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
In order to receive nursing home care you must be a resident of Nova Scotia, have a valid Nova Scotia Health Card, and be 18 years of age or older. If you do not meet some of these criteria, there may be some exceptions that allow you to reside in a nursing home, however each case must be considered on an individual basis. Those who do not meet all criteria may be required to pay the full per diem cost of care.
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. Although private nursing homes do not have to be licensed, they should be accredited. Private nursing homes control their own admissions, determine their own accommodations fees, and are not inspected by the government.
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:
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- have a physical or mental condition that is not stable
- death is likely in the next 5 to 7 days
- behave in ways that are harmful to yourself and/or others
- are in acute or active substance abuse
- have an infectious communicable disease or viral infection (some exceptions may apply)
- require treatments that are beyond the care capacity of the nursing home
- ingest nutrition by means other than mouth, gastrostomy, or jejunostony
- have inadequate food intake
- have been recently put on new medication and there are not been enough time to monitor its effectiveness
- require blood work more than 3 times per week
- require continuous bladder irrigation
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 $99.00 per day, effective November 1, 2011. 85% of a resident’s assessed income will be applied to their accommodation charge, as long as they have $230.00 per month for personal spending.
| Daily Accommodation Rate | ||
|---|---|---|
| Cost | $99.00 |
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.
If you have a spouse, the income of you and your spouse will be combined and divided by 2, in order to determine your accommodation fee. The spouse living in the community must have at least $16,994.00, or $1416.17 per month.
Private nursing homes determine their own fees, therefore you should contact the home to inquire about rates.
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
If your assessed income is less than 85% of the standard accommodation rate, you will not be eligible for a rate reduction. If you are eligible for a rate reduction, you will be required to complete a Consent to Release Tax Payer Information Form, and provide last
year’s Notice of Assessment from your tax return. You will not be required to sell your house or assets to pay for your nursing home accommodations costs.
You will only be required to undergo a financial assessment if you are requesting a rate reduction.
Discretionary Spending
Although nursing home residents pay for the accommodation portion of nursing home costs, they must have $2772 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. You can expect to pay $33.25 per day (effective November 1, 2011). If, however, your income is less than $18,786 you may be eligible for a rate reduction.
Programs and Services That Are Covered
Accommodation costs and government subsidy will cover the following costs in a nursing home:
- room furnishings (bed, bedside table, chair, dresser, wardrobe or closet)
- social work services
- physiotherapy
- occupational therapy
- recreational activities
- meals
- social programs
- trust account services
- linens, laundry, and labeling
- housekeeping
- assistance with Activities of Daily Living
- medication administration
- grooming or personal hygiene supplies
- 24 hour a day, 7 day a week nursing care
- equipment for general use (ie., shower chair, geri-chair, lifts)
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:
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- equipment for individual use
- hairdressing
- newspaper
- personal television
- phone
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.
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- All nursing homes permit visitors, however each home can determine their specific visiting hours. Some homes will allow visitors at any time of day, and others may have restricted visiting hours.
- Each resident room should have a bed, bedside table, chair, dresser, and wardrobe or closet.
- Homes encourage residents to bring in personal belongings such as pictures and decorations to help the resident feel as at home as possible.
- Some homes may allow a resident to bring in their own bed as long as it does not violate space or safety concerns.
- Most homes will allow a resident to bring personal appliances as long as the home first inspects the appliance to ensure that it abides by safety standards.
- Nursing homes are required to have at least one attending physician on staff to care for all residents.
- Nursing homes vary in terms of the types of diets they can accommodate, so you should contact the home to ensure that they can provide for dietary restrictions.
- Most homes have spiritual or pastoral programs, however they are not necessarily required to provide these programs.
- All nursing homes must have a Resident Bill of Rights.
- All nursing homes should allow residents the opportunity to establish and maintain a Resident’s Council.
- All nursing homes should allow family members the opportunity to establish and maintain a Family Council.
- Nursing homes should provide activities to all residents.
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:
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- 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 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.
