Newfoundland and Labrador
Understanding the Nursing Home System
General Defintion Of Newfoundland And Labrador Nursing Homes
Definition of Nursing Homes
As per the Provincial Long-term Care Standards, nursing homes “provide residential care and accommodations to residents who have high care needs and require on-site professional nursing services”. Nursing homes in Newfoundland and Labrador can also be referred to as a ‘Long-term Care Facility’.
In order to be eligible for nursing home care you must be:
- a citizen or permanent resident of Canada
- a resident of Newfoundland and Labrador
- assessed as needing nursing home care
Regional Health Authorities in the province are responsible for monitoring nursing homes to ensure compliance with the standards. The Department of Health and Community Services subsidizes nursing home care costs.
Nursing Home Ownership
The majority of nursing homes in Newfoundland and Labrador are public homes, however there is one private home in the province.
Most nursing homes have a selection of room layouts from which to choose. A basic, or ward room consists of 3 or more beds. A semi-private room has only 2 beds, and a private room has a single bed.
Applying To A Nursing Home In Newfoundland And Labrador
To apply for a nursing home bed, you must contact your local Regional Health Authority (RHA). Please see the “Applying to a Nursing Home” section of this website to find the number of the RHA in your area. You will be assigned a Continuing Care Nurse Coordinator and/or Continuing Care Social Worker who will collect information to determine your level of care needs. They will gather demographic information, information about your spouse, emergency contact information, Advanced Health Care Directives, and information about your Power of Attorney. They will also conduct a through in-home assessment and evaluate the following:
- physical functioning
- health history
- pain assessment
- skin integrity
- respiratory care
- urinary and bowel functioning
- foot care
- risk of falls
- depending on the above, they may or may not conduct a Standardized Mini-Mental Exam
With this information, they will determine your level of care needs and if a nursing home is the most suitable placement for you. A plan of care, which includes the placement decision, is sent to the Regional Assessment and Placement Committee. This Committee will approve your priority status.
Nursing home placement is based on the facility’s ability to respond to residents’ assessed needs and preferences. You will be asked to choose approximately 3 nursing homes that you prefer, and you will be added to those waiting lists. The wait list is managed according to need, such that those with the highest care needs are given priority. Newfoundland and Labrador have a first available bed policy and consequently, you will be required to accept the first nursing home bed that is offered to you, even if it not one of your preferred facilities. You are able to maintain your position on the waiting list of your preferred home, and transfer to that home when a bed becomes available.
Your Care Coordinator or Social Worker manager may have collected certain documents required by the nursing home. If not, be prepared to bring the following to the home at the time of admission:
- Power of Attorney for Finances (if one)
- Power of Attorney for Personal Care (if one)
- Previous year’s Notice of Assessment if you cannot pay the maximum accommodation rate
- Advanced Health Care Directives
- Health Card
Newfoundland And Labrador Nursing Home Costs
Private nursing homes in Newfoundland and Labrador determine their own fees, which is approximately $6000.00 per month. If you are interested in a private nursing home, please contact the home directly to inquire about specific costs.
Nursing homes residents are required to pay for some of the services provided in nursing homes, such as room and board, otherwise known as an accommodation fee. Publicly funded nursing homes charge a standard accommodation rate of $2,800.00 per month regardless of your bed type (i.e., ward room, semi-private, or private room). The nursing home decides which residents will receive each type of room based on several factors, such behaviour (resident who exhibit disruptive behaviours may be assigned a private room as to not disturb other residents), availability, and care needs.
|Daily Accommodation Rate||Monthly Accommodation Rate|
The Department of Health and Community Services provides subsidy to publicly funded nursing homes.
If you are not able to afford the standard accommodation fee, you may qualify for a rate reduction. The RHA will conduct a financial assessment using last year’s income tax return. You will neither be required to sell your house, nor will your assets be included in the financial assessment. Only your monthly income (i.e., pension, Old Age Security, and Guarantee Income Supplement) is used to determine your nursing home accommodation fee.
If you have a spouse who is living in the community and cannot afford to support his/herself, this can be used to offset your nursing home costs and may make you eligible for a rate reduction.
In determining an accommodation fee, each resident must have $150 per month available for personal spending.
Short-Stay Beds/ Respite Care in Newfoundland and Labrador
Respite care gives temporary relief to caregivers, or allows them to go on vacation knowing that their loved one’s care needs are met. Individuals applying for short-stay or respite care must apply to your local RHA in the same manner as those applying for permanent nursing home placement. The maximum number of respite days is 30 days per year. The cost of respite care is $20 per day. Your local RHA will advise you which nursing homes offers respite care.
