N/A = Insufficient sample size obtained to justify inclusion
* Fees range depending on what kind of nurse, such as a registered nurse (RN) or Licensed Practical Nurse (LPN) delivers care.

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GOVERNMENT-SUBSIDIZED NURSING HOMES
How Nursing Homes are organized and administered
Nursing homes or long-term care homes, as they are called in Ontario, are residential facilities that provide 24-hour skilled nursing care and supervision. They offer higher levels of personal care and support than those offered by retirement homes or supportive housing and cater to individuals, usually seniors, who have serious long term health care needs that cannot be fulfilled in the home. However, they also provide short-stay (respite) services in order to provide family caregivers with a break from caregiving duties or to provide the resident with support to regain strength and confidence, usually following a stay in a hospital.
Long-term care homes are owned and operated by various organizations including private corporations, municipal councils and non-profit organizations such as faith, community, ethnic or cultural groups. The fees for all nursing homes in Ontario, regardless of ownership, are set by the Ontario Ministry of Health and Long-Term Care.
All applications to long-term care homes in Ontario are coordinated by Ontario Health atHome, and all applications and admission to long term care homes are now arranged by one of Ontario's 14 branches. Once an assessment has been conducted to determine eligibility, the next step is to choose the homes to which to apply. Ontario Health atHome will provide lists and basic information about homes in the area, and an individual may apply to a maximum of five homes.
Eligibility/Requirements for Admission
In order to qualify to move to a long-term care home, a person must:
The LHIN will determine eligibility by conducting an assessment of health needs and the availability of alternative care options such as home care and informal caregivers.
Income/Asset Test
An income or asset test does not form part of the assessment conducted by the Ontario Health atHome. Anyone who meets the above criteria is eligible to apply for a spot in a nursing home regardless of their financial situation. If an individual’s income is not sufficient to pay for the basic accommodation, there is a subsidy available. However, it is only available for basic accommodation. Ontario Health atHome will assess whether an individual’s income is indeed insufficient to cover the cost of the nursing home based on income tax returns. If such is the case the total monthly income of the individual less $149 per month, will be taken towards covering the cost of a basic bed and the rest of the cost will be covered by the provincial government.
Costs
Fees for nursing homes are standardized across Ontario, regardless of ownership, and are established by the Ministry of Health and Long-Term Care (MOHLTC). The MOHLTC provides funding for homes. The amount paid by residents for their accommodation is called a "co-payment". Costs for accommodation in a long term care home depend upon the type of accommodation.
Type of Accomodation | (Description) | Co-payment Daily Amount | Co-payment Monthly Amount |
---|---|---|---|
Basic/standard accomodation | Usually wards (3 or more beds) but depends on when the home was constructed or renovated | $66.95 | $2,036.40 |
Preferred accomodation | Semi-private rooms | $80.72 | $2,455.24 |
Preferred accomodation | Private rooms | $95.65 | $2,909.36 |
Respite | Short stay | $43.34 | $1,318.26 |
Nursing Home fees include:
Additional services such as hairdressing, cable TV and telephone services, transportation, etc. are usually available for an additional fee. All long-term care homes have dining rooms and common rooms, and may also have features such as a lounge, gift shop, beauty salon, chapel, or garden.
RETIREMENT HOMES / RESIDENCES
How Retirement Homes are Organized and Administered
A retirement home in Ontario is a multi-residence housing facility that provides accommodation and services such as meals and cleaning services for older people. Retirement homes in the province are privately owned and operated and not administered by the provincial government. Each facility usually provides a private or semi-private room or complete living suite and then also provides common living quarters, including a lounge area, a common dining room, recreation rooms, cleaning services, social and/or religious programs and some basic health care services. The unit can be paid for on a monthly fee basis, like an apartment, or can in some instances be bought the same way as a condominium.
Admission, fees and waiting lists for retirement homes are controlled by the homes themselves, not by the government. Admission usually depends on the ability to pay and absence of serious medical conditions that require professional nursing care. Residents are responsible for paying their own fees and government subsidies are not available for accommodation in a retirement residence.
