Regulation - LGIC

2016 Long-Term Care (LTC) home and Hospital Chronic Care co-payment increase

Regulation Number(s):
Ontario regulation 79/10
Regulation 552
Instrument Type:
Regulation - LGIC
Bill or Act:
Long-Term Care Homes Act, 2007; Health Insurance Act
Summary of Decision:
The Lieutenant Governor in Council (LGIC) is amending Ontario Regulation 79/10 under the Long-Term Care Homes Act, 2007 (LTCHA) and Regulation 552 under the Health Insurance Act 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.
Further Information:
Proposal Number:
16-HLTC009
Posting Date:
Summary of Proposal:
The Lieutenant Governor in Council (LGIC) is amending Ontario Regulation 79/10 under the Long-Term Care Homes Act, 2007 (LTCHA) and Regulation 552 under the Health Insurance Act 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, 2016, these maximum rates will increase from $58.35 per day to $58.99 per day. This translates into a $0.64 change to the daily rate.

In addition, the LGIC is amending Ontario Regulation 79/10 under the LTCHA to increase the maximum rate that may be charged for preferred accommodation in LTC homes to account for inflation. Effective July 1, 2016, the maximum rate that can be charged for semi-private accommodation will increase from $70.35 per day to $71.12 per day. The maximum rate that can be charged for private accommodation will increase from $83.35 per day to $84.27 per day. These rates will apply to residents admitted on or after July 1, 2015 to newer LTC homes.

Furthermore, effective July 1, 2016 the increases to preferred accommodation rates would apply to all homes including older LTC homes as follows based on the admission date:
• Residents admitted to older LTC homes, and those admitted to newer homes before July 1, 2012 can be charged up to $67.08 and $77.19 per day (up from $66.35 and $76.35) per day respectively for semi-private and private accommodation.
• Residents admitted on or after July 1, 2012, but prior to July 1, 2013 can be charged up to $68.08 and $78.96 (up from $67.35 and $78.10) per day respectively.
• Residents admitted on or after July 1, 2013, but prior to September 1, 2014 can be charged up to $69.10 and $80.73 (up from $68.35 and $79.85) per day respectively.
• Residents admitted after September 1, 2014, but prior to July 1, 2015 can be charged up to $70.11 and $82.50 (up from $69.35 and $81.60) per day respectively.
• Residents admitted on or after July 1, 2015 can be charged up to $71.12 and $84.27 (up from $70.35 and $83.35) 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, 2016, Ontario Regulation 79/10 under the LTCHA is also 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 $1,372.93 to $1,388.03, and the deduction for each additional dependant will increase from $591.94 to $598.45.
Contact Address:
1075 Bay Street, 11th Floor, Toronto, Ontario, M5S 2B1
Effective Date:
July 1, 2016
Decision:
Approved