Nova Scotia Nursing Homes

Understanding the Nursing Home System


General Definition Of Nova Scotia Nursing Homes

 

Definition of Nursing Homes in Nova Scotia

As per the Department of Health and Wellness’s Long-term Policy Manual, nursing homes “provide personal and/or skilled nursing care in a residential setting to individuals who require the availability of a registered nurse on-site at all times.” Nursing homes can also be referred to as a ‘Long Term Care Facility’.

Eligibility

According to the Long Term Care Manual, a person may apply for nursing home admission if he/she:

1.  is lawfully entitled to be or remain in Canada,

2.  makes the person’s home and is ordinarily resident in Nova Scotia;

3.  meets the eligibility requirement for Nova Scotia`s Health Insurance Plan (i.e. the 

person has been issued a valid Nova Scotia Health Card with an effective date which 

precedes the date of the individual`s Long Term Care Facility Financial Application); 

and

meets4.  the eligibility requirement for Nova Scotia’s Health Insurance Plan (i.e. the 
person has been issued a valid Nova Scotia Health Card with an effective date which 
precedes the date of the individual’s Long Term Care Facility Financial Application); 
and

4.  is 18 years of age or older."

 

Government Responsibility

The Department of Health and Wellness is responsible for regulating and setting fees for nursing home care.

Nursing Home Ownership

Nursing homes in Nova Scotia can be either publicly or privately owned and operated. All public nursing homes must be licensed, and they should be accredited.

Accommodation/RoomType

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 Nova Scotia

 In order to apply for a nursing home bed, you must contact a Continuing Care Coordinator in your district health authority, by calling the province-wide single access line at 1-800-225-7225.  After contacting the office you will be assigned a Care Coordinator in your district, who will conduct a functional, health, social, and financial assessment.  You will also be required to provide medical documentation in the form of a Medical Status Report from your physician, or give your District Health Authority permission to request this information from your physician on your behalf.  The Care Coodinator will determine your Level of Care needs, and if nursing home placement is appropriate.  As per the Long-term Care Policy Manual you will not be eligible for a nursing home if you:

The form is then sent to the Placement Coordination Office along with the application.  Once a decision is made, the Care Coordinator will inform the client of the decision.

If the client has been deemed to require nursing home care, they must inform their Care Coordinator of the nursing homes they prefer.  The Care Coordinator relays this information to the Placement Coordination Office and they will try to place the client in their preferred home, however matching care needs takes precedence.

Waiting List

If you are put on a waiting list, the Care Coordinator will reassess your application every 90 days, or if there is a significant change, to ensure that the application and documentation reflects your current care needs.

Nova Scotia has a First Available Bed Provision to guide waiting lists. Your name will be submitted to all suitable nursing homes within a 100km radius of your location. This Provision applies to adult protection clients, those in hospital awaiting nursing home placement, and current nursing home residents who are awaiting transfer to another nursing home because of changing health needs. It does not apply to those in the community waiting for a nursing home bed, those in a nursing home waiting to be transfer to their preferred facility, or residents who want to extend their 30 day facility leave.

If you accept a nursing home bed that is not in your preferred facility, you can accept the bed and maintain your position on the waiting list of your preferred facility. If you are bound to the First Available Bed Provision, and you decline the bed offer, you will be removed from all waiting lists, and you will have to reapply at a later date. If, however, you are awaiting placement in the community, and you are offered a bed that is not in your preferred home, you are able to defer placement for 3 months to wait for a bed in your desired home. If you decline a second offer, you will be removed from all waiting lists.

If a nursing home bed becomes available, the home will advise the Placement Coordination Office, who will then send the home the list of the appropriate applicants, and the home determines if they can meet the client’s needs.

Appeals Procedure

If the Panel determines that the client does not need nursing home placement, and you disagree with this decision, you can request an Administrative review if you submit your appeal within 30 days being informed of decision. You must complete a Review Request Form.


