Tell Me More About Long Term Care Homes
This section contains a lot of information that you will find useful.
You can scroll down the page or jump to any one of the following
What are long term care homes like?
Are homes regulated?
How do I
apply for admission?
What is the cost of living
in a home?
Are there ways of obtaining extra
Adapting to a long term care
Checklist of questions to consider when
Advice on the MOHLTC Public
Reporting Website on long term care homes
Ministry of Health
& LTC (MOHLTC) website
What are long term care homes like?
Long term care refers to homes once known as homes for the aged and
nursing homes. This is where persons age 18 and over may receive
care over the long term. The long term care home takes over when either
there is no longer sufficient support for a person to live at home, or
the hospital is ready to discharge a patient who may not be able to cope
at home any longer.
Generally, residents are seniors and they require a heavy degree of
physical care, or they are dealing with Alzheimer disease or other forms
of dementia that require constant care. The objectives of long term care
are to promote as much independence as possible for as long as possible,
and to ensure the best possible quality of life for each individual
Long term care homes are staffed with health care aides (HCAs) and
personal support workers (PSWs) to assist residents with their daily
care. That may mean help with eating meals, assistance with bathing, and
with toileting and general grooming. There are registered nurses
(RNs) and registered practical nurses (RPNs) to provide health
care, promote wellness, assess for illness, provide treatments and
administer prescribed medicines. Each home has arrangements with
physicians who act as medical directors and attending physicians to work
with the residents and to be on call 24 hours a day.
Another key ingredient of the staffing mix in homes are the program
support people who provide social and recreational programs.
Residents either have a private room, or they share a room with one
(or sometimes more) other person. Housekeeping and laundry are
two of the services included for residents. There are dining rooms where
residents gather for three meals each day. The dietary department always
includes the services of a dietitian, ensuring good quality, appropriate
food,- whatever the specific person may require. There are common areas
for entertainment, activities, religious services - whatever the home
can provide to make life there one of quality. Some homes have means of
transportation to take residents to events and activities in the
OANHSS member homes encourage the community to participate with the
residents. They are often partners with various agencies in providing a
variety of services to the community, and in encouraging local groups to
use the homes, sometimes sharing office space, sometimes meeting space.
OANHSS members are innovators in creating outreach to their
neighbourhoods and within their homes.
All long term care homes in Ontario are regulated by the Ministry of
Health and Long-Term Care, and are inspected annually. In addition,
not-for-profit homes are accountable to their Committees or Municipal
Councils to adhere to the specific mandates determined by the governing
For more information, the provincial government has developed
a website providing details on home, community and
residential care options.
do I apply for admission?
Application for any home must be made through the CCAC (Community
Care Access Centre). CCACs can assist you by giving you information on
local long term care homes, the specific services these homes provide,
and things to look for or questions to ask when selecting a LTC home.
Case managers do the necessary eligibility assessments. It will be
suggested that you visit several long term care homes. You will then
know which meet your needs best. Let your CCAC know your three choices
so that they may forward your request to the homes you preferred. You
should be aware that some places will have waiting lists.
If you are in hospital, the discharge planner will help you with your
move to a home for continuing your care.
What is the cost of living in a long term care
The Ministry pays directly for the costs of nursing and personal
care, as well as for activation, through a funding formula determined by
the province. Residents pay for their room and food. Often the governing
bodies of not-for-profit homes (including municipalities) augment
funding to enhance services. Costs to be paid by residents (not by their
families) are set by the province, and are subject to change. The
province expects that charges are affordable to any applicant. The basic
fee paid by residents in homes is $56.14 per day or $1,707.59 per month
for standard accommodation (may be less for residents who are
unable to pay).The chart below provides a breakdown based on type of
Semi-Private (‘New’ or ‘A’
|Semi-Private (‘New’ or ‘A’ bed)**
|Semi-Private (‘B’, ‘C’ or
Private (‘New’ or ‘A’
|Private (‘New’ or ‘A’ bed)**
Private (‘B’, ‘C’ or
Short-Stay Resident (respite bed)
* Applies to residents admitted on or after July 1, 2013, to the
indicated bed as classified according to the Ministry design
** Applies to residents admitted on or after July 1, 2012, but prior to July 1, 2013, to the indicated bed as classified according to the Ministry design standard.
Depending upon the accommodation provided in the home, it may be
possible to apply for a private room, rather than the semi-private or
“basic” accommodation which every home has. Even the cost of
a semi-private and private room is regulated by the province.
Costs cover meals and nourishments, housekeeping, laundry, maintenance
of the home, and administration. Other charges are limited by
regulation, such as the drug dispensing fee from the
Residents who are unable to pay the costs set by the Ministry are
able to apply for a reduced rate. The CCAC or the home you choose will
be happy to explain how the ability to pay is calculated.
Families who wish to do so may, of course, decide they will
“subsidize”their relative to be in a private room when all
the relative can afford would be basic accommodation. That is simply a
matter to be determined within the family.
Residents may, at their own cost, provide a telephone or cable TV,
and there is a charge for hairdressing, usually provided “on
The following is a breakdown of the funding (per resident per day)
received by long term care homes from the Ministry of Health and
Long-Term Care (base level of care funding only - does not include
Long Term Care
Home Per Diems
(July 1, 2013)
Average Rate Per
Nursing & Personal Care
(based on a CMI of 100)
Programming & Support Services
ways of obtaining extra financial help?
