Moving to Community Care or a Long Term Care Facility
A long term care facility is a facility that provides 24-hour nursing care and supervision to people who have been assessed as needing to live in a place with 24-hour access to nursing staff. In Prince Edward Island, there are many long term care facilities – about half are privately operated and the rest are public long term care facilities or manors. Private long term care facilities must be licensed to operate.
Nursing Homes are now called Long Term Care Facilities.
A community care facility is a private facility or co-operative that provides accommodation, meals, housekeeping, help and supervision with daily activities and with personal care. Twenty-four hour nursing care is not provided. Community care facilities must be licensed to operate.
Dual facilities are licensed to provide community care and long term care in the same facility. Some of the private facilities in PEI are dual facilities. This can be helpful for spouses who require different levels of care but want to remain in the same place.
Contact your local Home Care Office to arrange for a health assessment.
The Home Care staff person will come to your home to discuss your personal situation and complete a health assessment. The health assessment lists your daily care requirements and helps staff determine what level of care you need. Home Care staff may suggest certain services, like respite care, that could allow you to stay in your home, if that is what you wish. The staff person will also explain what type of facility fits with your care needs. If a long term care facility is what you require, staff will use the assessment to begin the application process for you.
If your care requirements can be met by moving to a community care facility, you are free to decide which facility is right for you. If you need to apply for a subsidy because you cannot pay the whole bill, it is important to find out the costs for the home first. Many community care homes have subsidized beds but not all beds are subsidized. There is an upper limit to the subsidy that may dictate which home you can afford to go to.
If you have had an assessment, you can arrange for a copy of your Home Care assessment to go to the community care facility so they can understand your care requirements. With your permission, your doctor can also talk to the community care facility about your admission and your personal health history.
n assessment is carried out by a team of professionals to determine what level of care you need. It is started by contacting the Home Care office. Sometimes your doctor or a family member will arrange for this assessment to be done or you could phone to ask for an assessment. The assessment can be done in your home or, if you are already in a hospital, staff can do the assessment there.
The assessment usually begins with a nurse or a social worker speaking to you about your health needs and any particular issues that may be a challenge for you. Depending on your unique circumstances, the assessment usually includes many people – you, your family, your doctor and other professionals working with you. Your doctor provides the medical information. Usually you or your family are the first people talked to about the assessment.
If the assessment shows that you need long term care, your name is put on the placement list until a bed becomes available. The same list is used whether you applied for a public or a private long term care facility. You will be asked to list your top choices of facilities. You may not get into one of your first choices right away. You can ask to have your name put on a waiting list so you can transfer as soon as a bed becomes available.
You may be in the hospital at the time you are assessed as needing long term care. In this case, you will be charged at the same rate you would have to pay at the long term care facility while you wait for a room to become available. If the room you are offered is not in a long term care home you want to move into, the hospital may enforce their first available bed policy that would give you 24 hours to accept the bed offer or plan to move home. If you accept the bed, your name still remains on list for a transfer to your preferred facility.
You must be 60 years of age or older to be admitted to a long term care facility and you must need level 4 care or above. In some rare cases, someone younger may be considered for admission.
If your assessment indicates that you need Level 3 care or below, you are not eligible for long term care admission. You can apply to a community care facility for admission there. This is a private application made by you or by someone in your family. You may be able to arrange for a copy of your assessment to go to the community care facility. With your permission, your doctor can talk to the community care facility about your admission.
If you are in this situation, the community care facility is required to have an assessment done to determine the level of care you need. Many of the community care facilities do their own assessments. If your assessment shows you need a level 4 or 5 care, your name will go on the waiting list for a long term care facility.
Competent and capable both mean mentally competent. Competency is difficult to define and difficult to determine, but it is usually a decision made after a professional consultation.
If someone is competent to make medical decisions, that person has the ability to understand the subject matter for which consent is required and understands the consequences of giving or refusing consent.
If someone is competent to make financial decisions, that person is able to understand financial and legal matters and has the ability to make decisions.
Someone can be competent to make medical decisions but incompetent to deal with complicated financial affairs. A person may be competent at one time, lose that competency because of a stroke, perhaps, and then regain it later.
You cannot be forced to go into a community care facility or a long term care facility against your will as long as you are mentally competent. It is a choice you make. If you are mentally competent, you cannot be forced to undergo an assessment against your wishes.
