Questions & Answers (Long Term Care)

Entering Long Term Care

Are there different levels of care?

Yes. There are two types of long-term care homes in Luneburg & Queens Counties licensed by the Department of Health.

  • Residential Care Facilities - Homes for people who need supervision and limited help with personal care. These are licensed and inspected by the Department of Health.

  • Nursing Homes or Homes for the Aged - Homes for people who need help with personal care and professional nursing care. These are licensed and inspected by the Department of Health.

How will I know if I need to go to a long-term care home?

Everyone's situation is different. Some people enter long-term care because;

  • Family members who usually provided their care are no longer available;
  • They have health problems and require a high level of personal care or ongoing professional nursing care;
  • They are in hospital and cannot return home because of the need for ongoing professional nursing care; or
  • Their care needs exceed what Home Care can provide.

How do I apply for long-term care?

If you feel you or a family member needs long-term care, you can contact Continuing Care by calling the toll free intake line at 1-800-225-7225.

If you are in a hospital, you can also call through the toll free line or ask to speak with a hospital staff member who will arrange this for you.

Who determines what level of care I need?

Once a referral is made, a care coordinator will meet with you to assess your care needs. Other professionals may also need to meet with you and your family to better understand your personal situation. The care coordinator determines your level of care and makes final approval.

I may need a nursing home in a couple of years. Should I apply now?

No. Only those people who are ready to move into a home should apply.

Can I choose which facility I want to live in?

You can select the homes where you are willing to live. You can choose as many long-term care homes as you wish. Your name will be placed on these waiting lists according to the date you were approved for long-term care.

What should I keep in mind when selecting these homes?

It is important that you only put your name on the waiting lists of homes you are sure you want to go. You or a family member may consider visiting some homes. You may want to keep these points in mind:

  • The home is in a community where you would like to live.
  • Your family can visit.
  • There are activities and services offered at the home you would enjoy.

How long will I have to wait?

This depends on a number of factors. Wait times can range from several days to several months, depending upon how many people are waiting to get into a specific home, and how quickly appropriate vacancies become available.

If you live at home and your situation worsens while waiting for an opening, you should contact your care coordinator or the 1-800-225-7225. The care coordinator may be able to arrange for other services, such as additional home care or respite care.

I’m still waiting and my caregiver needs a break. What can we do?

Some long-term care homes offer respite beds for pre-arranged, short-term placements to allow your care needs to be met while your caregiver has a break. You or your caregiver can contact your care coordinator or the 1-800-225-7225 (toll free intake line) to ask questions and make arrangements. There is a daily fee for respite care.

What happens if I turn down a place that is offered to me?

If you are living at home and you refuse to move to a long-term home that you have chosen, you will be considered not ready for admission to any home and your name will be removed from all waiting lists. This is why it is very important to select homes where you are willing to live.

I am in hospital waiting for long-term care. What do I need to know?

Every effort will be made to have you placed in your home of choice. However, when suitable space is not available in these homes, you will be asked to move to the first available space within 100 km from the communities of your choice. As a suitable bed becomes available in one of your selected homes, you will be moved there.

If you refuse placement under the First Available Bed policy, the hospital will ask you to make alternative care arrangements outside of the hospital setting.

What if I disagree with the decision made on my eligibility for long-term care?

There is a review process that you can discuss with your care coordinator.

Paying for Long Term Care

Who pays for long-term care?

Government pays for:

  • Health-care costs for resident care. These costs may be related to salaries, benefits and operational costs of nursing and personal care; social work services; recreation therapy; and physical, occupational and other therapies. These costs will only be covered for residents who enter long-term care homes that participate in the provincial Single Entry Access System.
  • Transportation for dialysis and inter-facility transfers due to the First Available Bed policy.
  • A specialized equipment loan program for residents in long-term care. This program is administered by the Red Cross, Nova Scotia division. Depending on income, a resident may be required to pay a free.

Long-term care residents pay for:

  • Accommodation charges, which include: salaries, benefits & operational costs of maintenance, dietary services, housekeeping, management and administration departments, capital, and return on investment. This charge is collected by the long-term care facility
  • Personal expenses including: Clothing, eyeglasses, hearing aids, dental services, funerals, pharmacare co-pay, transportation (two exceptions noted above), and other services provided by the long-term care facility.

How much are the accommodation charges?

Individuals who are able to pay the standard accommodation charge are not required to undergo a financial assessment

Each year, the Department of Health sets the standard accommodation charge for long-term care homes. These rates are based on average operating costs. Residents are notified of their accommodation charges at least 20 days before the November 1 effective date.

The figures used below are in effect from November 1, 2008 – October 31, 2009

Nursing Homes   $86.50 per day
Residential Care Facilities   $52.00 per day
Community Based Options   $47.50 per day
Respite Charge   $30.20

Residents pay the standard accommodation charge and retain all remaining income and assets.

How can I apply for a reduced accommodation charge?

Individuals can apply to have their accommodation rate reduced by undergoing an income-based financial assessment.

You will be asked to provide your income tax information (Note of Assessment provided by Canada Revenue Agency) for the designated tax year. The financial assessment will look at your net income and account for a spouse or dependent child who lives in the community. Residents are not expected to pay more than 85 % of their assessed income toward accommodation charges.

The financial assessment will not look at any assets, nor will you be expected to sell your assets to pay toward your accommodation charge.

The Department of Health will conduct a financial review for you each year, or you can request a review at any time if your financial situation has changed significantly.

What is a Minimum Retained Income?

The Department of Health ensures residents keep some income to cover expenses after paying for long-term care. Residents retain at least 15 % of their annual income. In no instance will residents be left with an amount below the Minimum Retained Income amount. Residents will have full control over the use and management of their retained income and all assets.

My spouse is still living in the community ~ Financial Assessment Process for Spouses

Many people entering long-term care have a spouse who will continue to live in the community. The financial assessment to determine a reduced accommodation rate will account for this situation.

Single seniors are able to retain 15 % of their income or $2,700, whichever is greater, before they pay accommodation charges. This reflects a $48 increase in minimum retained income amount.

Couples who cannot pay the standard accommodation charges will also keep more of their money. Spouses who live in the community can retain $16, 165 per year. That is an increase of $173 per year to spousal income threshold amount.

The spouse remaining in the community will be able to retain 50 % of the joint family income and control over all assets. In some circumstances, a portion of the long term care resident's income may be transferred to the spouse in the community, providing that the resident's income does not fall below the minimum retained income amount, described above.

What is included in “net income?” Does it include my investments and savings accounts?

This is taken from your most recent Notice of Assessment from the Canada Revenue Agency, your "income" that will be considered as part of your financial assessment is derived from net income (line 236) minus taxes payable (line 435). Line 236 may include income from pension, employment, dividends, interest earned on investments, RRSP's, etc.

What if I disagree with the decision made on the financial assessment?

Following the financial assessment, you will receive a letter (The Authorized Accommodation Charge) from the Department of Health informing you of the amount you are expected to pay for long-term care. If you disagree with the result of the financial assessment, you may request an administrative review. A review request form will be attached to your Authorized Accommodation Charge letter.