Long-term Care Homes
Long-term care homes are designed for people who require 24-hour a day nursing care and supervision. As of April 11, 2022, the Fixing Long-Term Care Act and O. Reg. 246/22 govern long-term care homes in Ontario.
ACE can give legal advice to the older adult whose rights are in issue, and in some instances their substitute decision-maker(s) where the person is mentally incapable, regarding a variety of issues related to living in a long-term care home.
Applications for admission to long-term care homes must be made through one of Ontario's 14 Home and Community Care Support Services organizations (HCCSS) (formerly the Local Health Integration Network (LHIN)). Once a placement co-ordinator from the HCCSS determines that you are eligible, you may choose up to five homes where you would like to go. If the homes you choose agree to accept you, you can then be admitted. If there are no beds available, you will be put on a waiting list until an appropriate bed is available in one of them. If your situation becomes a crisis (for example, your caregiver dies and you cannot stay alone) or you are in a hospital, you will be put on a crisis waiting list for each home you have chosen. This means that you are no longer limited to choosing five homes.
In most cases, admission to a long-term care home requires your informed consent. If an evaluator determines that you are not mentally capable of making a placement decision, your substitute decision-maker will make the decision for you. In an emergency, if you are incapable, it is possible for you to be placed into a long-term care home without obtaining consent, but this is unusual. As of September, 2022, if you are in hospital, the HCCSS placement co-ordinator can choose and accept homes on your behalf in certain circumstances. If this is happening to you, please get legal advice immediately.
The provincial government pays for the cost of providing nursing, personal care, as well as programs and support services. You pay only for your accommodation, which includes meals. The maximum amount you can be asked to pay each month to live in a long-term care home is set by the government. If you want semi-private or private accommodation (called preferred accommodation), you will have to pay an extra amount, which is also set by the province. If you are staying in basic accommodation but you cannot afford even this basic rate, you can apply for a rate reduction. If you are entitled to the rate reduction, in most cases you will have a small amount left over each month for your personal expenses after paying the accommodation fee. If you ask, the home must help you make all appropriate applications for reductions. Financial considerations are not a barrier to admission under any circumstances: a home cannot turn you down based on your income or ability to pay. If you have requested and placed into preferred accommodation, there are no rate reductions available. However, in some circumstances you may ask for basic accommodation but be placed into preferred, for example due to room availability: in those cases you will be treated as if you are in basic accommodation with respect to accommodation fees.
If you decide to accept a semi-private or private room, you must be sure that you can pay this amount indefinitely unless you enter into a specific written contract with the home that says otherwise. While you can apply for an internal transfer to basic accommodation upon admission, it may take years and you will have to pay the higher rate while waiting for the transfer.
The Ministry of Long-Term Care inspects long-term care homes for compliance with the FLTCA and its regulations. Inspections can be triggered in a number of ways, such as proactively by the Ministry, through critical incident reports made by the homes, or through complaints by residents, their families or the public. For more information about the long-term care home complaint process: click to learn more.
To make a complaint contact:
Long-Term Care ACTION Line
1-866-876-7658 or 416-326-6777 (outside of Ontario)
TTY services: 1-800-387-5559 or 416-327-4282 (outside of Ontario)