Yes. If you are a veteran, there are programs and services to assist
you. For more information visit the Veterans Affairs
If you are admitted to a long term care home and cannot pay the full
cost that is mandated by the Ministry of Health and Long-Term Care,
someone in the home can advise you about applying for the Guaranteed
Annual Income Supplement (GAINS). As well, in cases of need, it is
possible to apply for “exceptional circumstances” regarding
the costs the resident is required to pay, and the home will assist in
If there is an assessed need for equipment, such as a special chair,
the physiotherapist can help you through applying through the Ministry
of Health and Long-Term Care Assistive Devices Program (ADP).
If the resident is under age 65, there are programs through social
service agencies in your area that may be able to help.
If you haven't done so already, you can also obtain details on
the Old Age Security Program from the Government of Ontario
Adapting to a long term care home
There is no doubt that there will be a period of adjustment, not only
for the resident, but also for anyone who has been providing the care.
Sometimes it may feel as if your care, or that of your family member is
being given to complete strangers, and there may be feelings of anxiety.
If that sounds familiar, you are not alone! Feelings of guilt and
abandonment are usual, and some take longer than others to deal with
those issues. The home can help by suggesting a support group that could
be useful to families in sharing ways of handling those very normal
feelings. In fact, the home may have a family support group right there
that will welcome you.
Making the new surroundings as much like home as possible is a
good beginning. Talk to the home about what can be brought to the new
home. That may include pictures for the wall, perhaps a special
bedspread, maybe a small piece of furniture that holds important
memories. For families, it helps to take a tour with the new resident,
letting her show off her new surroundings. Reassure the person that you
and others will be able to visit. If the resident is able, she is
certainly free to leave the home for visits or to go to a restaurant -
anything that matches her capabilities. He or she is encouraged to
participate in the many activities planned in the home. Depending upon
the circumstances, families may be able to volunteer in some of those
activities, and that involvement gives everyone a deeper sense of
inclusion in the new home.
Every home has its own plan to help residents feel at home. It is
hard to imagine being lonely while surrounded by staff and other
residents, but it can happen, for the first while especially. Perhaps it
will be appropriate to have a telephone in the resident’s room so
that contact with family and friends is at hand. Staff are particularly
supportive of new residents and their families. Don’t hesitate to
let them know how you are feeling. Most homes have a Residents’
Council, run by the residents, where residents are invited to meet each
other and discuss any issues that may have arisen Before you know it,
the home will be “home”, and you will see the results of the
appropriate care that is being given. Regular conferences are held with
the staff to prepare and update the planning for each resident’s
care. Families and residents are invited to attend and to contribute
their ideas. Rest assured there is always someone at the home to talk to
whenever there is a question.
Checklist of questions to consider when visiting
The following are some questions you might want to consider getting
answers to as you visit homes to help you in your decision making
What group governs the home? Is it operated on a not-for-profit
or for-profit basis? What is its Mission Statement?
Is it convenient for family and friends to visit?
Is there a welcoming atmosphere when I enter the
Do residents appear well groomed and appropriately
How do I see staff reacting toward residents and amongst
themselves? Do they appear to know residents’ names?
Is the home clean? Is it free of offensive
Are resident rooms well appointed? Is furniture in good repair?
Is a call bell - or some communication device or system - within easy
reach? What personal belongings may the resident bring?
Is there privacy in the resident’s room? Are areas
provided in the home for private visits with residents?
Visit during a meal time. Check the menus and the choices
provided. Is the dining area clean and inviting? Do the meals look
appetizing? Are special diets provided? Is a dietitian involved with
meal planning and assessment of residents? Are family members or friends
able to have an occasional meal with the resident?
Is there a special secured area for the safety of residents who
might wander away? Is there special programming provided in that area?
Are those residents included in activities with the rest of the
How is the community involved with the home? Is there an
Auxiliary and/or volunteer group?
Are there any restrictions about visiting?
What activities are provided for the residents? Are there
provisions for services to improve mobility rehabilitation? Are there
activities away from the home in which the residents may
Is there at least one Registered Nurse on duty at all times?
What other staff are employed in the home?
Who are physicians attending the home? How often do they
Are safe outdoor areas easily available to
Print checklist in PDF format
Advice on the MOHLTC Public Reporting Website on long
term care homes
Not-for-profit homes across the province have always supported full
public access to information. Our accountability is strengthened by
greater transparency, including open councils, regular community
meetings, and public reports through municipal councils, not-for-profit
and charitable boards.
The Ministry of Health and Long-Term Care has created a Public Reporting website to provide consumers with
information on the performance of long term care homes.
The following is advice on importance information to look for on this
Home Profile Page
Look for who operates the home. This will tell you if the home
is not-for-profit (charitable, municipal or not-for-profit nursing
Be sure to visit homes you are interested in to see what they
look like. Don’t rely solely on the information on the website
about design of the home and configuration of the resident rooms.
Where a website is provided, go to it to get more information
on the home.
Be aware that this information is already posted in homes and
has been for years but the information in the homes also includes the
action the home is taking to address any unmet standards. The
information in the home is also the most recent whereas the website data
may not be current. Homes often have corrected any concern within days
after the finding is made.
Contact the home administrator to ask about nature of the
‘unmet standards’ and/or ‘verified concerns’ to
understand the degree to which this finding truly impacts on care and
services to residents.
Be careful not to rely on it exclusively on this data in making
decisions. You should always consider a number of factors, and use a
variety of information sources, when choosing a home. For example:
visit prospective homes and talk to staff
review resident satisfaction surveys
ask about the accreditation status of the home
ask for references from residents, families and/or ask to speak
to a member of the residents’ and/or family council
You would not choose your own home without seeing it, or buy a car
without test driving it. Choosing a long term care home for yourself or
a loved one is a very important task. Do it with care