Manitoba Nursing Homes
Understanding The Nursing Home System
General Definition Of Nursing Homes
Definition of Nursing Homes
In the province on Manitoba, nursing homes are referred to as a “Personal Care Home“ (PCH). PCHs care for individuals who need 24 hour a day, 7 day a week nursing supervision, and who can no longer live safely at home because of health concerns.
Eligibility
In order to be admitted into a PCH you must a resident of Manitoba and have a valid Manitoba health card. If you are new to Manitoba, but have lived in the province for at least 24 months, you may be eligible for nursing home services. If you previously lived in Manitoba for at least 10 years, but have been absent for less then 10 years, you may also still be eligible.
Government Responsibility
Manitoba Health is responsible for setting fees and inspecting PCHs.
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 in a room. Please see ‘Manitoba Nursing Home Costs’ below for fees associated with each room.
Applying To A Personal Care Home In Manitoba
The application process is fairly similar amoung most Regional Health Authorities (RHA) in Manitoba, in that you must contact your Home Care Office in your RHA to apply to a nursing home. However, Winnipeg has a separate Long-term Care Access Centre to handle nursing home admissions. If you are in the Winnipeg region, please contact 1-204-940-3600. For all other regions, please see the “Applying to a Nursing Home” tab on the left hand side of the screen to obtain the telephone number for the RHA in your area.
Once you have decided that you need assistance with your health care needs and you contact your local Home Care Office, you will be assigned Home Care Case Coordinator. With information from your physician, your case manager will determine if you are eligible for nursing home placement. The Case Coordinator will complete an application and conduct a thorough assessment to determine your care needs. The Case Coordinator will forward this information to the Regional Panel, who will review the application to determine if you are eligible for a nursing home bed. In some regions, the applicant and their family members may be present for the Panel meeting.
If you are not deemed eligible, the Case Coordinator will work with you to discuss other care options, such as home care or other supports in the community. If you are not satisfied with this decision, you may be able to make an appeal. In the Winnipeg region, contact the Director of the Long-term Care Access Centre to dispute the decision of the Panel.
If, on the other hand, the Panel approves your application, your information will be sent to Manitoba Health to confirm your insurability within the PCH program. If your insurability is confirmed, you will be required to submit a list of your preferred PCHs to the Case Coordinator and your information is sent to these homes to ensure that they can meet your care needs.
Waiting List
If a nursing home can meet your care needs, the home will advise you that your name has been added to their waiting list. When a bed becomes vacant in a PCH, the committee will review all applicants on the waiting list to decide who will be offered the bed. Factors such as the length of time an applicant has been on a waiting list, urgency of care needs, risk factors, and ability of the PCH to meet the care needs of the applicant will influence who will be offered the bed. Either the PCH, or the Case Coordinator will contact you to advise you of the bed offer.
If you are in hospital awaiting nursing home placement you must accept the first bed that becomes available, regardless if it is one your preferred PCHs or not. You are able to request a transfer and maintain your position on your preferred home’s waiting list, and when a bed becomes available in a home of your choice, you will be able to relocate.
Appeal’s Procedure
If the Panel decides that you are not eligible for nursing home placement, you can appeal this decision by writing to the Appeal Panel, and presenting your case before the panel.
Admission Documentation
Upon admission to a PCH, you will be requested to provide:
- last year’s Notice of Assessment
- Health Care Directives (if one)
- Power of Attorney (if one)
- Veterans Affairs of Canada coverage (if any)
- Social Insurance Number
- Old Age Security Number
- PHIN number
- DVA number
Manitoba Nursing Home Costs
Nursing homes in Manitoba are either a public or private homes, but Manitoba Health determines both of their fees. Although nursing home costs are subsidized by the government, you will be required to pay for some of the services, such as room and board. This fee is known as an accommodation rate. Individual accommodation rates are determined only by your income, and you will not be asked to disclose the value of your assets or sell your house to pay for your nursing home care. As off August 1, 2010 the minimum accommodation rate for nursing home care is $31.30 per day, and the maximum rate is $73.40 per day. These rates typically change August 1 of every year.
| Daily Accommodation Rate | Monthly Accommodation Rate | |
|---|---|---|
| Minimum Rate | $31.30 | $954.00 |
| Maximum Rate | $73.40 | $2238 |
If you request a semi-private room, you can expect to pay the standard maximum rate ($73.40 per day), and up to an additional $2.50 per day. If you request a private room, you will pay the standard maximum rate and up to an additional $5 per day. However, if you do not request a semi-private or private room, but the nursing home chooses to place you in one of these rooms, you are not required to pay an additional amount. There are several reasons why this may occur:
- The Assessment Panel advises the home that there is an emergency admission awaiting a nursing home placement, however the nursing home does not have a standard room available.
- The resident requires isolation.
- The resident’s medical condition and/or care needs necessitate a private room.
