5.1 Long-Term Care Facilities

Long-term care facilities take care of people who are no longer able to live independently in their own homes even with the range of community supports available in Ontario. Long-term care facilities are designed for people who require on-site 24-hour nursing services, daily personal assistance, or are at risk in their current homes.

Long-term care facilities are provincially funded and regulated. They are sometimes known by their historic terms: nursing homes, municipal homes for the aged and charitable homes for the aged.

• Nursing homes are licensed by the province and are subject to the provisions of the Nursing Homes Act. They may be operated by non-profit or for-profit operators, which include single owner operations and chain operations with multiple homes. About 90 percent of nursing homes are operated by for-profit operators.
• All homes for the aged are non-profit. All municipalities are required by legislation to operate a municipal home for the aged under the Homes for the Aged and Rest Homes Act. Larger municipalities often operate more than one home.
• Charitable homes for the aged are operated by non-profit organizations under the Charitable Institutions Act. All long-term care facilities are subject to the same provincial standards with respect to care and services and resident fees.

Eligibility and Access to Long-Term Care Facilities

A Community Care Access Centre (CCAC) case manager determines eligibility for admission to a long-term care facility. The CCAC also determines priority for admission and manages the waiting lists for facilities.

Generally, applicants must be 18 years of age or over, have a valid Ontario Health Card and require on-site 24-hour nursing care, plus assistance with activities of daily living or on-site supervision/monitoring throughout the day to ensure their safety or well being.

It must be shown that the applicant’s care requirements can best be met in a long-term care facility and that none of the publicly funded community-based services or other caregiving, support or companionship arrangements available to the applicant are sufficient, in any combination, to meet his or her requirements. If the person does not meet eligibility requirements for a long-term care facility, the case manager can provide information about other available options.

Your local CCAC is the first place to learn more about eligibility requirements and how to access long-term care facilities. Staff at the CCAC will discuss options available and help you find accommodation in a long-term care facility, if needed.

You can also view a list of long-term care facilities in your community Ministry of Health and Long-Term Care at www.Itccareers.com/Facilitysearch/english and www.healthyontario.com

Accommodation Rates

All nursing and personal care services are paid by the Ontario Government. Residents pay for their accommodation costs (a needs test often based on their income). The maximum amount that residents can be charged for accommodation is determined by the province and set out in regulations. Accommodation rates are generally set each July 1 by the Ministry of Health and Long-Term Care.

People who cannot pay the full basic accommodation rate (previously known as ward accommodation) can apply to the Ministry of Health and Long-Term Care for a rate reduction. People in preferred accommodation (semi-private and private rooms) must pay the full rate for basic accommodation plus a premium for the semiprivate or private room. There is no rate reduction for people in preferred accommodation.

Residents may choose to purchase additional services beyond what long-term care facilities are required to provide (e.g. cable television, personal telephone, and hairdressing/barbering). All such charges must be agreed to by the resident in advance. A facility may not charge a resident for these services without the resident's agreement in writing.

Services in Long-Term Care Facilities

Long-term care facilities provide health services for people who can no longer live independently in their own homes and who need nursing and/or personal care 24-hours a day. These facilities are designed with a homelike environment where each resident can feel safe, comfortable, and well cared for in a private, semi-private or basic room. Healthy living, activities and socialization with appropriate nursing care on-site are common features in all long-term care facilities.

Long-term care facilities are funded specifically to provide nursing and personal care and promote quality of life and independence through the provision of recreational activities, therapy services, counselling, spiritual care and other programs. Long-term care facilities employ registered nurses, registered practical nurses and personal support workers/health care aides, program staff, housekeeping and maintenance staff. All meals are provided including therapeutic and texture modified diets if necessary. Every long-term care facility must employ the services of a dietician.

Short Stay/Respite Beds

Some long-term care facilities may offer short-stay programs providing respite or supportive care. A short-stay bed may be used on a temporary basis if a person requires a short-term admission as a result of a crisis. Short-stay programs are also targeted to those individuals who may require or benefit from a short stay in a long-term care facility or whose caregiver may need relief for a short period. All users of short stay/respite beds are expected to return to their home in the community within a specified period of time.

Residents’ Bill of Rights

All three Acts that regulate long-term care facilities (Nursing Homes Act, Homes for the Aged and Rest Homes Act and the Charitable Institutions Act) include a Residents’ Bill of Rights. The Residents’ Bill of Rights spells out in detail residents’ rights and the responsibilities of the facility to fully respect, promote and support these rights, as well as residents’ autonomy and decision-making. Every resident has the right to be treated with courtesy and respect, in a way that fully recognizes the resident’s dignity and individuality and to be free from mental and physical abuse. Residents must also be given the opportunity and support to establish and maintain an organized residents’ council.

