Community Care Info

For a list of the Long-Term Care Homes in the South East Local Health Integration region, click here.

The Ministry of Health and Long-term Care's webpage on Long Term Care Home Inspection Reporting is useful for finding information on Long Term Care Homes by Local Health Integration Region ( LHIN).

Moving to a Long-Term Care Home becomes the most appropriate care option when staying at home is no longer possible.

Specifically when:

• nursing care and assistance must be available at all times
• the care required is extensive
• the impairments are either physical, cognitive, or both
• an individual's needs can no longer be met by existing caregivers or available visiting support services

Long-Term Care Homes are sometimes also called "Nursing Homes" or "Homes for the Aged."

Government Funding and Monitoring

All Long-Term Care Homes are funded, regulated, monitored and inspected by the Ministry of Health and Long-Term Care (MOHLTC). According to provincial standards, all homes must offer the same core services to adults of any age, including:

• nursing and personal care services on a 24 hour basis
• one or more staff doctors on call
• physiotherapy services, all necessary medical supplies and nursing equipment
• complete meal services, laundry services, bedding and linen
• active resident and family councils
• appropriate social programs and recreational activities
• linkages with religious and pastoral services

For more information on the provincial standards for long-term care homes, click here.

Funding and Costs
All Long-Term Care Homes receive provincial funding based on the number of residents and the levels of care provided. All homes charge the accommodation fees set by the Ministry of Health and Long-Term Care as follows:

Types of Accommodation	# of People Sharing a Room	Government set Maximum Monthly Co-Payments	Daily Rates
Basic Room	1 to 4 depending upon when the home was built or renovated	$1,614.21 *	$53.07
Semi-Private Room (Preferred Accommodation)	2 people with a shared bathroom	$1,857.55 *	$61.07
Private Room (Preferred Accomodation)	1 person with private bathroom	$2,161.71*	$71.07
Short-Stay Program		$1,050.29 *	$34.53
Note:  These rates are effective July 1, 2009 and are subject to change * Subsidies are available for individuals with low incomes

Differences among individual 
Long-Term Care Homes
Individual LTC Homes may differ from each other in a variety of ways, including:

• room styles, sizes and layout
• types and frequency of recreational and social programs
• religious or cultural focus
• philosophy of care
• optional services offered (such as on-site banking, hairdressing, dry cleaning and uninsured foot or dental care services)
• size and strength of the volunteer core
• the design of the building and surrounding grounds, garden area
• the age, size, and location of building
• transportation options for resident outings
• whether or not they provide a designated and controlled smoking area

Performance Record

To see whether the home has been accredited by the Canadian Council on Health Services Accreditation (CCHSA) click here.

To see the latest copy of the annual inspection review report for the home of your choice from the Ministry of Health and Long-Term Care click here.

Ownership and Governance

• small or large corporations
• charitable organizations with specific religious, cultural, or ethnic affiliations
• municipal governments
• Long-Term Care Homes may operate on a for-profit or not-for-profit basis

A Note on Retirement Homes

Retirement Homes are different from Long-Term Care Homes in that:

• Resident fees are set by each retirement home operator
• The care is not regulated or monitored by the provincial Ministry of Health and Long-Term Care.

A Community Care Access Centre (CCAC) Coordinator will assess your needs, determine your eligibility for a Long-Term Care Home and guide you through the stages of the application process. If you are in hospital, a social worker or discharge planner will assist with the application process.

Steps in the Application Process

1. Assessment of applicant’s health status and care needs
2. Identification of decision maker for the application
3. Consent to proceed with the application
4. Eligibility determination
5. Selection of home and accommodation type
6. Assignment on the Waiting List
7. Responding to an offer of a space in a chosen home

These steps are the same for both a short-stay or long-stay in a Long-Term Care Home.

• Long-Stay refers to accommodations that are obtained for an indefinite period of time
• Short-Stay refers to temporary stays at a home.  The maximum number of time a person can stay is 90 days per year.  The short stay can provide respite for caregivers and/or supportive services often following a stay in hospital.

IMPORTANT TO KNOW

Applicants can apply to a home anywhere in Ontario, and are not restricted to homes in the city/area they live in.

• Submit an application only when the applicant is ready for placement, as a space in any of the chosen homes may be available very quickly
• Applications will be reviewed by the chosen homes and accepted or rejected. After an application is sent to a home, the CCAC expects a response within five days about whether they can meet the applicant’s requirement for physical space and care
• It is important to start preparing for the move as soon as the application has been submitted and accepted on the waiting list of the selected homes.

