Prince Edward Island Yukon Territory Northwest Territory Nunavut Quebec
Main legislation Community Care Facilities and Nursing Health Act, R.S.Y. 2002, c. 106 Hospital Insurance and Health and Regulated by the same legislation as Health Services and Social Services, Homes Act, R.S.P.E.I. 1988, c. C13. -no act specifically deals with continuing Social Services Administration Act, the NWT. An Act respecting, R.S.Q. c. S-42. (CCFA) care, but the Health act includes R.S.N.W.T. 1988, c. T-3 (HSSS) continuing care services (s. 1(1)(d)) Nursing Home Regulations, P.E.I. Reg. Hospital and Health Care Facility Mandatory lease forms and the EC10/88. (CCFR) Thomson Centre Continuing-Care-Day- Standards Regulations, N.W.T. Reg. particulars of a notice to a new lessee, Program Fees Regulation, Y.O.I.C. 036-2005. Regulation respecting, R.Q. c, R-8.1, r. General Regulations, P.E.I. Reg. 1998/219. (TCR) 1.02 (MLR) EC391/84. CCFGR Yukon Health & Social Services provides a full list of services1 and diagrams outlining structure.2
Ancillary Legislation Long-Term Care Subsidization Act, [NOTE: finding information in this R.S.P.E.I. 1988, c. L-16. jurisdiction was very difficult, as none of the 3 homes in the Territory have a General Regulations, P.E.I. Reg. website, and none of the board/minister’s EC615/05. (LTCSR) requirements, standards, etc are available online]
Discrete Assisted Living or Yes, the Community Care Facilities and No No No Nursing Homes Act regulates Community Supported living care facilities, which fall at the supportive legislation? living end of the spectrum.3
Lesser care Home Care: “provides health care and Yukon Home Care Program: Home Care: Home Care: Home Care: Home care is available support services including, assessment, Provides: Aids with daily activities such as through CLSCs, and is given on a care coordination, nursing, personal care, Home Support workers who assist with Home care available to aid with bathing, dressing, grooming, and light needs basis. They provide care for Lexicon/ respite, occupational and physical activities of daily living; services such as “foot care, home household tasks.8 personal assistance with daily parameters therapies, adult protection, integrated Occupational Therapists; intravenous therapy, home support, activities, as well as some health care.9 of care palliative care, community-based dialysis, Physiotherapists; and nursing, nutrition services, palliative assessment for nursing home admission R.N.s who provide assessments, care, rehabilitation, respite care.”6 and community support services.”4 treatments, and referrals.5 Has 5 of more residents (CCFA, s. 1) For an example, see Tlicho’s Regional Homecare program.7
More care Community Care Facility: “is a privately Continuing Care Facilities: There are 3 There appears to be nursing homes, Supportive Housing: owned and operated establishment with 5 and independent living facilities. It is privatized, and unlicensed. or more residents. These facilities 1. McDonald Lodge: “provides residential Services are organized by health Regional health boards have the ability provide services such as housekeeping, care to individuals who require light to Authorities.13 to inspect premises if they receive a meals, assistance with grooming and moderate assistance (personal care) with formal complaint. (HSSS, ss.46, 60-72) hygiene. Twenty four hour nursing care is their activities of daily living and not available at these facilities.”10 But monitoring and/or professional care on an note that some CCFs and NH are provide intermittent basis throughout the day. in the same facility Also provides Home Care Nursing and Home Support Services to clients who live
More care Community Care Facility: “is a privately Continuing Care Facilities: There are 3 There appears to be nursing homes, Supportive Housing: owned and operated establishment with 5 and independent living facilities. It is privatized, and unlicensed. or more residents. These facilities 1. McDonald Lodge: “provides residential Services are organized by health Regional health boards have the ability provide services such as housekeeping, care to individuals who require light to Authorities.13 to inspect premises if they receive a meals, assistance with grooming and moderate assistance (personal care) with formal complaint. (HSSS, ss.46, 60-72) hygiene. Twenty four hour nursing care is their activities of daily living and not available at these facilities.”10 But monitoring and/or professional care on an note that some CCFs and NH are provide intermittent basis throughout the day. in the same facility Also provides Home Care Nursing and Home Support Services to clients who live in their own home. There are 11 residential beds, including two respite beds.”11
2. Macaulay Lodge: “offers 44 beds of intermediate level residential and respite care for seniors and adults. The program provides care and support to individuals who require moderate assistance with their activities of daily living and monitoring and/or professional care on an intermittent basis throughout the day.”12
Most Care Nursing Homes/Manors: Provides 3. Copper Ridge Place: provides Traditional 24 hour nursing home Traditional 24-hour nursing home ‘Centres d’heberegement et de soins “accommodation, supervisory care, extended care, complex chronic care for facilities17 facility.18 de longue duree’ (CHSLD) personal care and nursing and medical people who need extensive assistance -tentatively supportive housing, but the services on a 24/7 basis.14 with their daily living and monitoring, neediest go into it, so it primarily gives and/or 24 hour care, as well as a special high level services.19 Care is “carried out by or under the care program for clients w/ dementia.16 supervision of an R.N. The type of care provided involves skilled professional assessment and observation on a 24 hour basis.”15
Covered by Residential No. Section 1(b) of the General The Landlord and Tenant Act, is silent on The Residential Tenancies Act’s Same statute as NWT. Yes, supportive housing in Quebec Regulations, P.E.I. Reg. EC10/89 the issue. Section 59’s definition of definition of “rental premises” is “a falls under the Civil Code provisions Tenancy Legislation? exempts all premises licensed under the residential premises as “premises used living accommodation or land for a dealing with tenancy (C.C., art. 1982 – Community Care Facilities and Nursing for residential purposes…” would appear mobile home used or intended for 1978. Home Act, from the Rental of Residential to include continuing care facilities. use as rental premises and includes Property Act, R.S.P.E.I. 1988, c. R-13. a room in a boarding house or The MLR requires that a person lodging house” entering into a lease that includes care must have it all laid out in the This might include nursing homes. agreement. (MLR, s. 2)
Consumer Protection? No specific consumer protection rights or No specific consumer protection rights or No specific consumer protection No specific consumer protection rights No specific consumer protection rights coverage. coverage. rights or coverage. or coverage. or coverage.