If you have been declared mentally incompetent by your health practitioner, then the proxy you have named in a health care directive will make decisions for you. If you have not named a proxy, the health practitioner will name a substitute decision-maker for you from a list provided in the Consent to Treatment and Health Care Directives Act.
You may regain competency later and you may be able to make decisions for yourself. An example of this could be if you have had a stroke and are unconscious or cannot speak – if you regain consciousness and the ability to communicate and make decisions, you may have regained competency and may be able to make these decisions yourself.
It is important that your family knows your wishes in the area of medical treatment so they can advise health practitioners. It is also a good idea to name a proxy in a health care directive so you know that it will be someone you trust who is making decisions for you if you cannot make them or communicate them yourself.
It is a good idea to visit the long term care facilities you are interested in before you list them as your top choices. Call ahead to make an appointment to have a tour of the home. Ask lots of questions when you are there. If you can’t go yourself, ask a family member or friend to go. You can make a list of the questions you would like them to ask when they are there. You could also ask a family member or friend to go with you so you can get their impressions.
Here are some questions you could ask while visiting the facility:
- If I become ill and have to go to the hospital, how long will my bed be kept for me?
- How many people live here?
- Can a couple share a room even if they need different levels of care?
- What furniture and personal belongings can I take with me to the facility?
- When can my family and friends visit?
- What activities are available?
- Are services like physiotherapy, occupational therapy and speech therapy available? Is there a cost for these services?
- Is foot care available?
- Will I have my own bathroom?
- Will I continue to have my own doctor or is there a house doctor?
- Is there a residents’ council?
- If I have special dietary requirements, will they be provided by the home?
If you have more questions, write them down so you won’t forget to ask them.
This is a personal choice. If you are applying to enter a community care facility, it is important to visit a few before you make your choice. Many facilities offer welcoming tours. Make a list of your questions to take with you. The list of questions for long term care facilities will get you started.
The rates for beds vary slightly in community care facilities. You may wish to comparison shop for costs of care. Don’t forget to ask what services are included in the rate.
If you need to apply for a subsidy because you cannot pay the whole bill, it is important to find out the costs for the home first. Many homes have subsidized beds but not all beds are subsidized. There is an upper limit to the subsidy that may dictate which home you can afford to go to.
Most long term care facilities and community care facilities have booklets describing their facility, their policies, and their prices. You can call the home to have this information sent to you.
Your rights in a home are similar to your rights in the community. You will have to make adjustments to living in a facility with other people who have likes and dislikes that may differ from yours. However, you should expect the home to ensure certain basic rights such as privacy, dignity, and individuality.
What are my financial obligations when I move to a community care facility?
If you are moving to a community care facility, you are expected to pay for your care to whatever extent you can. If your assets (income and savings or investments) are not enough to cover your bill each month, the province may subsidize your care under the Social Assistance Act.
To be considered for financial assistance, you have to go through a financial assessment. You will have to give complete information about all your assets, income and liabilities or debts. If you are a Veteran, you may be eligible for assistance with the cost of community care. For further information, contact Veterans Affairs Canada.
Do I have to disclose my financial situation if I go into a community care facility?
You have to disclose your information only if you are asking for subsidization.
What happens to my home (principal residence) if I cannot pay for community care?
Your principal residence is protected only if you have a family member or spouse living in it as their principal residence when you move to the community care facility. The person occupying your home must have been living there before you applied for admission to the home. If no family member is occupying the home at the time you move, it must be sold for fair market value and the proceeds used to pay your bill.
After your death, your principal residence remains exempt from claims as long as it was deemed exempt upon your admission to the facility and circumstances have not changed – that is, the family member is still living in the home.
What happens to my other assets?
Property that can be converted to cash, including house and land, Registered Retirement Savings Plans, life insurance, pensions, bonds, an inheritance or a benefit received from a trust, is considered an asset available to pay your bill.
What happens to the unpaid bill when I die?
If you have no assets, the debt is forgiven. If you have remaining assets, these will go towards paying your bill.
Does the government take over my bank account and my pension once I go into a community care facility?
Government does not take over control of either bank accounts or pensions. If you go into community care, you will receive a monthly itemized bill that you are expected to pay. Your income comes to you in the same way it always has, unless you make other arrangements.
