Long-Term Residential Care
Long-term residential care services provide 24-hour professional supervision and care in a protective, supportive environment for people who have complex care needs and can no longer be cared for in their own homes or in an assisted living residence. Long-term residential care services include:
- standard accommodation;
- development and maintenance of a care plan;
- clinical support services (e.g., rehabilitation and social work services) as identified in the care plan;
- ongoing, planned physical, social and recreational activities (e.g., exercise, music programs, crafts, games);
- meals, including therapeutic diets prescribed by a physician, and tube feeding;
- meal replacements and nutrition supplements as specified in the care plan or by a physician;
- routine laundry service for bed linens, towels, washcloths and all articles of clothing that can be washed without special attention to the laundering process;
- general hygiene supplies, including but not limited to soap, shampoo, toilet tissue, and special products required for use with facility bathing equipment;
- routine medical supplies;
- incontinence management;
- basic wheelchairs for personal exclusive use;
- basic cleaning and basic maintenance of wheelchairs; and
- any other specialized service (e.g., specialized dementia or palliative care) as needed by the client that the service provider has been contracted to provide.
For more information on wheelchairs, see Client FAQs (below).
If you require long-term residential care services, supportive and compassionate care is provided in residential care facilities with the goal of preserving an individual’s comfort, dignity and quality of life as their needs change, and to offer ongoing support for family and friends. For more information about palliative care and end-of-life care services provided in residential care facilities, go to:
For more information about long-term residential care services, go to:
Is this care right for me?
Long-term residential care services are for people who can no longer be cared for in their own homes or in an assisted living residence and:
- have severe behavioural problems on a continuous basis;
- are cognitively impaired, ranging from moderate to severe;
- are physically dependent, with medical needs that require professional nursing care, and a planned program to retain or improve functional ability; or
- are clinically complex, with multiple disabilities and/or complex medical conditions that require professional nursing care, monitoring and/or specialized skilled care.
What are the long-term residential care eligibility criteria?
In addition to the general eligibility criteria for home and community care services, to be eligible for residential care services you:
- have been assessed as having 24-hour professional nursing supervision and care needs that cannot be adequately met in your home or by housing and health services;
- are at significant risk by remaining in your current living environment, and the degree of risk is not manageable using available community resources and services;
- have an urgent need for residential care services;
- have been investigated and treated for medical causes of disability and dependency that may have been remedial;
- have a caregiver living with unacceptable risk to their well-being, have a caregiver who is no longer able to provide care and support, or do not have a caregiver available;
- will accept the first appropriate bed where your preferred facility or location could not be accommodated on admission;
- have consented to admission to the facility, and agreed to occupy the bed within 48 hours of notification of the availability of the bed, unless alternative arrangements have been made in advance with your health authority; and
- have agreed to pay your assessed rate and any additional optional charges for services, programs or supplies that are not included as a benefit but are offered by the service provider.
To read the general eligibility criteria for all home and community care services, go to:
How do I arrange for long-term residential care services?
If you are interested in receiving long-term residential care services or know of someone who might be in need of these services, you can contact your health authority's home and community care office or you can have a health care professional make a referral on your behalf.
For contact information and a detailed description of how to arrange for long-term residential care services, please see:
Veterans please note:
If you are a veteran and you are eligible for home and community care services, your health authority is required to contact Veterans Affairs Canada for an assessment of eligibility for federal benefits and arrange your placement on their veterans’ priority access bed waitlist in those facilities with veterans’ priority access beds.
Access to Long-Term Residential Care Services
If you and the health authority professionals working with you determine that you qualify for publicly subsidized residential care services, then you will be offered a bed based on the urgency of your care needs and other factors including:
- Your facility preferences;
- Availability of caregivers and community supports;
- Your clinical care needs;
- Appropriateness of the facility; and
- Potential risk from abuse, neglect or self-neglect in present living situation arising from ability of the client and/or their caregiver to manage their health and daily living needs.
Priority access to a residential care bed means that you will be expected to accept the first appropriate bed that becomes available and is offered to you. Once you and your family are informed that a bed is available, you are expected to move into the facility within 48 hours. Publicly subsidized beds are in high demand, so it’s important that they are used by those who need them.
Health authorities try to accommodate individual needs and move clients into a facility that is their first choice. However, as the goal is to find a residential care facility that meets the care needs for people at risk as quickly as possible, sometimes individuals are not placed in the facility that is their first choice. In these situations, transfer to the preferred facility will be managed in an equitable manner. For more information about transferring to your preferred facility, see the How do I transfer to my preferred facility? section below.