Costs for Retirement Homes
Type of Accommodation | Provincial Median | Provincial Range |
---|---|---|
Private Rooms (per month) | $3,856.50 | $1,800.00 - $8,700.00 |
One Bedroom Suites (per month) | $5,210.00 | $2,850.00 - $14,000.00 |
Type of Accommodation | Toronto Median/Range | Ottawa Median/Range | Kingston Median/Range | Windsor Median/Range |
---|---|---|---|---|
Private Rooms (per month) | $4,473.25 / $2,650.00 - $8,700.00 | $3,597.50 / $2,475.00 - $6,350.00 | $3,860.00 / $3,010.00 - $5,100.00 | $3,560.00 / $3,375.00 - $6,575.00 |
One Bedroom Suites (per month) | $5,624.50 / $2,850.00 - $14,000.00 | $5,195.00 / $3,000.00 - $11,450.00 | $5,477.00 / $4,195.00 - $6,843.00 | $4,706.25 / $2,950.00 - $4,975.00 |
Home First Program
How Home First Program Works
Home First Program is a program that was started in 2010. It is an option provided to seniors who are in the hospital with an acute illness and are considering going to long term care.
Eligibility
Ontario Health atHome will work with the family and the senior to arrange necessary in-home services for a limited time until either the client recuperates, or a long term care bed becomes available. However, home care assistance is limited (no 24 hour care provided), and family support in caring for the senior is required.
Please note that the senior is required to take the first long term care bed that becomes available to them regardless of their preference. Once admitted here, they can then wait for a bed to become available in their preferred facility.
Also note that if a senior's assessment is deemed unsafe or inappropriate for safety and/or medical reasons, the Home First Program will not be made available to that senior. There must be the required support at home for them to be discharged home from the hospital.
GOVERNMENT-SUBSIDIZED HOME CARE
How Government-subsidized home care is organized and administered
All Home and Community Care Support Services are now referred to as Ontario Health atHome and continue to administer all home care subsidized by the provincial government. Once contacted, Ontario Health atHome will assign a Care Coordinator who will conduct an assessment of the senior’s needs and develop a care plan to meet those needs. Home care services allow seniors to live at home independently for as long as possible.
There are four main categories of Home and Community Support Services:
Eligibility/Requirements for Admission
To receive home care services from Ontario Health atHome, a person must have:
Income/Asset Test
An income or asset test does not form part of the assessment conducted by Ontario Health atHome. Anyone who meets the above criteria is eligible to apply for home care regardless of their financial situation.
Costs
Ontario Health atHome services are provided at no cost to clients, and are dependent on assessment and availability.
PRIVATE HOME CARE
Resources from Ontario Health atHome are limited and go to the neediest. As a result, many seniors get inadequate amounts of services from Ontario Health atHome, and therefore have to rely on private home care services to receive the appropriate amount of care to meet their needs.
Costs of Private Home Care
Type of Service | Provincial Median | Provincial Range |
---|---|---|
Meal Delivery (per meal) | $8.00 | $6.00 - $13.00 |
In-home Meal Preparation (per hr) | $37.50 | $10.00 - $47.50 |
Laundry/Housecleaning (per hr) | $35.00 | $10.00 - $47.50 |
Personal Care (Bathing/Dressing) (per hr) | $38.00 | $18.00 - $47.50 |
Companionship/ Supervision (per hr) | $37.50 | $18.00 - $47.50 |
Skilled Nursing* (per hr) | $69.00 | $45.00 - $100.00 |
Physiotherapy (per hr) | $150.00 | $125.00 - $200.00 |
Occupational Therapy | $150.00 | $120.00 - $200.00 |
In Home Relief (per hr) | $38.00 | $18.00 - $80.00 |
Palliative Care (per hr) | $45.95 | $30.00 - $80.00 |
24 Hour Care (per hr) | $37.50 | $18.00 - $47.50 |
N/A = Insufficient sample size obtained to justify inclusion
* Fees listed are for RNs however, these fees may vary depending on the type of nurse, such as a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), delivering the care.
