Prince Edward Island Nursing Home

Understanding the Nursing Home System


General Defintion Of Prince Edward Island Nursing Homes

Definition of Nursing Homes in Prince Edward Island

In Prince Edward Island, public nursing homes are referred to as government manors. Nursing homes refer to homes that are privately owned. Both manors and privately owned nursing homes provide accommodations and services, personal care, and medical care to those needing nursing care and supervision 24 hours a day, 7 days a week.

Eligibility

In order to receive nursing home care in the province of Prince Edward Island you must be a resident of Prince Edward Island at least 6 months of the year, be a Canadian citizen or landed immigrant, and have a valid P.E.I. Health Card. Normally, nursing home care is reserved for individuals who are at least 60 years of age or older, however you may be eligible if you are under the age of 60 if your care needs necessitate nursing home care and services, and no other resources can meet your needs.

Government Responsibility

The Department of Health is responsible for setting nursing home fees for manors, and determining the subsidy amount for those unable to pay the full costs of nursing home care. The Department of Health will pay the basic health care costs for residents in both manors and private nursing homes.

Accommodation/Room Type

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 Prince Edward Island

In order to apply for a nursing home or manor in Prince Edward Island, you must go through a single point of entry system, in which you contact your local Home Care Office. Please see the “Applying to a Nursing Home” tab on the left hand side of the screen to find the number of your local Home Care Office. Once you contact the office, you will be asked to complete a one page application form, in which you provide basic demographic information. Arrangements will be made for a Placement Coordinator to conduct an assessment using a Senior Assessment Screening Tool, which measures functional and cognitive abilities, home management skills, and several risk factors. Medical information from your physician will also be collected to further understand your care needs. This information, along with the assessment, will be used to determine your Level of Care. If you are a Level 4 or 5, you are deemed to need manor or nursing home care.

A committee of 6 individuals meets on a biweekly basis to review and discuss applications for clients needing nursing home care, and to determine who will be offered a bed. Bed offers are made based on priority date, which is the date in which, after you have been assessed as needing a manor or nursing home bed, you acknowledge that you will accept a bed when one is offered. If you are living in the community, you are able to provide a list of manors or homes are you are willing to move into (your preferred home list), and you can wait until a bed becomes available in one of your preferred homes/manors. If you are offered a bed, you can turn down the offer, however if you are offered a bed a second time and you reject the offer again, you will be removed from the waiting list. If you are awaiting a bed in the hospital, you are required to take the first available bed. If it is not one of your preferred homes, you can later request a transfer to the home/manor of your choice. You will maintain your priority on the waiting list.

When you are offered a bed, an individual from the Home Care Office, not the nursing home, will contact you to advise you that a bed is available. If you are willing to accept a bed in a home that is not on your preferred list, you are able to move in the manor/home and maintain your spot on the waiting list of your preferred home. However, if you move into a manor/home and later decide that you want another facility, you will have to begin a new application process, and you will added to a waiting list as if you are a new applicant.

Appeals Procedure

If the Placement Coordinator determines that you are not eligible for manor/nursing home placement, there is not a formal appeal process, however you are able to:

Please note, that this application process is typical for the majority of regions in Prince Edward Island, however the region of Charlottetown utilizes a unique system in which you contact the individuals home/manors to apply for admission.


Prince Edward Island Nursing Home Costs

In Prince Edward Island, manor 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 manor will determine room type according to need, availability, and behaviour. For example, a resident with disruptive behaviours is more likely to reside in a private room as to not bother other residents.

As of April 2012, the accommodation cost for nursing home residents with a government subsidy is $77.60. Private nursing homes determine their own rates, therefore, you must contact individuals homes to inquire about fees.

Government Subsidy

The Department of Health will pay for all basic heath care costs in both manors and nursing homes, and residents only pay for accommodation charges, such as room and board, known as an accommodation fee.  If you have an annual net income of less than $30,000 you may qualify for government subsidy. 

Discetionary Spending – Comfort Allowance

Comfort allowance refers to a predetermined sum of money available to those who receive government subsidy and it allows residents to purchase items for personal use, comfort, and recreation, or programs and services that are not covered by accommodations fees or funded by the government. Those on subsidy will have $103 per month available for personal spending.

Applying for a Rate Reduction

If your annual net income is less than $26,500.00, you may qualify for a rate reduction by applying to the Long-term Care Subsidization Program. You will be required to provide documentation proving your annual income (Income Tax and Benefit Return, and Notice of Assessment). Please call 1-888-365-5313. Only your income, not personal assets or your house, will factor into the decision as to whether or not you are eligible for a rate reduction. However, you will be required to contribute all of your income to cover your nursing home costs.

If you have a spouse living in the community, the combination of your total net income and your spouse’s is split 50/50, and this figure is then used to determine if you are eligible. Therefore, the community dwelling spouse is able to retain 50% of the total income of the applicant and spouse. In order to ensure that the community dwelling spouse has sufficient funds to continue residing in the community, it may be necessary to reduce the accommodation fee for the nursing home resident.

You will undergo a financial assessment, only if you are applying for a rate reduction.

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 need are met. In order to apply for respite care, you are required to contact your local Home Care Office in the same manner in which you apply for a permanent bed. The application and assessment process is also the same. You are able to use respite care for a maximum of 30 days per year. The cost of respite care is based on a percentage of OAS and GIS income (which most Prince Edward Island residents receive), and is typically $37.95 per day. In the event that your income is insufficient to cover these costs, you may qualify for a rate reduction.

Programs and Services That Are Covered

The 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 the government or the accommodation fees, therefore there will be out-of-pockets costs.

Medications

Some medications may not be covered under the provincial medication program, and therefore, will require out-of-pocket costs.


Prince Edward Island Nursing Home Policies, Programs, And Services

Although nursing homes vary according to some programs and services, the following are relatively standard across all nursing homes:

Restraints

Homes vary in their use of restraints, but in all homes and individual resident situations, restraints must be used only if:

Hospital Stays

If you are a nursing home resident who has to go to hospital, you will be required to continue paying the accommodation fee while away from the home. As long as you are expected to return to the nursing home, the home is expected to hold your bed.

Weekend and Vacation Leaves

Residents of nursing homes are able to go on vacation and be out of the facility on weekends, however, similar to hospital stays, you are required to continuing paying the accommodation fee.


Prince Edward Island Nursing Home Government Regulations And Inspections

Privately Owned Nursing Homes

Privately owned nursing homes must abide by the Continuing Care and Nursing Home Act. They must hold a license from the Community Care Facilities and Nursing Homes Board, who also inspects these facilities on a regular basis. Any violations are reported to the Administrator, who will then develop a compliance plan outlining the measures that will be taken to correct the issue. The Board also conducts a follow-up inspection to ensure that all violations have been rectified. If corrections have not been made in the appropriate time frame, or if the violations are of a serious nature, the home may be issued a provisional license. This license must be posted in the home, as well as an explanation as to why the provisional license was issued. However, the detailed inspection report is not posted.

Manors

Manors experience a different regulation process. In most provinces, the Accreditation process is voluntary, however Manors in Prince Edward Island, must be accredited from Accreditation Canada, (formerly Canadian Council for Health Services Accreditation). Once accredited, the manor will receive an accreditation certificate, which should be prominently displayed. They are not inspected on an annual basis, in the same way private nursing homes are.

Complaints

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.