If you and your family believe that there may be difficulties being able to move in within the 48 hour time period, alternative arrangements can be made with your health authority. Please speak to your health-care professional about your circumstances.
You may also want to talk to your health care professional if you have concerns about managing your costs while you transition from your home to a residential care facility.
Couples in Residential Care
When both people are eligible for residential care, the health authority makes every effort to place couples in a facility together.
When only one member of a couple is eligible, and the couple wishes to stay together, the health authority will explore, with the couple, those options that may help to maintain their relationship.
Health authorities will work with spouses to identify reasonable arrangements that would enable them to maintain and support their relationship.
For more information, go to:
How do I decide which residential care facility is best for me?
Your health care professional will determine which facilities best meet your individual care needs. It is important to discuss with your family which facility you prefer. It is advisable that you visit prospective facilities. Tours need to be scheduled in advance with the residential care facility staff to ensure someone is available when you arrive.
There are many things to consider as you plan for your future care needs. In B.C., residential care and support options are available from both publicly subsidized and private pay service providers. The following booklet contains information about eligibility, cost, services, oversight, and practical examples of things to consider when selecting a residential care facility:
Many facilities have an information brochure or package that provides an overview of their philosophy, services and answer many of your questions.
Ask for the admissions agreement or similar documentation. An admission agreement will clarify what services are provided, what services are not available, and any extra charges that may apply. Many facilities also have their own websites.
To learn more about residential care facilities in your region, visit the residential care pages on your health authority website using the links below:
How do I transfer to my preferred facility?
While every effort is made to offer you a bed in your preferred facility, sometimes you may first be offered a bed in a facility that is not your first choice. If you find yourself in this situation, please speak with your health care professional, or once in the facility, with the director of care, facility liaison, residential care coordinator or social worker. They will work with you to add your name to the transfer list for your preferred facility, if appropriate. You may change your mind at any time if you want to stay at your current facility.
The amount of time you wait before you are offered the opportunity to transfer to your preferred facility will depend on a number of factors including the number of people who are also waiting to transfer to that facility.
If you are paying privately for residential care while waiting for access to publicly subsidized care, you cannot be guaranteed your subsidized bed will be in the same facility. If the facility that you are living in has subsidized beds, you can identify that facility as your preferred choice for placement. All individuals applying for residential care services must accept the first appropriate bed offered. However, if you are offered a bed in a facility that is not your first choice, you may request a transfer once you have been admitted to a publicly subsidized bed, as described above in Access to Long-Term Residential Care Services.
Choosing to pay privately for residential care should not impact the length of time you wait for your initial placement in a subsidized residential care facility. If you have concerns with the length of time that you have been waiting for initial placement, you should raise your concerns with your health-care professional.
Health authorities post summary inspection reports on their websites for routine and follow-up inspections of facilities licensed under the Community Care and Assisted Living Act or licensed or designated under the Hospital Act. The reports include information relating to substantiated complaints and inspections.
Family and Resident Councils
A family and/or resident council is a group of persons who either live in a residential care facility or are the contact person, representative or relatives of care facility residents, and who meet regularly for a common purpose related to the care facility. A resident/family council is self-led, self-determining and democratic. Councils exist to engage the resident community in collaborative activities which will advance the quality of life for residents.
Is there a cost for long-term residential care services?
If you receive publicly subsidized long-term residential care services, you will pay a monthly rate of up to 80 per cent of your after tax income towards the cost of housing and hospitality services, subject to a minimum and maximum monthly rate. Your monthly rate is calculated based on your “after tax income” (as defined in the Continuing Care Fees Regulation) in one of two ways:
If your after tax income is less than $19,500 per year, your monthly rate is calculated as your after tax income less $3,900 and divided by 12 (Formula A).
Note: The $3,900 deduction ($325 per month X 12 months) is set to ensure that most clients have at least $325 of income remaining per month after paying their monthly rate.
If your after tax income is equal to or greater than $19,500 per year, your monthly rate is calculated as your after tax income multiplied by 80 per cent and divided by 12 (Formula B).
For more information on how your after tax income is calculated, please see:
The minimum monthly rate is adjusted each year based on changes to the Old Age Security/Guaranteed Income Supplement (OAS/GIS) rate as of July 1 of the previous year. For 2018, the minimum monthly rate for a client receiving long-term residential care services is $1,130.60 per month.
If you and your spouse are sharing a room in a residential care facility and are both in receipt of the Guaranteed Income Supplement (GIS) benefit at the married rate, your monthly rate will be calculated based on your after tax income, subject to a minimum and maximum monthly rate. For 2018, the minimum monthly rate for a couple sharing a room and both in receipt of the GIS benefit at the married rate is $783.50 per month per person.
