This article originally appeared in the November 2017 edition of Fifty-Five Plus Magazine.
For the first time ever, seniors now outnumber children in Canada. Accordingly, more and more people are living in collective dwellings, either long-term care homes or retirement residences.
However, many people are unaware about the differences between these facilities. One key difference is that long-term care homes provide 24-hour nursing care and supervision to their residents, whereas retirement homes provide rental accommodation with care and services available for their residents at an additional cost. However, there are plenty of other differences as well.
Here are the top things you should know about long-term care homes and retirement homes in Ontario.
Long-term care homes are governed by the Long-Term Care Homes Act, 2007 in Ontario. The Long-Term Care Act contains laws about:
- Appropriate care treatments;
- Reporting and complaint procedures;
- Admission requirements to long-term care homes;
- Long-term care home councils, and;
- Compliance and enforcement.
Most importantly, the Long-Term Care Homes Act also includes a “Resident Bill of Rights”. It has 27 sections and includes residents’ right to be free from abuse and to have a friend or family member present at important meetings.
Retirement homes are governed by the Retirement Homes Act, 2010. This Act includes laws about:
- The applicable licensing requirements for retirement home owners;
- Residents’ rights;
- The standard of care and staff training requirements;
- Abuse and negligence protections for residents;
- The powers of inspectors, and;
- Offences, penalties and enforcement against retirement home owners.
Retirement homes are also governed by the Residential Tenancy Act, because retirement homes provide rental accommodation. The Residential Tenancy Act outlines what retirement homes need to provide to new residents in their Care Homes Information Package, and also covers the eviction rights for both the owner and the renter.
Long-term care homes are subsidized by the government. That is, the government pays the cost of nursing, food and some personal care options for the residents. However, residents are still responsible for paying a co-payment for accommodation fees, with semi-private or private accommodation costing more.
The accommodation fees increase annually, typically on July 1st. In addition, the owner of the long-term care home, or licensee, can charge residents extra fees. For both accommodation fee increases and extra charges, the licensee must provide 30 days’ notice to the resident.
Current maximum accommodation fees in Ontario long-term care homes are:
- Basic Accommodation (shared room with 2-4 beds): $59.82/day or $1,819.53/month;
- Semi-Private Accommodation: $72.12/day or $21,92.65/month;
- Private Accommodation: $85.45/day or $2,599.11/month.
Retirement homes, on the other hand, are not subsidized by the government. A new resident is required to sign a lease and the landlord of a retirement home is subject to the rental laws listed in the Residential Tenancy Act. This means that:
- A landlord cannot increase rent without giving the tenant 90 days’ notice
- A landlord must wait 12 months before increasing the rent. This is taken from the date when the unit was initially rented or the date when the rent was last increased, and
- A landlord cannot vary from the government’s rent increase guidelines, unless they are undertaking to carry out a capital expenditure or additional service.
Here are some examples of current accommodation fees in Ontario retirement homes:
- Active Retirement homes with little assistance: $89.97/day or $2,789/month;
- Assisted Living homes: $103.35/day or $3,204/month;
- Homes that provide care for individuals with advanced dementia: $147.87/day or $4,584/month.
Residents will also be responsible for any additional care expenses, and these can increase monthly costs by hundreds, or even thousands, of dollars.
Access to additional care
Long-term care homes, as indicated above, are meant to provide residents with access to medical care. Therefore, long-term care workers are required by law to provide additional care to their residents, and to monitor whether any residents require this.
Retirement homes only provide medical care if it is included in a resident’s “plan of care”. The plan of care is determined when the resident begins his/her stay at the retirement home. Every plan of care must be approved by a person with the required expertise in providing care, and the resident can request that the assessment be completed by an external provider.
Admissions and Accommodations
Long-term care homes can only be accessed through Community Care Access Centres (CCAC) in Ontario. CCAC is an organization that coordinates and arranges home care services by making use of private senior service agencies to eligible people. CCACs are funded by the provincial government, and the goal of CCAC is to connect people with the right care at the right time and in the right place. In long-term care homes, the accommodations can range from a basic room that accommodates 3-4 people per room, to a semi-private room or to a private room. Additional costs are associated for semi-private and private rooms.
A person can apply directly to a retirement home to determine if the retirement home has any available apartments. Generally the accommodations range from private rooms, which are suitable for one person, or larger suites that are available for couples.
Each long-term care home has its own internal complaint policy. However, there are many other additional forums for residents to submit their complaints.
A long-term care resident can access the Community Care Access Centres’ ACTION phone line (toll free: 1-866-434-0144) seven days a week from 8:30 AM – 7:00 PM. Additionally, the resident or their family can contact the Health Services Appeal and Review Board (firstname.lastname@example.org or toll free: 1-866-282-2179) or the Ontario Patient Ombudsman (www.patientombudsman.ca or toll free: 1-888-321-0339).
Similarly, each retirement home should also have its own internal complaint process. If residents are still unsatisfied with their treatment, they can contact the Retirement Homes Regulatory Authority (RHRA). The RHRA acts on behalf of the government and ensures licensees have complied with retirement home licensing requirements, informs residents of their rights, and inspects retirement homes to ensure they are complying with provincial care standards.
The RHRA can be reached by email (email@example.com) or telephone (toll free: 1-855-275-7472). However, if a retirement home resident has a complaint about rent or eviction, then the resident should either seek legal services, or contact the Advocacy Centre for the Elderly (1-416-598-2656).
For more information on long-term care versus retirement residents, contact our Wills and Estates Practice Group.