Long-term care facilities are required to post the Residents’ Bill of Rights in both English and French, in large print and in locations in the facility that are easily accessible to residents or their substitute decision-maker. On admission, each resident or substitute decision-maker receives a copy of the Bill of Rights and the processes for obtaining information, raising concerns, lodging complaints or recommending changes regarding the facility and its services (without fear of restraint, interference, coercion, discrimination or reprisal). The long-term care facilities are expected to establish policies regarding the promotion of residents’ rights, what constitutes resident abuse, how to prevent abuse, and actions to be taken in all instances of alleged abuse. Where abuse has been confirmed, the long-term care facilities are expected to make resources available to assist the abused resident and the person responsible for the abuse.

Public Reporting on Long-Term Care Homes

The Public Reporting on Long-Term Care Homes tool will provide information about the performance of long-term care homes during a specified reporting period. The information will be updated regularly. For more information on the Public Reporting on Long-Term Care Homes, visit http://publicreporting.ltchomes.net.

Complaints

Even if you have participated in choosing your new home, some adjusting and compromising may be necessary as you settle in. If a problem arises, it is best if you and/or your family/substitute decision-maker solve it before it becomes a crisis. Always try to discuss your concern first with the person in charge of the service about which you have a complaint. The administrator of the facility is the person to see if this action is not effective in resolving your problem or if you have other concerns or needs that may arise after you move in.

If you are living in a long-term care facility and you cannot reach a resolution with the administration, you can raise your concerns with the local office of the Ministry of Health and Long-Term Care. The ministry employs a group of staff specifically to monitor long-term care facilities and investigate resident complaints. You can obtain the number for your local office by calling the Seniors’ INFOline at 1-888-910-1999.

Residents’ Councils

Long-term care facilities are required (when requested by the resident population) to have active councils or committees. Every resident has the opportunity to participate on residents’ councils, and thus have an influence on the quality of life in the home. The purpose is to encourage an exchange of ideas, suggestions and concerns regarding all aspects of care and activities in the home to enhance relations with staff and volunteers.

For more information on residents’ councils, contact:
Ontario Association of Residents’ Councils
351 Christie St.
Toronto ON M6G 3C3

Phone: 416-535-3718
E-mail: oarc@idirect.com

Family Councils

Many long-term care homes have an active family council. A Family Council is an autonomous group of family/friends of residents that provides a venue for mutual support, information and education, and advocacy. Although all Family Councils have these goals in common, each Council is unique in meeting the needs of its members, the residents, and the home.

For more information on family councils, contact:

The Family Councils Program
40 Orchard Blvd., Ste. 219
Toronto ON M4R 1B9

Toll-free: 1-888-283-8806
Phone: 416-487-4355
Website: www.familycouncils.net

The Waiting List

Community Care Access Centres (CCAC) manage admissions to all long-term care facilities including determining priorities for admission and managing the waiting lists for long-term care facility admissions. Persons most in need of a long-term care facility are placed first. If you are interested in entering a long-term care facility, contact the CCAC in your area for assistance. See the Directory, for the CCAC in your area.

A Transfer is Possible

It may happen that you find yourself in a facility that does not match your expectations or preferences, and you may wish to transfer to another facility. You are entitled to apply for a transfer to another long-term care facility. To explore this possibility, please call the CCAC in your area.

Long-Term Care Facilities Located in First Nations Communities

There are three long-term care facilities located in First Nations communities:

Wikwemikong Nursing Home
2281 Wikwemikong Way
PO Box 114
Wikwemikong ON P0P 2J0
Phone: 705-859-3107

Iroquois Lodge Nursing Home
Chiefswood Rd.
PO Box 309
Ohsweken ON N0A 1M0
Phone: 519-445-2224

Tsi Ion Kwa Nonh So: Te
Cornwall Island, I.R.
RR #3
Cornwall ON K6H 5R7
Phone: 613-932-1409

5.2 Chronic Care

Chronic Care is provided in hospitals for people who cannot be treated at home or in long-term care facilities. Patients may require immediate access to a physician due to an unstable physical condition, require treatment for a progressive illness such as Alzheimer Disease or access to specialized care such as palliative care or tube feeding. Residents are charged a co-payment set by the Ministry of Health and Long-Term Care in a fashion similar to that of the long-term care facilities.

For more information about the referral process, see your physician or a CCAC case manager.