Rate Reductions
If you are unable to pay the minimum accommodation rate because of exceptional circumstances, you may be eligible to apply for a rate reduction by requesting a review of your case. Prior to May 31, complete a Tax Information Release Form, or file an application for Reduced Residential Charge (the nursing home will complete section E).
Government Subsidy
The government of Manitoba subsidizes the cost of nursing home care. The costs are shared by Manitoba Health and Healthy Living, under the Personal Care Home insured program.
Short-Stay/Respite Care in Manitoba
Respite care gives temporary relief to caregivers, or allows them to go on vacation knowing that their loved one’s care needs are met. In order to apply for respite care, you must contact your local Home Care Office, and you will be assessed using the same paneling process as a permanent nursing home placement. The cost of respite care is $31.30 per day, and you are limited to 21 respite days per visit.
Discretionary Spending
In determining the accommodation fee a nursing home resident must pay, each nursing home resident must have $277 per month ($3324 per year) available for personal spending.
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
- linens
- housekeeping
- activities
- social programs
- medication administration
- assistance with Activities of Daily Living
- physician care
- personal care services
- some mobility aides for general use (i.e., walker)
- basic medical supplies
- 24 hour a day, 7 day a week professional nursing care
- physiotherapy and occupational therapy, if the facility is approved to provide these services
Programs and Services Not Covered
The following programs and services are not covered by government subsidy or the accommodation fee, and therefore the resident will incur out-of-pocket costs.
- hairdressing
- T.V. cable for personal use
- transportation
- personal newspaper delivery
- tuck shop
- dry cleaning
- ironing
- foot care
- dental care
- labeling of clothes
- medical devices for personal use
Medications
Nursing home residents do not pay for medications that are prescribed by a physician and are covered under Manitoba’s Personal Care Home Program. However, mediations that are not included in this plan are paid for by residents.
Manitoba Nursing Home Policies, Programs, And Services
Although nursing homes vary according to 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 able to bring in personal items to make their room feel like home. It is recommended to bring in items such as pictures, a bedspread, and decorations.
- The nursing home will allow you to bring in one piece of furniture (approximately 10 square feet), permitting it is approved by the home.
- Residents may be 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 pad, toaster, iron, coffee maker, and heater.
- Homes are required to have an attending physician, however residents are able to keep their own doctor if he/she has visiting privileges in the home.
- The home will tailor meals and snacks 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 Residents Bill of Rights.
- Nursing home residents, and their family members, must be given the opportunity and support to establish and sustain a Resident’s Council and Family Council, respectively.
- 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. The room may allow family members to spend the night with the dying resident.
Restraints
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
Hospital Stays
If a nursing home resident must go to hospital, they are required to continuing paying the nursing home accommodation fee to hold their bed. The nursing home must hold the bed for a maximum of 21 consecutive days. Beyond this length of time, you can apply for an extension, but each case is reviewed on an individual basis. If you are not granted an extension, the nursing home will discharge you and you can reapply for admission to the home when your health improves.
Vacation Leave/Extended Leave
Nursing home residents are able to go on vacation for not more than 21 days per calendar year. You are required to pay the nursing home accommodation fee while on vacation in order to hold your bed. If you choose to extend the leave beyond 21 days, you can continue to hold your bed if you pay the accommodation rate, in addition to the government per diem rate.
Social Leaves
Social leaves are absences from the nursing home for a period not exceeding 3 days, or a maximum of 72 hours, at any time per week. This does not include vacation/extended leave. While on social leave, you must continue paying the accommodation fee.
Manitoba Nursing Home Regulation And Inspections
Manitoba nursing homes must abide by the Personal Care Homes Standards and Regulations, as part of the Health Services Insurance Act. All nursing homes must be licensed. In addition, they 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 nursing homes prominently display.
Government Inspections
Manitoba Health is responsible for monitoring and inspecting nursing homes every 2 years. Upon the completion of an inspection, the inspector will verbally review the findings with administration, staff, and family (if they wish to attend). The nursing home will receive a written report within 6 – 8 weeks, and the Administrator must write and submit, within 50 days, a Corrective Action Plan, which outlines how and when concerns will be corrected. The Administrator must submit a status update 100 days later, to inform the inspector of progress made in fixing the concerns. Inspectors revisit up to 1/3 of nursing homes within a year of the inspection, depending on the nature of the findings, to ensure that the home has corrected problems and concerns. Inspection reports are not made available to the public.
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.
As per the Health Services Insurance Act, a nursing home must have a “written policy for dealing with complaints made by residents and others about the home’s care, services, or environment”. Furthermore, nursing homes must “post an outline of how to lodge a complaint in a prominent and easily accessible location in the Personal Care Home”. If you are not satisfied with the home’s response, you can contact the Long-term Care Manager at your local RHA.
In cases of suspected abuse and neglect, the Personal Care Home Program, which is an
independent body, conducts investigations. If you are in the Winnipeg area, please call 788-6366, or outside the Winnipeg area, please call 800-855-0511.