Type of Service | Toronto Median/Range | Ottawa Median/Range | Kingston Median/Range | Windsor Median/Range |
---|---|---|---|---|
Meal Delivery(per meal) | $9.00 / $7.00 - $12.00 | $8.00 / $7.00 - $13.00 | $8.00 / $7.00 - $10.00 | $8.00/ $7.50 - $8.25 |
In-home Meal Preparation (per hr) | $37.50 / $10.00 - $47.50 | $39.50 / $37.50 - $40.00 | $40.00 / $40.00 | $40.00 / $40.00 |
Laundry/Housecleaning (per hr) | $37.50 / $10.00 - $47.50 | $38.00 / $25.00 - $40.00 | $22.00 / $21.00 - $40.00 | $40.00 / $40.00 |
Personal Care (Bathing/Dressing) (per hr) | $38.48 / $18.00 - $47.50 | $39.50 / $36.10 - $45.00 | $40.00 / $40.00 | $40.00 / $40.00 |
Companionship/ Supervision (per hr) | $37.50 / $18.00 - $47.50 | $39.00 / $36.10 - $40.00 | $40.00 / $40.00 | $40.00 / $40.00 |
Skilled Nursing* (per hr) | $69.00 / $50.00 - $100.00 | $68.00 / $45.00 - $80.00 | $77.50 / $75.00 - $80.00 | $72.75 / $68.00 - $80.00 |
Physiotherapy (per hr) | $150.00 / $140.00 - $200.00 | $165.00 / $140.00 - $175.00 | N/A | N/A |
Occupational Therapy (per hr) | $145.00 / $120.00 - $200.00 | $157.50 / $140.00 - $175.00 | N/A | N/A |
In Home Relief (per hr) | $38.95 / $18.00 - $47.50 | $39.50 / $36.10 - $80.00 | $44.50 / $24.00 - $80.00 | $65.00 / $40.00 - $80.00 |
Palliative Care (per hr) | $39.50 / $30.00 - $52.95 | $56.67 / $36.10 - $80.00 | $65.00 / $40.00 - $80.00 | $66.50 / $40.00 - $80.00 |
24 Hour Care (per hr) | $37.50 / $18.00 - $47.50 | $38.50 / $36.10 - $40.00 | $40.00 / $40.00 | N/A |
N/A = Insufficient sample size obtained to justify inclusion
* Fees range depending on what kind of nurse, such as a registered nurse (RN) or Licensed Practical Nurse (LPN) delivers care.
How Adult Day Programs Work
Adult day programs are designed for dependent adults/seniors, physically located in the community, to provide a safe group setting during the day when family members are not available to care for them. These centres are usually open daily, Monday through Friday (some on Saturday as well). They provide a secure, caring and positive setting for those who are experiencing memory loss, communication disorders, social isolation or physical disabilities. Nutritious lunch meals are provided which usually accommodate any special diet, along with an afternoon snack. Participants need to be mobile, with the possible assistance of a cane, walker or wheelchair. Adult day programs can be public or private, non-profit or for-profit.
Most adult day programs in Ontario are managed and operated by and accessed through Ontario Health atHome. Seniors pay daily fees to cover part of meals & activities.
The purpose of an adult day program is:
Candidates for adult day programs may be:
Costs
The fees are set by individual programs and vary with the number of hours, inclusion of meals, and the use of transportation.
Type of Program |
Provincial Median (per day) |
Provincial Range (per day) |
---|---|---|
Full day (meals, snacks, activities, transportation) |
$25.00 | $18.00 - $50.00 |
Type of Program |
Toronto Median/Range |
Ottawa Median/Range | Kingston Median/Range | Windsor Median/Range |
---|---|---|---|---|
Full day (meals, snacks, activities, transportation) |
$26.00 / $18.00 - $50.00 | $22.00 / $18.00 - $35.00 |
$22.00 / $22.00 - $24.00 | $24.00 / $20.00 - $30.00 |
Scenario 1: Low level of care (early in the crisis management stage of care)
Mrs. Williams is an 85 year old widow living in her own home. She has osteoarthritis and leg edema. She must wear support stockings to relieve her edema and because her fingers and back are arthritic, she needs help getting dressed. To get around her home, she uses a walking support device or rollator. Both of Mrs. Williams' daughters help her out regularly on weekends and evenings while her son-in-law helps maintain the house and takes care of the lawn.
After fracturing her femur in a significant fall 9 months ago, Mrs. Williams' mobility has been severely decreased and she lost 9 kg or almost 20 lbs as a result. She tells her daughters that she forgets to eat and the food in her refrigerator is spoiled. During their visits, her daughters notice she eats very little and sometimes chokes on her food.
To help her eat safely and address her other needs, Mrs. Williams and her daughters agree it's time for some formal care. She needs her meals delivered to her home, someone to supervise her meals and assistance with dressing and bathing. She would also benefit from a home safety assessment.
Care plan to assist family caregivers part-time
Services Required |
Frequency |
Covered or Subsidized by Government (1) |
Services Required to be paid by client |
Cost per unit |
Monthly Cost |
---|---|---|---|---|---|
Meal Delivery (meals/wk) |
10 | 0 | 10 | $8.00 | $311.75 |
Meal Supervision (hrs/wk) |
5 | 0 | 5 | $38.00 | $817.00 |
Personal Care (Bathing/Dressing) (hrs/wk) |
5 | 2 | 3 | $38.00 | $490.20 |
Total per month |
n/a | n/a | n/a | n/a | $1,651.20 |
In addition, there will be expenses for two visits of an occupational therapist including a 1 hr. initial assessment and 45 min. follow up after equipment has been installed. The two visits will cost $262.50 altogether.