 

Step Details

1. Assessment of applicant’s health status and care needs
   A thorough assessment of the applicant's situation is conducted. This assessment is usually completed at the applicant’s home or at the bed side in a hospital. It involves obtaining information from a physician on the applicant’s medical and health status
2. Identification of decision maker (for LTC application process)
   An evaluation of the applicant's capacity to provide consent is required. This confirms who will make the various decisions and sign the forms within the application process. If the applicant is not capable, then a substitute decision maker provides the consent.
3. Consent to proceed with the application
   When the capable client or the substitute decision-maker has signed the consent form, the application process can then proceed.
4. Eligibility determination
   Eligibility is based on the criteria set by the provincial Ministry of Health and Long-Term Care. A person is considered eligible if he/she has:
   • A valid Ontario Health Card
   • Care requirements that can be met by Long-Term Care Homes when the required services are not available in the community.

In addition an applicant must need one of the following:

• Availability of nursing care 24-hours per day
• Daily assistance with personal care
• Supervision throughout the day
• To be at risk of harming others or oneself, emotionally or physically, if the applicant remains in current residence

Note: Income does not affect eligibility. A provincial subsidy is available for rooms at the basic rate for applicants with lower incomes. A tax “Notice of Assessment” is required as a proof of income.

5. Selection of home and accommodation type
   A CCAC Coordinator is always available to answer questions as you go through the process of selecting a home. Applicants can choose up to three homes and must specify the desired style of room (e.g. basic, semi-private or private accommodation).
   
   CCR gives you a number of ways to search for a Long-Term Care Home and view the detailed information about accommodations and services.
   • If you are interested in a specific one, just type the name into the Keyword Search
   • To search by specific Meidcal and Lifestyle needs click here
   • To see the locations of all Long-Term Care Homes in the area, and then choose from location, click here to go to our map page

Things to consider when choosing a home:

• geographic location and amenities nearby
• care philosophy and the availability, friendliness and qualifications of staff
• features of the different accommodation types (e.g. size of rooms, number of beds per room, bathrooms, common areas etc)
• recreational and outdoor activities
• optional services, such as hairdressing, newspaper delivery, foot care, in-house banking
• religious, cultural or ethnic focus
• smoking areas
• secure environments and gardens for people who are very disoriented and at risk of wandering

The best way to select a home is to visit it in person. Arrange a tour of several homes in order to compare options and get a feel for each place and the staff. If you are interested in seeing a particular part of the home (such as a secure unit for people who are very disoriented) then you should request this when phoning to arrange your tour.

Bring a checklist to ensure that you are asking the questions that are important to you during a tour or meeting. To download a suggested checklist, click here (or you can obtain a paper copy of a checklist by calling your local Community Care Access Centre).

6. Assignment on the Waiting List
   Once the homes have been selected and they have accepted your application, you will be placed on a waiting list. Waiting periods range from a day or two to several months, or even longer, depending on:
   • type of accomodation (only 40% of beds in each home are at basic rate)
   • applicant's cognitive status and the type and level of care required
   • need for special care (e.g. feeding tube, etc)
   • the home's designation as serving specific ethnic, linguistic or religious communities

However, if there is a short or no waiting list, a bed may be offered immediately. Note: Whenever a person requires crisis placement in a home, a suitable place is found within a couple of days.

Responding to an offer
When space becomes available at one of the three homes of your choosing, the CCAC staff will ask you to accept or reject the offer within 24 hours of receiving the call.  If you accept the offer, you may choose to keep a position on the waiting list for your top choice.  If you refuse the offer, your application to all chosen homes will be cancelled.  In this case, you cannot reapply for six months, unless there is a significant change in condition or circumstances.

For more information on preparing to move to a Long-Term Care Home, please see the next section.

When a CCAC Coordinator calls with the offer of a space in one of your selected homes, you are asked to decide within 24 hours whether or not to accept. If accepting, you must move in within five days of the offer. Additional charges may apply if you are not able to move in by the second day.

As soon as the application has been submitted, you can begin to plan the move.  Preparing For the Move Into Long-Term Care; “A Checklist” will help prepare you for the move.

