Information for service providers

If you’re a service provider, you can learn more about services and accounts payable and access resources for Special Care Facilities and Residences.

Special Care Facilities and Residences

What’s new

Effective December 2019, updates were made to the following ministry forms to better match the types of facilities/residences and services for short-term and long-term care. The existing process for using these forms will not change. The ministry will continue to process any old forms that are submitted, however, if you keep your own printed forms, please consider replacing them at your earliest convenience.

If you have any questions about how to use these updated forms, contact Special Care Facilities.

Eligibility

  • For an eligible client who receives accommodation and care in a special care facility/residence, the ministry pays a user charge to the facility/residence on behalf of the client
  • To qualify as a special care facility/residence, facilities/residences must be either a residential care or assisted living facility/residence
  • If a recipient is residing in a facility/residence that does not qualify as a special care facility/residence, the ministry cannot pay user charges, but can pay an eligible recipient a support allowance and shelter allowance, or room and board

A client may also be eligible for:

 For more information about services

Admittance and discharge process overview

To determine if an individual is eligible:

  • Complete the Confirmation of Income HR3639 (PDF) before admittance to a facility/residence and fax the form to 1-855-771-8768
  • A ministry worker will complete the form and let you know if the individual is eligible and any income that would affect user rates
  • Once complete, the form will be faxed back to you

If an individual is not in receipt of income or disability assistance:

  • Individuals may apply for income assistance online
  • Upload HR3319 (PDF) to the My Self Serve Service Request or fax to 1-844-371-8896
  • Date of eligibility is the date the online application was submitted

If an individual does not have a Social Insurance Number (SIN):

Fax the following documents to 1-844-371-8896: 

Admittance process

To set up a user rate for an eligible recipient while they reside in a special care facility/residence:

  • Complete the Admittance/Discharge form (PDF) within 24 hours and fax to 1-855-771-8768
  • A ministry worker will complete the form and fax it back to you to let you know:
    • If the client is eligible
    • Any user charges
    • The date of eligibility
    • About current or pending income deductions

Discharge process

When a client is being discharged, complete the Admittance/Discharge form (PDF) within 24 hours and fax to 1-855-771-8768. The form:

  • Confirms the user rate
  • Reflects the recipient’s stay
  • Confirms they receive the benefits they are entitled to

Payment/invoice process overview

When a recipient is admitted to a special care facility/ residence, the approved accommodation and care rate for that facility/residence is paid for the period that includes the day of admission or the date of eligibility for Income Assistance but does not include the day of discharge or death. These are sample forms. If you require paper invoices, contact Special Care Facilities.

  • Invoice form HR150A (PDF) is used to invoice daily user rates 
  • Invoice form HR150B (PDF) is used for monthly user rates

When completing the invoice:

  • Do not exceed 11 client names per invoice
  • Excess earned income and unearned income received by the client must be deducted from the monthly invoice submitted by the facility/residence to the ministry
    • For example, the facility/residence must deduct $500 from the invoice if a client receives $500 in monthly CPP benefits
  • The system-calculated CPP tax exemption should not be deducted from the invoice
  • Each residence/house has its own Service Provider ID number
  • If you do not know your Service Provider ID number, contact the ministry
  • Submit the facility/residence Invoice on the first day of each month following rendered service (June Facility/Residence Invoice is submitted July 1)

You can invoice online using the Service Provider Portal or invoice manually by faxing to 1-855-771-8768

Reporting changes

For facility/residence name change, payment changes or new owner changes, contact the ministry at 1-866-866-0800 or fax 1-855-771-8768.

Client income and user rates

  • One-time income, received in the month of application, is deducted dollar for dollar from the user rates for that same month
  • Ongoing income is deducted dollar for dollar from the user rates from the month of application and ongoing each month
  • Earned income and unearned income are treated differently—check out the list of income and exemptions

Clients who are 65 and over

OAS/GIS in pay

Clients who turn 65 generally transition to OAS/GIS and become responsible to pay their own user fees. In these cases the clients may remain eligible when they turn 65 and the following month. For example: If a client turns 65 in April, then that client is eligible for April and May user rates, but is responsible for paying their own user rates starting in June.

OAS/GIS not in pay

If a client is not in receipt of OAS or GIS income, the ministry may be able to pay user rates. Eligibility is determined monthly. The ministry requires confirmation that both OAS and GIS have been applied for and current 30-day bank statement.