If 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 licenced, regulated and funded by the Ministry of Health and Long-Term Care (MOHLTC). Eligibility for placement in long-term care is determined by your local CCAC. 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 are able 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 the residents. There is a doctor available for the 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 (MOHLTC). There may be an extra charge for some services (such as cable TV, telephone, hairdressing), depending on the residence.
A co-payment reduction may be available for individuals who have chosen ward/basic accommodation. If you wish to apply for a rate reduction, the CCAC 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 local Community Care Access Centres. 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 Ministry) that can be met in a long-term care home in order to be eligible for placement in one. 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.
Often, when someone requires long-term care there is a clear sense of urgency to get them necessary support, especially if the family is struggling to manage at home and, the place you want has a long waiting list. You can choose up to five long-term care homes. If you turn down a bed offer from one of your chosen, all of your applications will be withdrawn and your application for placement will be closed for 3 months. Should your circumstances or situation within that 3 month period, you will need to contact your CCAC Care Coordinator for reassessment (in the situation where a ‘crisis’ placement is required, there may in fact be no choice as often the person will go to a place that has a bed and can meet their current needs and then, if desired, the family can move them to another place at a later date.) In addition to choice, in situations where long-term care is required, even in a non-crisis situation, time may be a limiting factor often because a caregiver or a hospital is in need of a fairly quick decision & application. Despite these issues, multiple relocations can be difficult on a frail senior, especially one that also has some cognitive issues, so if at all possible before choosing we recommend that you take the time to visit & research places you are considering. If you can, take tours of the homes that are either recommended to you or ones you believe, based on proximity or services, you are thinking of applying to. If at all possible, consider homes that are close to family and friends so your loved one can have frequent visitors. It will most certainly benefit in the adjustment to their new surroundings if familiar faces come to visit. Once you choose the homes you want to see, call them to find out when they have tours or if your time is limited, if they are willing to take you on a private tour.
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 CCAC. Short stay respite is designed to provide relief for your caregiver. 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 Health and 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: www.health.gov.on.ca. To report any concerns about specific long-term care homes, you can call the Long-Term Care ACTION Line at 1 (866) 434-0144. For additional information on long-term care homes and listings on several in Ontario, please visit our website at www.senioropolis.com.
Monthly Room Rates: As of September 1, 2014
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) – daily rate is $56.93/day or $1,731.62/month
Semi-private (usually 2 people per room) - $64.93/day ($1,974.96/month) in an older bed or in a newer bed if admitted prior to July 1, 2012; $65.93/day ($2,005.37/month) if resident was admitted to a newer bed on or after July 1, 2012 but before July 1, 2013; $66.93/day ($2,035.79/month) in a newer bed if admitted July 1, 2013 but before September 1, 2014; $67.93/day ($2,066.21/month) if admitted to a newer bed on or after September 1, 2014.
Private (one person per room) - $74.93/day ($2,279.12) in an older bed or if admitted before July 1, 2012; $76.68/day ($2,332.35/month) if resident was admitted to a newer bed on or after July 1, 2012 but before July 1, 2013; $78.43/day ($2,385.58/month) in a newer bed if admitted July 1, 2013 but before September 1, 2014; $80.18/day ($2438.81/month) if admitted to a newer bed on or after September 1, 2014.
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) - $36.85/day
Note: fees are increased periodically so please check with your local CCAC for up-to-date rates.
These fees do not include optional services like cable, phone or things like, transportation and hairstylist visits. Please see section 245 of the Long-Term Care Homes Act for ‘non-allowable resident charges’.
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 of them, if one’s health declines before the others’.
Esther Goldstein, B.Sc., B.S.W., RSW