Scenario 2: Intermediate Level of Care (late in the crisis management stage of care)
Mr. Leung is a 72 year old widower. He lives with his daughter and her husband in a small community outside the city. Mr. Leung has cataracts in both eyes. He also has dementia which has progressed to the point where he requires continual supervision. He forgets to take his medication, does not eat properly and cannot safely prepare meals. He needs cues for dressing and bathing.
Mr. Leung's daughter and her husband assist him mornings, evenings and weekends but aren't available on weekdays. For weekdays, they enrolled him in an adult day program 2 days per week and hired someone to accompany him to and from the program. For the remaining 3 days of the week they've hired someone to supervise him and keep him company. They've also arranged help for laundry and house cleaning.
Care Plan to assist family caregiver full days, during the week
Services Required |
Frequency |
Covered or Subsidized by Government (1) |
Services Required to be paid by client |
Cost per unit |
Monthly Cost |
---|---|---|---|---|---|
Companionship/Supervision (hrs/wk) |
24 | 0 | 24 | $37.50 | $3,870.00 |
Adult Day Program (excluding transportation) (days/wk) |
2 | 2 | $25.00 | $215.00 | |
Safety Supervision (hrs/wk) |
2 | 2 | 0 | 0 | $0.00 |
Laundry/Housecleaning (hrs/wk) |
3 | 0 | 3 | $35.00 | $451.50 |
Total per month |
n/a | n/a | n/a | n/a | $4,536.50 |
Scenario 3: High level of care (in the dependence stage of care)
Mr. and Mrs. Jensen live in a two-bedroom condominium. Mr. Jensen is 93 years old, alert and aware but physically frail. Mrs. Jensen is 88 years old, diabetic and recently had a stroke. Her balance is poor and she's at high risk for falling. She can only walk short distances and needs help to get around. She also has heel ulcers that make walking even more difficult. For longer distances, she uses a wheelchair.
Her family doctor recommends Mrs. Jensen move to a nursing home. But because Mr. and Mrs. Jensen's daughter promised she wouldn't send her parents to a nursing home, she needs to make alternate arrangements. Options include a caregiver to assist Mrs. Jensen with bathing, dressing, toileting, walking, meal preparation, household chores and transportation to and from appointments. A nurse could monitor and chart her medicine use and blood sugar levels, clean her heel ulcers and change her bandages. Mr. and Mrs. Jensen would also benefit from a home safety assessment by an occupational therapist who may recommend safety bars, raised toilet seats, better lighting, removing clutter and securing loose rugs.
Care plan to assist family caregivers full-time, every day
Services Required |
Frequency |
Covered or Subsidized by Government (1) |
Services Required to be paid by client |
Cost per unit |
Monthly Cost |
---|---|---|---|---|---|
In Home Meal Preparation (hrs/wk) |
14 | 0 | 14 | $37.50 | $2,257.50 |
Personal Care (Bathing Dressing) (hrs/wk) |
56 | 20 | 36 | $38.00 | $5,255.46 |
Skilled Nursing (hrs/wk) |
2 | 1 | 1 | $69.00 | $296.70 |
Laundry/Housecleaning (hrs/wk) |
2.5 | 0 | 2.5 | $35.00 | $376.25 |
Total per month |
n/a | n/a | n/a | n/a | $8,812.85 |
In addition, there will be expenses for two visits of an occupational therapist including a 1 hr initial assessment and 45 min follow up after equipment has been installed. The two visits will cost $262.50 altogether.
(1) The hours of care alloted by the LHIN mentioned above are an estimate only. Actual hours alloted by the LHIN may be more or less depending on a formal assessment and regional availability.
© 2024 Assistance Services Group (ASG). All rights reserved.
ASSISTANCE SERVICES GROUP is a comprehensive, impartial service that promotes and supports caregiver wellness and wellness for seniors, enabling families to give the best possible care to aging family members, while also taking best care of themselves. ASSISTANCE SERVICES GROUP has researched and prepared this report carefully. To the best of ASSISTANCE SERVICES GROUP ’s knowledge, all information included is accurate and unbiased. However, ASSISTANCE SERVICES GROUP cannot and does not guarantee the accuracy or completeness of the information. ASSISTANCE SERVICES GROUP cannot accept responsibility for any problems that might arise in relation to your choice of services, whether or not your choice was influenced by information in this report.
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