Nova Scotia Nursing Home Costs

The Department of Health and Wellnes sets nursing home rates, which are applicable from November 1 – October 31. A nursing home resident can expect to pay up to $110.00per day, effective November 1, 2016. 85% of a resident’s assessed income will be applied to their accommodation charge, as long as they have $260  per month for personal spending.

 Daily Accommodation Rate 
Cost $110 (effective November 2016)  

In Nova Scotia, nursing homes residents do not pay a different rate according to room type. Meaning, there is not one rate for a private room, another rate for a semi-private room, and yet another rate for a ward room. The nursing home decides which residents will receive each type of room based on several factors, such behaviour (a resident who exhibits disruptive behaviours may be assigned a private room as to not disturb other residents), availability, and care needs.

 

Government Subsidy

The Department of Health and Wellness subsidies the cost of nursing home care and the nursing home resident is expected to pay for the accommodation portion.

Applying for a Rate Reduction

Nursing home residents are not expected to contribute more than 85% of their assessment income towards the accommodation fees.  If you cannot pay for the full accommodation fee you may be eligible to apply for a rate reduction in which case you will be asked to provide your Notice of Assessment. 

Discretionary Spending

Although nursing home residents pay for the accommodation portion of nursing home costs, they must have $3126 per year available for personal spending.

Short-Stay Beds – Respite Care

Respite care gives temporary relief to caregivers, or allows them to go on vacation knowing that their loved one’s care needs are met. The availability of a respite bed will vary by home. A home that offers a respite bed must have a license to offer this type of care. To apply for respite care call 1-800-225-7225. You will undergo a needs assessment to determine if you are eligible to receive respite care. If you are approved, you must apply to receive respite care within one year of this date. An individual can apply for a maximum of 60 respite care days per year, and the number of days between July 1 - October 1 must not exceed 30 days. 

Programs and Services That Are Covered

Accommodation costs and government subsidy will cover the following costs in a nursing home:

Programs and Services Not Covered

The following programs and services are not covered by government or accommodation fees, therefore will be out-of-pockets resident costs:

Medications

Residents of nursing homes are required to pay for prescription drugs, although some residents may be able to participate in the Nova Scotia Pharmacare Benefit Plan.


Nova Scotia Nursing Home Policies, Programs, And Services

Although nursing home may vary according to some programs and services, the following are fairly standard across all homes.

Restraint Policy

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:

Hospital Stays

If a resident goes to hospital, they are required to continuing paying the nursing home accommodation fees. The nursing home is required to hold the resident’s bed if they are expected to return to the home within 30 days. If the hospital stay is expected to exceed 30 days, the home will continue to hold the bed if the hospital gives the Care Coordinator a written prognosis detailing the need for the absence. Again, the resident must continue to pay the accommodation fees.

Vacation Leaves

A resident may go on vacation for a time period not exceeding 30 days per year. The resident must continue to pay the accommodation fees during the absence.


Government Regulations And Inspections

Nursing homes are expected to abide by the Homes for Special Care Act. Homes that receive public funding are required to have a license. Homes that do not receive public funding are not required to have a license.

All nursing homes should 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.

Nursing Home Inspections

Publicly funded nursing homes undergo an annual inspection to ensure compliance with the Homes for Special Care Act. Homes that do not receive public funding are not required to have a license. Under some circumstances, homes may have an inspection more than once a year, if there have been concerns with the home in the past. The inspector will want to see that the home has put processes in place to correct past concerns and to ensure that they will not happen in the future.

Upon the completion of an inspection, the inspector will write a report and present it to the Administrator. If there are any areas of concern, the Administrator will write a corrective action plan, which outlines when and how the problem will be rectified. In the event of a serious concern, the government may revoke a license, renew the license with conditions, or grant a temporary license. In all these cases, the inspector should conduct a follow-up visit before the next annual inspection to ensure that the home has addressed the concerns.

Complaints

If you have a concern with the nursing home, first speak with relevant 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.