Subsidization is based on income rather 20 29 How is it funded than total financial resources. Fees set by gov -- $18-$21 as of Nov. Home care is free. Nursing Homes and home care is Supportive housing is completely See LTCSR, s. 6) 2007.27 entirely subsidized by the private, and the rental costs are Nursing Homes cost $712/month, but government.31 determined by the owner. The The cost of CCFs must be paid by the Home care is free.28 every client receives a pension that is relationship is a landlord/tenant, and resident, and are privately owned and enough to cover the fees.30 the tenant is able to file a complaint operated.21 Adult day care fees are $5.00 for each with the Regie du logement can meal, and $1.20 for each one way trip to adjudicate on the rental costs (but not There are both public and private nursing and from Thomson Centre (TCR, s. 1) the care costs)32 homes. There are 9 public nursing homes, and The Health Insurance Board of Quebec admission is based on an assessment (RAMQ) does an income asset test, and on priority. The assessments are and determines what a resident of a performed by representatives from CHSLD has to pay. hospitals, home care, housing, and long- term care programs.22 As of Jan/07 the cost of of co-pay fees was between $32.30 and $51.99/day.33 Accommodation rates (as of 01/07) for public manors are a maximum of $65/day The cost of private nursing homes are for self-paying residents.23 on average between $700- $3409/month.34 “Basic Health Care Services” are funded by the department of Health for NH Home care is free except for residents. It includes: “nursing and housekeeping. Housekeeping rates (if personal care, incontinence and infection any) are based on the income of the control measures and basic stock client.35 supplies for hygiene and grooming”24 Home care services are limited, and “Personal Expenses” are not covered by many people need to supplement it the government, and include “eyeglasses, with private home care. (Average cost hearing aids, dental service, estimates are available.)36 internet/cable, telephone service, hairdressing, clothing, dry cleaning, personal equipment, ambulance service and general transportation”25
Residents on subsidy are entitled to a “comfort allowance” which is to be used pay for non covered things (LTCSR, s. 12)
A list of average prices are available.26
Complaint/ Dispute A board, created by the CCFA monitors No info readily available. Information unavailable Information unavailable In supportive housing people can get the operation of facilities to ensure Due to the fact that there are only 3 adjudication under the Regie du Resolution adherence to prescribed standards, and facilities in the jurisdiction, these issues logement for the rental type issues, but they have the power to give or revoke are likely covered by policy rather than not the care.37 licenses. (CCFA, ss. 4-10) legislation, and the policy is not posted online. Fadoq (Federation de l’age d’or du Inspectors inspect nursing homes Quebec) is a non-profit that accredits annually (CCFR, s. 4) housing providers (with the Rose D’or), but it is voluntary.38 Their website is www.fadoq.ca, but they have no
Complaint/ Dispute A board, created by the CCFA monitors No info readily available. Information unavailable Information unavailable In supportive housing people can get the operation of facilities to ensure Due to the fact that there are only 3 adjudication under the Regie du Resolution adherence to prescribed standards, and facilities in the jurisdiction, these issues logement for the rental type issues, but they have the power to give or revoke are likely covered by policy rather than not the care.37 licenses. (CCFA, ss. 4-10) legislation, and the policy is not posted online. Fadoq (Federation de l’age d’or du Inspectors inspect nursing homes Quebec) is a non-profit that accredits annually (CCFR, s. 4) housing providers (with the Rose D’or), but it is voluntary.38 Their website is www.fadoq.ca, but they have no English resources.
Staffing indicators “Operator of a nursing home shall ensure No info readily available. Information unavailable Information unavailable Private supportive housing is that it is staffed sufficiently, as determined Due to the fact that there are only 3 unregulated and unlicensed. (credentials, ratios) by the Board with respect to numbers and facilities in the jurisdiction, these issues capabilities and arrangement, so as to are likely covered by policy rather than provide for the residents’ safety, comfort, legislation, and the policy is not posted nursing and other care in a manner online. appropriate to their state of health and degree of activity” (CCFR, s. 26)
An R.N. must be on duty in a NH at all times (CCFR, s. 27).
For CCFs, when an R.N. is not on duty, all staff providing direct care to residents must have first-aid qualifications, and at least one staff member must be qualified and competent to render CPR. (CCFGR, s. 21)
NHs and CCFs must always have enough staff to be able to effectively evacuate residents in case of fire etc (CCFGR, s. 31)
Entry/Exit Criteria Generally residents in nursing homes Assessment and admission is managed Local Health and Social Service Home care allows approximately 5 Centres locals de service have “multiple complex diagnoses, the by an Assessment/Admission Authorities assess clients, and refer hours/week for home making services, communautaire (CLSC) a.k.a. local most common being dementia, stroke, Coordinator.40 them to the appropriate care facility.41 and 2 hours per day for personal care community service centres, are the and diabetes, and all require a high level services such as bathing and dressing gatekeepers to CHSLDs. To enter a of nursing care that can no longer be -If a client requires more care than that CHSLDs, a person must be assessed provided at home or in community care then they are recommended for by a social worker/nurse and a doctor 39 42 43 1 Social, Family & Regional Services,facilities.” online: Yukon Health & Social Services
6 “Home Care Program,” online: Northwest Territories Health and Social Services