Regulation - LGIC
2015 Long-Term Care (LTC) home and Hospital Chronic Care co-payment increase
Regulation Number(s):
79/10
552
552
Instrument Type:
Regulation - LGIC
Bill or Act:
Long-Term Care Homes Act, 2007 and Health Insurance Act
Summary of Decision:
All amendments described in the Summary of Proposal section above have been approved and will come into force on July 1, 2015.
Further Information:
O. Reg. 129/15
Proposal Number:
15-HLTC018
Posting Date:
Summary of Proposal:
Ontario Regulation 79/10 under the Long-Term Care Homes Act, 2007 (LTCHA) and Regulation 552 under the Health Insurance Act have been amended to increase the maximum rate that LTC home residents may be charged for basic accommodation and the maximum rate that chronic care patients in hospital may be charged for meals and accommodation to account for inflation. Effective July 1, 2015, these maximum rates will increase from $56.93 per day to $58.35 per day. This translates into a $1.42 change to the daily rate.
In addition, Ontario Regulation 79/10 under the LTCHA has been amended to increase the maximum rate that may be charged for preferred accommodation in LTC homes to account for inflation. Effective July 1, 2015, the maximum rate that can be charged for semi-private accommodation will increase from $67.93 per day to $70.35 per day. The maximum rate that can be charged for private accommodation will increase from $80.18 per day to $83.35 per day. These rates will apply to residents admitted on or after July 1, 2015 to newer LTC homes only, e.g., LTC homes classified as "New" or "A" and are generally aligned with design standards issued in 1999 and 2009, as applicable.
Older LTC homes will only be able to charge a maximum rate of $66.35 and $76.35 per day for semi-private and private accommodation, respectively.
All residents residing in a LTC home before July 1, 2012 can only be charged maximum rates of $66.35 and $76.35 per day for semi-private and private accommodation, respectively.
Residents admitted to newer (i.e. "New" or "A") semi-private and private beds on or after July 1, 2012 but prior to July 1, 2013 can only be charged maximum rates of $67.35 and $78.10 per day respectively. Residents admitted to newer semi-private and private beds on or after July 1, 2013 but prior to September 1, 2014 can only be charged maximum rates of $68.35 and $79.85 per day respectively. Residents admitted to newer semi-private and private beds on or after September 1, 2014 but prior to July 1, 2015 can only be charged maximum rates of $69.35 and $81.60 per day respectively.
The higher rates for newer LTC homes reflect the higher costs of building and maintaining newer LTC homes. The changes to the preferred accommodation rates will support the redevelopment of older LTC homes.
Effective July 1, 2015, Ontario Regulation 79/10 under the LTCHA is has also been amended to increase the deduction for dependants used in the calculation of a rate reduction for eligible residents in basic accommodation. The deduction for the first dependant will increase from $1,339.44 to $1,372.93, and the deduction for each additional dependant will increase from $577.50 to $591.94.
A previous technical amendment to both Regulation 552 under the Health Insurance Act and Ontario Regulation 79/10 under the LTCHA simplified the ongoing harmonization of the comfort allowance and the Ministry of Community and Social Services' Personal Needs Allowance (PNA) by directly incorporating by reference the PNA as set out in regulation under the Ontario Disability Support Program Act, 1997.
In addition, Ontario Regulation 79/10 under the LTCHA has been amended to increase the maximum rate that may be charged for preferred accommodation in LTC homes to account for inflation. Effective July 1, 2015, the maximum rate that can be charged for semi-private accommodation will increase from $67.93 per day to $70.35 per day. The maximum rate that can be charged for private accommodation will increase from $80.18 per day to $83.35 per day. These rates will apply to residents admitted on or after July 1, 2015 to newer LTC homes only, e.g., LTC homes classified as "New" or "A" and are generally aligned with design standards issued in 1999 and 2009, as applicable.
Older LTC homes will only be able to charge a maximum rate of $66.35 and $76.35 per day for semi-private and private accommodation, respectively.
All residents residing in a LTC home before July 1, 2012 can only be charged maximum rates of $66.35 and $76.35 per day for semi-private and private accommodation, respectively.
Residents admitted to newer (i.e. "New" or "A") semi-private and private beds on or after July 1, 2012 but prior to July 1, 2013 can only be charged maximum rates of $67.35 and $78.10 per day respectively. Residents admitted to newer semi-private and private beds on or after July 1, 2013 but prior to September 1, 2014 can only be charged maximum rates of $68.35 and $79.85 per day respectively. Residents admitted to newer semi-private and private beds on or after September 1, 2014 but prior to July 1, 2015 can only be charged maximum rates of $69.35 and $81.60 per day respectively.
The higher rates for newer LTC homes reflect the higher costs of building and maintaining newer LTC homes. The changes to the preferred accommodation rates will support the redevelopment of older LTC homes.
Effective July 1, 2015, Ontario Regulation 79/10 under the LTCHA is has also been amended to increase the deduction for dependants used in the calculation of a rate reduction for eligible residents in basic accommodation. The deduction for the first dependant will increase from $1,339.44 to $1,372.93, and the deduction for each additional dependant will increase from $577.50 to $591.94.
A previous technical amendment to both Regulation 552 under the Health Insurance Act and Ontario Regulation 79/10 under the LTCHA simplified the ongoing harmonization of the comfort allowance and the Ministry of Community and Social Services' Personal Needs Allowance (PNA) by directly incorporating by reference the PNA as set out in regulation under the Ontario Disability Support Program Act, 1997.
Contact Address:
1075 Bay Street, 11th Floor, Toronto, Ontario, M5S 2B1
Effective Date:
July 1, 2015
Decision:
Approved