If my spouse is still living, does all my income go towards the cost of community care?
If you have a spouse who is not in the community care facility, only half (50%) of any savings, investments or cash that you have together will be applied against your bill.
If you and your spouse receive significantly different pension amounts, you must apply to Canada Pension Plan and Old Age Security for involuntary separation. This means you are not living together because of circumstances beyond your control and it will allow a 50/50 splitting of your total pension income.
Some cases of hardship may make it possible to vary from the 50% policy. Each situation is looked at individually.
Can trusts for my children or grandchildren be taken to pay my bill?
Every case is looked at individually. If it appears that you set up these trusts very recently in an attempt to avoid paying your bill, a claim will be made to recover the amount owing. Ongoing payments into the trust will stop as they cannot be made from your income or assets.
What happens if my spouse dies and our home (principal residence) is empty?
There is an expectation that the home will be sold. The proceeds are considered available to pay your bill.
Can my farm be taken to pay for my care?
A working family farm may be protected, but it depends on the family’s situation. Provincial law recognizes hardship and each case is dealt with individually.
What happens to my son or daughter and their family if they are living in my home?
If your family shared the home with you as their principal residence prior to you going to community care, there would not be an expectation that the home be sold.
If my bill is not paid in full, does it affect my will?
Your debts will be paid from your estate before bequests are honoured.
What happens if my money runs out?
You can apply for a subsidy under the Social Assistance Act. You will go through the financial assessment process described in this booklet. Your costs in the community care facility may then be subsidized by the province.
If my income does not cover my bill, will I have any money for the little extras, like writing paper?
A comfort allowance is provided to residents who are subsidized under the Social Assistance Act.
What if I receive an inheritance or other proceeds while I am living in a community care facility on a subsidy?
If your financial situation changes while you are living in a facility, you will be reassessed. If the assessment shows that you can now pay for some or all of your care, you will be billed.
Is there any way to protect my planned retirement savings?
If you are going into a community care facility, you are expected to pay for your care. Money and assets you have will go toward the bill.
If you are single, 100% of your money from any source is considered available to pay your bill. If you have a spouse living in the community, including a common law spouse, 50% of the family assets is considered available to pay your bill. You may need to arrange for pension income to be evenly split.
What documents do I need for a financial assessment?
You will need to take the following with you to the financial assessment meeting:
- Social Insurance Number;
- Personal Health Number;
- Written documentation or recent bank statements of all income for both you and your spouse;
- Receipt if you have a prepaid funeral;
- Bank statements for the past 2 years;
- Documentation of current value of all financial assets including investments, stocks, bonds, Registered Retirement Savings Plans, Registered Retirement Income Funds, Registered Education Savings Plans, trust funds, annuities, and other similar investments;
- Deeds, tax receipts and rental receipts for all properties you own including your home. This includes any property you sold or transferred in the past 2 years;
- Written documentation of life insurance policies and written confirmation of cash surrender value to date;
- Written documentation of safety deposit box contents;
- Proof of ownership of any cars and recreational vehicles;
- Income tax returns for the past 2 years for both you and your spouse;
- Documentation of Power of Attorney;
- Legal documents for separations, divorce, and custody;
- Information about medical insurance.
For more information you can speak with the Functional Assessment Coordinator, Social Programs, Community Services and Seniors.
What are my financial obligations when I move to a long term care facility?
Since January 1, 2007 only your net income is considered when paying for your stay at a long term care facility. The cost of basic health care is covered by the PEI Department of Health and Wellness. You are billed only for room and board in the home and that is paid using your net income. This means that your assets, like property and investments, do not have to be used to pay your bill.
What happens if I don’t have enough income to pay my bill?
If your income is not high enough to pay the room and board bill, you may be subsidized by the province for the rest under the Long Term Care Subsidization Act. You will have to apply for the subsidy. Your income will be used to determine your eligibility.
Usually the income used by the province to determine if you are eligible for subsidy is the net income on your income tax return. This is line 236 on your Canada Revenue Agency Notice of Assessment. There may be adjustments to the line 236 amount, such as rental income or some tax-free investments, if they are not claimed on your income tax.
What do I need to provide to apply for subsidization?