Here are some suggested strategies:

Step 1: Plan ahead for the move:

• Have money set aside to pay for the first month’s accommodation fee and any optional services (e.g. cable TV).
• Have the most recent Income Tax Notice of Assessment (the official Canada Revenue and Customs Agency document confirming your annual income) available if applying for the accommodation subsidy
• If possible, once the offer of a place has been accepted, go to the home and sign the contract in advance.
• Have copies of the Power of Attorney papers available if needed
• Identify which possessions you will move on or after moving day– this could include pictures, afghan, radio, or other accessories (you need to check with the staff of the home to confirm which furnishings are suitable)
• Label personal items (e.g. eyeglasses, radio, clock)
• Provide instructions for the things that are not moving to the home

Step 2: Moving Day:
If possible, have a family member or friend help on moving day to assist with settling in. Be sure to remember essential items, including:

• All medications (both prescription and over-the counter) in the original labeled containers.
• Clothing that is machine washable
• Familiar things to make the room feel like home.

It is not recommended that you bring valuable items (e.g. cash, precious jewelry, figurines or artwork) until arrangements have been made with the home for safekeeping

Before bringing food or alcoholic beverages, ask the staff about the home’s policies on these matters.

Step 3: Settling In
The residents and their families will go through the transition period in their own time and in their own way. Families can support the transition by:

Decorating the room in a way that captures the tone of the person’s previous home by displaying:

• photos or awards of the person’s accomplishments
• crafts or items they may have made
• photos of key events or favourite people
• samples of collections
• gifts or art that grandchildren may have given
• items that bring nature to the room, like plants or flowers (if safe for the resident)

Talking with staff will help them get to know the person moving in. Tell them about:

• key events in their life
• likes and dislikes, such as foods, music, hobbies
• special routines or preferences with hygiene or personal care
• strategies that have worked to overcome difficulties with speech, memory, hearing or if they have dementia or behavioural challenges

Reaching out to other residents, their families and the staff to learn more about the people, routines and programs available.

When someone moves to a Long-Term Care Home, it is important to remember that the family’s caring role does not end – it just changes in nature. Family and friends can maintain a caring role in a variety of ways:

• visiting at the home
• participating in activities at the home
• staying for a meal
• helping with meals or hygiene care, as appropriate
• going on outings
• taking the family member for a visit to your home
• having family celebrations in the home
• phoning regularly
• sending greeting cards or short notes

Communicating with staff

Regular contact with staff will ensure a connection between the family and the staff caregivers, and will help support the continuity of care provided.

Families can:

• phone or meet with staff in-person, to hear about changes in care or the resident’s needs
• ask staff about needed personal items such as clothing or magazines that can be brought or purchased
• request more informal meetings with staff as needed, in addition to the standard Family Conferences held at least once a year to exchange information for the care planning process

Dealing with Concerns

If a concern arises about the delivery of care, the most direct way to resolve the issue is to speak to a staff member.

If this does not help resolve your concern, then speak to the Director of Care and/or Administrator.

Each home will have a Resident’s Council and possibly a Family Council that might help to resolve a concern about the operation of a home:

• The Resident’s Council is made of up of residents (may include a staff member)
• The Family Council is comprised of resident’s family members (may include a staff member).

If the response of the administrative staff or the Councils is not satisfactory, then it may be beneficial to file a complaint with the Ontario Ministry of Health and Long-Term Care.

By telephone:
Long-Term Care ACTION Line at 1-866-434-0144

Or send a letter to:
Director, Long Term Care Homes Branch
Ontario Ministry of Health and Long Term Care

5th Floor, Hepburn Block

80 Grosvenor Street

Toronto, ON M7A 1R3

For more detailed information about filing a complaint to the Ministry of Health and Long-Term Care, click here.

Getting Support for Yourself as a Caregiver

The love and emotional support of a family member continues to be a vital part of the quality of life for a loved one in a Long-Term Care Home. Therefore, finding the support you need to continue as a caregiver can be very important for carrying on in your role

There are caregiver support networks.  Some of these groups are organized on the basis of a cultural, faith, service orientation (e.g. Day Program) or disease orientation (e.g. Alzheimer’s Disease). You can search for one using CCR keyword search, or call your local CCAC office and ask for information about your local caregiver groups.

You can also find support from various agencies that provide expertise and advice to people coping with a particular disease (e.g. the Alzheimer’s Society or the Cancer Society). Many of these organizations offer on-line forums and resource materials. To locate some of the agencies helping people with a specific disease, go to our Resources page.

To learn how the waitlist works, click here.

The "Long-term Care Home Service Inventory For Patients And Families" provides a table comparison of the services of interest to patients and families that each LTC home in the South East region provides.  This document is large and best printed on ledger size paper (11"x17"), or at the very least legal size.

 

The "Long-term Care Home Service Inventory For Professionals" provides a table comparison of the services of interest to healthcare professionals that each LTC home in the South East region provides.  This document is large and best printed on ledger size paper (11"x17"), or at the very least legal size.

For a Long Term Care Planning Guide, click here.