2021, c. 39, Sched. 1
fasken.com - Transitioning Patients from Hospitals to Long-Term Care
ola.org - Bill 7, More Beds, Better Care Act, 2022
ontario.ca - More Beds, Better Care Act, 2022, S.O. 2022, c. 16 - Bill 7