You or a family member or the person with your Power of Attorney needs to provide copies of your tax returns for the last two years and a copy of the most recent Canada Revenue Agency Notice of Assessment. If you have a spouse, you need to take a copy of his or her tax return and Notice of Assessment as well.
If your spouse is living in the community, your assessed income will be half of what you make together. There are a few exemptions you can make before the amount is halved.
What are the rules concerning my property if I go into a long term care facility?
Your property is yours and not considered at all – it is an asset, not income. Assets are no longer considered in the financial assessment for long term care admission. You are not expected to use assets to pay your bill unless you want a private room or other special services not provided within the subsidy program.
What do long term care rooms cost?
If you are insured through the PEI medical insurance plan, you pay for your room and board only – the cost of basic health care will be covered by the Department of Health and Wellness. The cost for room and board is set each year. A yearly increase is usually due to increases in the actual cost of providing room and board. In 2019, the rate was $92.19 per day.
Your eligibility for long-term care subsidization is reassessed each year. This means you must file an income tax return each year. The PEI Department of Health and Wellness must be able to get a copy of your records from the Canada Revenue Agency to do this yearly assessment.
It is important that you have a Power of Attorney document prepared before you go into a long term care facility. If you become incompetent or physically unable to sign your name while you are in a long term care facility, a Power of Attorney can authorize access to your Canada Revenue Agency records. Without a Power of Attorney, a longer and more expensive process of having the Supreme Court appoint a committee for you must be done. For more information, see the booklet called “Powers of Attorney”.
For more information you can speak with Administrative Support, Corporate Services and Long-Term Care, Health PEI.
Andrews of Charlottetown, Charlottetown 902-368-2790
Bevan Lodge, Sherwood 902-894-5858
Burnside Community Care, Clyde River 902-675-2393
Champion Lodge, Charlottetown 902-894-8968
Charlotte Residence, Charlottetown 902-894-8134 (women)
Corrigan Home, Charlottetown 902-894-9686
Emerson Lodge, Charlottetown 902-892-0791
Geneva Villa, Charlottetown 902-628-6642
Grafton House, Charlottetown 902-367-2875
Langille House, Charlottetown 902-628-8228
Old Rose Lodge, Charlottetown 902-368-8313
Smith Lodge, Charlottetown 902-892-4220
Stamper Residence, Charlottetown 902-894-3815 (women)
Tenderwood Lodge, Charlottetown 902-566-5174
Valley House, Charlottetown 902-628-8268
Villa Marguerite, North Rustico 902-963-3962
Bayview Lodge, Souris 902-687-3122
MacKinnon Pines Lodge, Montague 902-838-2656
Perrin’s Marina Villa, Montague 902-838-4075
Woodland Home, Souris 902-687-3315
Chez-Nous Ltee., Wellington 902-854-3426
Kensington Community Care Home, Kensington 902-836-3019
Lady Slipper Villa, O’Leary 902-859-3544
Miscouche Villa, Miscouche 902-436-1946
Andrews of Parkhill, Summerside 902-888-2273
Rev. W.J. Phillips Residence, Alberton 902-853-3109
Rosewood Residence, Hunter River 902-964-2436
The Mews, Kensington 902-836-4678
Tignish Seniors Home Care Co-op, Tignish 902-882-4663
Long Term Care Facilities
Garden Home, Charlottetown 902-892-4131
Beach Grove Home, Charlottetown 902-368-6750
PEI Atlantic Baptist Nursing Home, Charlottetown 902-566-5975
Colville Manor, Souris 902-687-7090 Riverview Manor, Montague 902-838-0772
Maplewood Manor, Alberton 902-853-8610
Margaret Stewart Ellis Wing, O’Leary 902-859-8750
Wedgewood Manor, Summerside 902-888-8340
Dual Facilities (both community care and long term care)
Andrews of Stratford, Stratford 902-367-4100
Andrews of Park West, Charlottetown 902-566-2260
Andrews of Summerside, Summerside 902-436-0859
Clinton View Lodge, Kensington, 902-886-2276
Dr. John M Gillis Memorial Lodge, Belfast 902-659-2337
South Shore Villa, Crapaud 902-658-2228
Summerset Manor, Summerside 902-888-8310
The Mount Continuing Care Community, Charlottetown: 902-370-8888
Whisperwood Villa, Charlottetown 902-566-5556