Long-term care (LTC) home legislation establishes timelines for the acceptance of a bed offer and admission that are designed to ensure existing beds in LTC homes are fully utilized. When a Community Care Access Centre (CCAC) makes an offer of admission to a person, the person is given a strict time limit in which to decide whether or not he or she will accept the offer and subsequently to move into the LTC home. The LTC home is allowed to charge the applicant certain fees during the time that the bed is being held for the person.
11.7.1 Timeline for Acceptance of Offer of Admission
An applicant has one day to accept an offer of admission to a LTC home of his or her choice. This timeframe is established by operation of the regulatory provisions related to authorization of admission. The Nursing Homes Act (NHA) regulation states:
Authorization of admission
s. 155(1) Subject to section 156, the placement co-ordinator designated for a nursing home under subsection 20.1 (3) of the Act shall authorize the admission of a person to the home if, and only if,
…
(e) in the case of a person who is applying for authorization of his or her admission to the home as a long-stay resident, the person agrees in writing with the licensee of the home that,
(i) the person will move into the home before noon of the fifth day following the day on which he or she is informed of the availability of accommodation in the home,
According to this provision, an applicant is expected to move into the LTC home by the fifth day after the day on which the person is made the offer of admission. That gives the person one day within receiving the offer to accept or reject the offer and sign the agreement with the home.
11.7.2 Accommodation and Bed-Holding Fees
Once a person has accepted the offer of admission, the bed may be held for up to five days following the date of notification, if the person pays the applicable bed holding and
accommodation fees. This means that a person who is offered admission will have five days to move in, not counting the date of notification.
The date of notification does not count as one of the days for bed-holding purposes as it is the day the applicant has to decide whether to accept the offer of admission.
Section 155 of the NHA regulation sets out the applicable fees that the LTC home may charge during the five-day period, and subsection 47(4) establishes the amount of the daily bed-
holding fee which is payable in addition to the accommodation fee for that part of the period available for bed-holding:
Authorization of admission
s. 155 (1) Subject to section 156, the placement co-ordinator designated for a nursing home under subsection 20.1 (3) of the Act shall authorize the admission of a person to the home if, and only if,
…
(e) in the case of a person who is applying for authorization of his or her admission to the home as a long-stay resident, the person agrees in writing with the licensee of the home that,
(i) the person will move into the home before noon of the fifth day following the day on which he or she is informed of the availability of accommodation in the home,
(ii) if the person moves into the home before noon of the fifth day following the day on which he or she is informed of the availability of accommodation in the home, the person will pay, (A) for each day following the day on which the person is informed of the availability of accommodation in the home and preceding the day on which the person moves into the home, the amount that the licensee would have charged him or her for accommodation for that day had he or she been a long-stay resident lodged in the available
accommodation on that day, and
(B) if the person moves into the home on or after the third day following the day on which he or she is informed of the availability of accommodation in the home, the daily bed- holding amount as determined under section 47 for each day from and including the second day following the day on which the person is informed of the availability of accommodation in the home and preceding the day on which the person moves into the home, and
(iii) if the person does not move into the home before noon of the fifth day following the day on which he or she is informed of the availability of accommodation in the home, the person will pay,
(A) for each of the five days following the day on which the person is informed of the availability of accommodation in the home, the amount that the licensee would have charged him or her for accommodation for that day had he or she been a long-stay resident lodged in the available accommodation on that day, and
(B) for each of the second, third, fourth and fifth days following the day on which the person is informed of the availability of accommodation in the home, the daily bed- holding amount as determined under section 47.
Absences
s. 47(4) The daily bed-holding amount for a day after March 31, 1995 is $53.
The following chart outlines the applicable accommodation and bed-holding fees for the five- day bed-holding period described in the above referenced provisions.
Day Resident Moves In Accommodation Fee Bed-holding Fee ($53) Day 0
Date of Notification of Availability
Yes for day 0 No
Day 1
Following Notification
Yes for day 1 No
Day 2
Following Notification
Yes for day 1 and 2 No
Day 3
Following Notification
Yes for days 1,2 and 3 Yes for day 2
Day 4
Following Notification
Yes for days 1,2,3 & 4 Yes for days 2 and 3
Day 5 (Before Noon of Day 5)
Following Notification
Yes for days 1,2,3,4 and 5 Yes for days 2,3 and 4
Applicant does not move in Yes for days 1,2,3,4 and 5 Yes for days 2,3,4 and 5
Saturdays and Sundays count for bed-holding purposes even if the LTC home does not admit applicants over the weekend. This is owing to the fact that the ordinary meaning of the word “day” in the regulation means calendar day. Therefore, if a home does not admit on any particular day such as weekends or holidays, the accommodation and bed-holding fees still apply if the particular day falls within the bed-holding period.
However, there are no provisions in the regulation which address when the CCAC has to make a bed offer, so a placement co-ordinator may wait to make a bed offer until after the weekend if he or she knows that the home does not admit applicants over the weekend.
Additionally, the payment of accommodation and bed-holding fees is part of a contractual arrangement between the applicant and the LTC home operator.
Accommodation and bed-holding fees apply to all applicants including those who are already residing in another LTC home and hospital-based applicants who are paying the chronic care co-payment.