Programs and Services That Are Covered
Resident accommodation fees and government subsidy will cover the following costs in a nursing home:
- room furnishings (bed, nightstand, easy chair, and dresser)
- meals and snacks (including special diets)
- laundry services
- social programs
- resident’s council
- medication administration
- assistance with Activities of Daily Living
- physician care
- pastoral services
- personal hygiene
- some mobility aides for occasional use (i.e., walker)
- professional nursing care
- nutritional services
- basic medical supplies
- therapeutic rehabilitative and restorative services
Programs and Services Not Covered
The following programs and services are not covered by the government or accommodation fees, therefore the resident will incur out-of-pockets costs.
- Hairdresser services
- T.V. cable for personal use
- newspaper for personal use
- tuck shop
- dry cleaning
- cloth labeling
Resident will not be required to pay for medications that are covered under the provincial drug plan.
Newfoundland And Labrador Nursing Home Policies, Programs, And Services
Although nursing homes vary in terms of providing some programs and services, the following are fairly standard across all nursing homes.
- All nursing homes permit visitors, however each home can determine their own visiting hours.
- Residents are encouraged to bring personal items to make their room feel like home. It is recommended to bring in items such as pictures, a bedspread, and some furnishings, depending on size and room dimensions.
- Residents are permitted to bring in some personal appliances, however, all must be approved by the home to ensure that they meet safety requirements. Some examples of appliances that are not permitted due to safety concerns are a hot plate, kettle, electric blanket, heating pads, toaster, iron, coffee maker, and heater.
- Homes are required to have an attending physician to care for all residents.
- The home will tailor meals and snack according to residents’ dietary restrictions. Some residents may need to be referred to a registered dietitian for an assessment.
- Each nursing home is required to abide by and post the Resident Bill of Rights.
- Nursing Home residents must be given the opportunity and support to establish and sustain a Resident’s Council.
- Family members should be provided with the opportunity to establish and maintain a Family Council.
- Each nursing home must provide activity programs and some programs should be offered in the evenings, weekends, and outside the facility.
- Each nursing home should provide spiritual or religious programs.
- All nursing home differ in the degree to which they offer palliative care. Some homes may provide comfort measures to a resident in their final hours, whereas other homes may have a separate room for palliative residents and their family.
Although homes may vary in their use of restraints, they should all have a least restraint policy, which typically requires that restraints are only used if:
- it is used as a last resort
- the resident is harmful to self or others
- all other interventions were unsuccessful
- the restraint is as minimal as possible
- the resident is assessed on a regular basis to ensure the resident’s safety and comfort, and to establish if the restraint is still required
- the family is informed
- the use of the restraint is documented, as well as each time the restraint is assessed
Absences Due to Hospital Stays
While a nursing home resident is in the hospital, the nursing home is required to hold the nursing home bed, however the resident must continue to pay the monthly accommodation fee.
Nursing home residents are able to go on vacation for an unlimited period of time, however they are required to continuing paying their monthly accommodation fee.
Newfoundland And Labrador Nursing Home Regulations And Inspections
All nursing homes are required to be accredited by Accreditation Canada (formerly the Canadian Council for Health Services Accreditation). Accreditation Canada is an independent, non-government agency that evaluates health care facilities. Homes that have been through this process, and have been granted accreditation are presented with a plaque, which most home prominently display. Because nursing homes must be accredited, they are not required to be licensed.
Newfoundland and Labrador Nursing Home Inspections
Regional Health Authorities are responsible for monitoring and inspecting nursing homes on an annual basis to ensure compliance with provincial Long-term Care Facilities Operation Standards, which is mandatory legislation. Upon completion of the inspection, the inspector will write a report outlining the performance of the home and the report is given to the Administrator and RHA. The Administrator must write a Corrective Action Plan, which outlines how and when issues and concerns will be corrected. Most concerns are not of a serious nature, and the issues, if any, are handed internally. If a concern is of a serious nature and/or residents are deemed to be at risk, the report will go the government, who can initiate an investigation and order Directives as to how to correct problems.
Although these reports are not posted in each nursing home, according to the Freedom of Information Act, you are able to request to read the report.
Each nursing home must have a formal complaint procedure, which must be provided, in writing, to each resident upon admission. Once the nursing home receives a complaint, the resident must receive a written response within 2 business days. Within one month of filing the complaint, the home must provide the resident with a full response based on an investigation.
If you have a concern with the nursing home, first speak with the staff to make them aware of the problem and discuss ways to address the issue. If you are not satisfied with this response, contact the Manager of the department. Serious issues, or concerns that are still not corrected, should be brought to the attention of the Administrator.