10 Frequently Asked Questions Regarding Long Term Care in Ontario, Canada

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***Disclaimer: This article is for informational purposes only and does not provide medical, legal, or health advice and is not a substitute for mental health services

We’ve been hearing it all over the news. The words “long term care” spark fear in the general public now more than ever with the development of the coronavirus and its quick spread throughout nursing homes.

Typically speaking, many people don’t want to apply for Long Term Care (LTC). They want to stay in their own homes as long as they possibly can. This is especially true now with COVID-19 being passed along rapidly from within nursing home walls and, sadly, leading to the unfortunate passing of many seniors.

It is important to note though that there are some circumstances where applying to LTC is essential. For example, what about when a person’s care needs are beyond what a person can manage themselves? What if the person or their family cannot afford private care to supplement publicly-funded care to make remaining at home possible?

And what if the person’s family member has their own personal care needs, dependent children, do not live nearby, have significant work responsibilities or work hours limiting their spare time, preventing them from being able to lend a consistent helping hand to their loved one? These are just a few examples of scenarios where submitting an LTC application may be necessary.

Here are some Frequently Asked Questions (FAQs) to assist in the LTC application process in Ontario, Canada.

***Please note -- I do not work for the Ontario Ministry of Health and Long Term Care or Home and Community Care Support Services -- I am a Social Worker sharing my perspective having worked in health care and supported many patients and their families who applied to long term care.

1. What are the criteria for LTC?

You can apply to LTC whether you are at home and are struggling to manage taking care of yourself, or whether you are in another location (e.g. a family member’s home, a retirement home, a hospital, etc.) and it is determined that your care needs cannot be fully met in the community.

LTC seeks to meet your care needs when it is no longer possible for you to live on your own safely and your needs are beyond what can be supported by home care services.

All LTC applicants must be at least 18 years old, have a valid Ontario Health Insurance Program (OHIP) card, and require frequent personal care and supervision.

2. How many LTC homes can I apply for?

You technically only need to apply to one long term care home to submit an application. You can choose up to a maximum of 5 LTC homes.

3. What if I want to see the LTC homes before I make my choices?

Prior to COVID-19, it was fairly easy to set up in-person tours where applicants could request to see the LTC home and observe the room set up, atmosphere, and general experience. This often helped people make informed decisions regarding their LTC choices.

In the current times, it may be more challenging to do in-person tours. A virtual tour, phone call, video call, or some other tour format may be needed. You may wish to call the LTC homes you are interested in to find out what the options are and proceed from there.

4. How does the LTC application process work?

To apply for LTC, you can call 310-2222 (no area code needed) or look up your local Home and Community Care site by postal code.

A home and community care coordinator will review your application, assess your eligibility for LTC, and explain the different LTC home options available to you depending on what you can afford (basic, semi-private, private rooms), the approximate wait times available based on the type of room(s) you select, and the regions that you are open to.

5. Does the LTC application process differ if I am in a hospital or in the community?

The number of long term care homes you may be encouraged to choose could be impacted if you are in hospital (e.g. acute care, a rehabilitation hospital, complex continuing care, etc), and cannot return home to “wait for long term care”.

If you are in a hospital waiting for LTC, you are technically occupying a hospital bed that otherwise may have been used for another medically fragile individual.

You may be encouraged by your healthcare team to follow the hospital policy regulations to choose at least several “short waitlist” to facilitate your transition to LTC as quickly as possible.

You may also have to pay a co-payment fee because you are waiting in a hospital for an LTC bed. These matters will be discussed by your healthcare team with you and your family.

6. How much does LTC cost and what does the cost include or cover?

You will need to provide your Notice of Assessment (NOA) — this will be used to calculate how much you will pay monthly if you have selected a Basic (subsidized) LTC accommodation, in which the Ontario government covers a portion of the monthly cost if you qualify for the subsidy.

You may receive a small monthly allowance to take care of any other small external costs or participate in any special activities or interests you enjoy.

If you have chosen a semi-private or private accommodation, that has a set monthly rate that is regulated in the province of Ontario and is revised annually or as required. You can ask your LHIN coordinator for the fee information.

The LTC cost that you pay monthly covers the health care services you receive from the personal support workers and nurses, the space you occupy in your room, your medical supplies, medication, and your food. You will need to provide your own toiletries (e.g. toothpaste, soap, shampoo, personal products, etc.).

7. What happens when I receive an LTC bed offer?

When an LTC bed is available, you will receive a call from the LTC placement office. They will inform you of the bed offer details (LTC home available, date of move-in, monthly cost, etc.).

You will need to make a decision of accepting or rejecting this LTC bed offer as well as move into the LTC home within the required timeframe. It is strongly encouraged in general that LTC applicants accept their first bed offer, as they can wait in the first approved home for their other top choices; these may have a much longer waitlist.

If you reject the LTC bed offer, the LTC placement office will inform you of the implications for your LTC application.

8. Can I apply myself or can my family member apply to LTC for me?

Your family member can only submit an LTC application on your behalf if they are a designated Power of Attorney (POA) or Substitute Decision Maker (SDM) for you and you are currently not capable to apply yourself.

If you have a POA document already in place, you or your family member may wish to share that with your local LHIN representative who is helping you with the LTC application process.

If you don’t have a POA or SDM in place and there are concerns from you, your family, or your healthcare team about your ability to make a decision regarding applying for LTC, your doctor may decide to do a cognitive assessment or refer you to a psychologist or neuropsychologist for an assessment, who will assess for any concerns regarding your ability to apply for LTC.

If there are concerns about your capacity, your doctor may discuss implications with you and your family regarding your family initiating an application on your behalf, if appropriate.

If the concerns about your capacity are temporary, you can be re-assessed for your ability to make an LTC application decision at a later time.

9. What if I have concerns about the LTC home once I’m living there?

You can ask to speak with the LTC home manager or director of care to share your concerns and feedback. It’s important that they take your concerns seriously and follow up on resolving them as quickly and effectively as possible. You can also speak with your local home and community office in your region.

In addition, you can contact the Long-Term Care Action Line to report your concerns.

You may wish to contact your Member of Provincial Parliament (MPP) office as well since LTC is a provincially regulated program. Your government should be aware of any significant concerns given they address matters at a systemic and broad level.

10. Who do I contact if I have more questions about LTC?

If you have questions about the LTC application process in Ontario, Canada, it is best that you contact the organization in charge of LTC applications directly. You can call 310–2222 or search on the Home and Community Care website to get connected to your local region’s office.

Wishing you well on your journey.

Davina Tiwari MSW, RSW, CSFT

Registered Social Worker and Certified Solution Focused Therapist

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