The maximum client rate is adjusted each year based on changes to the Consumer Price Index over the previous year. For 2018, the maximum monthly rate for a client receiving long-term residential care services is $3,278.80 per month.
For more general information on the costs of publicly subsidized home and community care services in B.C., please see:
If payment of your assessed monthly rate would cause you or your family serious financial hardship, you may apply to your health authority for a temporary reduction of your monthly rate. For more information, please see "What if I cannot afford my assessed monthly rate?”, below.
What if I cannot afford my assessed monthly rate?
If you are receiving long-term residential care services and payment of your assessed monthly rate would cause you or your family serious financial hardship, you may be eligible for a reduced rate.
Serious financial hardship means that payment of your assessed monthly rate would result in you (or your spouse, if applicable) being unable to pay for:
- adequate food;
- monthly mortgage/rent;
- sufficient home heat;
- prescribed medication; or
- other required prescribed health care services.
For more information on eligibility and how to apply for a temporary rate reduction of your monthly rate, please see:
What optional services can I choose to pay for in addition to my monthly rate?
Residential care service providers may also offer you optional equipment, products, and services in addition to those that are included as part of your residential care services. If you choose to receive any of these optional services, you may be required to pay an additional fee over and above your monthly rate. These optional services may include:
- personal cable connection and monthly fee;
- personal telephone connection and basic services;
- nutrition supplements, where the client requests a specific commercial brand rather than the brand provided by the service provider;
- personal newspaper, magazines and periodicals;
- hearing aids and batteries, including replacement batteries;
- personal transportation;
- extra or optional craft supplies, entertainment and recreational activities that are additional to activities and supplies provided as benefits above, and are chosen by the client;
- an administration or handling fee associated with the service, where reasonable, to perform a task or service that would normally be the client’s responsibility;
- purchase or rental of equipment that is for the exclusive use of the client (e.g., walker, crutches, canes or other devices, and maintenance as required);
- modifications to basic wheelchairs/ modified wheelchairs, specialized wheelchairs, as per Policy 6.F.1;
- therapist fees for assessment and determination of modified wheelchair and specialized wheelchairs;
- miscellaneous charges associated with wheelchair cleaning and maintenance such as non-basic maintenance services, emergency cleaning, and damage;
- companion services;
- personal dry cleaning or laundry services for items requiring special attention; and
- personal hygiene and grooming supplies that the client chooses in preference to general supplies provided by the service provider including:
- facial tissue
- hand lotion
- denture cleaner
- brush and comb
- hair shampoo and conditioner
- talcum powder
- shaving cream
- special soap
- preferred incontinence supplies.
Frequently Asked Questions about Wheelchairs for Residential Care Clients
- What is the policy on basic wheelchairs in long-term residential care facilities?
Effective January 1, 2016, long-term residential care residents who reside in publicly-subsidized residential care facilities will now have access to a free basic wheelchair for personal exclusive use, if required. Basic maintenance and basic cleaning of the basic wheelchairs will also be provided as a free benefit.
- When is the policy effective?
Effective January 1, 2016, clients who are assessed as needing a basic wheelchair will be eligible for one. For additional information, please speak with your service provider.
- What qualifies as a basic wheelchair?
A basic wheelchair is a manual, self-propelled, safe and durable wheelchair that enhances personal mobility; has a basic contoured seat cushion; and which is reasonable to obtain and maintain. A basic wheelchair is a wheelchair without modification, upgrade, customization or specialization. A custom made wheelchair is not a basic wheelchair. Bariatric wheelchairs and wheelchairs with super-low seating are not basic wheelchairs. For additional information, please speak with your service provider.
4. What if I rented, purchased or acquired a wheelchair with my own resources prior to the revised policy coming into effect?
It is important to discuss with your service provider the benefits and disadvantages of continuing with your existing ownership or rental agreement for a basic or modified wheelchair.
If you purchased or rented a wheelchair with your own resources prior to the revised policy, there is no reimbursement/ retroactive payment available.
However, if the cost of the equipment is causing serious financial hardship, speak to your case manager about applying for a temporary rate reduction of your client rate.
- I am eligible/ have access to wheelchair benefits from another organization, can I utilize both sets of benefits?
No. If you are eligible for wheelchair benefits from other organizations (such as Veteran’s Affairs Canada, Worker’s Compensation, etc.), you do not qualify for the wheelchair benefit provided through the Ministry of Health, Home and Community Care Program.
If you have extended health benefits which provide assistance with wheelchairs, discuss your options with your service provider.