Wills and Estate Planning
Going to a Nursing Home
NURSING HOME ADMISSION
How do I enter a nursing home?
The Department of Social Development must approve all requests for services in nursing homes - even if you pay your own way. Staff from the Department will decide your eligibility by looking at your long term health care and social needs. If these are greater than what you, your family and the community can provide, you may be eligible for nursing home care.
However, going to a nursing home is just one option. The Department provides a range of Long Term Care Services for seniors and adults with disabilities who need help. Services include personal support, as well as physical, social and mental health services. These are not covered by Medicare. However, people who can't pay the full cost can ask the Department to assess them for financial assistance. To find out more, contact Social Development (look at the back of this booklet or blue pages of your telephone book) or Mental Health Services (in blue pages) or Extra-Mural Program (white pages of your telephone book).
Can someone make me go into a nursing home?
Going into a nursing home is voluntary. To get in, you must agree to an assessment. Nobody can force a competent person to have this assessment or to go to a nursing home.
What happens when I do need nursing home care?
After the Department of Social Development finds you eligible and approves your application for placement in a nursing home, they will send your name to all of the nursing homes within 100 kilometers of the municipality from where your home is located. When these homes have a vacancy, they must select residents from the approved list. If your spouse wishes to be admitted to the nursing home with you, you can make this request to the Department.
Will I have a say which nursing home I go to?
Yes. When you are eligible for admission, you can show your preference by applying directly to the nursing home you prefer. Choose more than one to increase your chances of getting in early. If you can, visit the homes in your area before you decide. Ask about their policies.
What if I'm not offered the nursing home I want?
If there's no vacancy in the nursing home you prefer, you may have to go wherever there is one within 100 kilometers of the municipality from where your home is located. You would not have to go where you do not understand the official language spoken.
What if I don't want to go to the nursing home offered to me?
You are allowed one refusal. But if you refuse a second offer, the Department will take your name off the waiting list and reassess your situation. If you can't get into the nursing home you prefer, you can always apply to transfer there later. Most people end up in the home of their first choice. If you are in the hospital waiting for a placement, be sure to ask about hospital policies. The hospital may start to charge you for your room if you refuse a vacancy.
Is it hard to transfer from one home to another?
No, it is not hard to transfer. You can transfer anywhere in the province where there is a vacancy. All you or your family must do is send an application to the nursing home of your choice. How long you wait to get in depends on the vacancy rate at that nursing home. However, before you apply, consider taking a month to get used to the nursing home you are in. You just might like it! After that time, if you still want to transfer, then go ahead and make the application.
YOUR RIGHTS IN A NURSING HOME
What rights do I have in a nursing home?
Your rights are much the same as your rights in the community. You may have to get used to living with other people who have their own likes and dislikes. However, you should expect certain basic rights such as privacy, dignity, and individuality. For example, the staff should knock before entering your room and you should be able to have private visits with your family. You should be allowed to come and go, if you can do so safely. You have the right to be as independent as possible.
Can I expect the nursing home to be safe and clean?
Yes. The provincial government has set standards for nursing homes. By law, the operator must keep the buildings, equipment and surroundings of the home clean, neat and safe. There are also standards regulating the services that homes must give the residents.
What can I bring with me to a nursing home?
You can bring most items space will allow. Find out how much room you have. Many people bring their clothes, pictures, favourite chair and television. For the safety of all residents, the nursing home must check any electrical appliances that you bring along. The nursing home may have a policy against bringing a pet along.
NURSING HOME COSTS
How much does it cost to live in a nursing home?
The amount a nursing home resident may have to pay to cover the costs of the nursing home, including room and board services, can vary. As of April 2013, the maximum amount is $107 per day. On a monthly basis, this would amount to about $3,255. The maximum amount payable will increase to $113 per day in April 2014. This amount may be adjusted from time to time. The Department of Social Development will cover the costs of nursing and rehabilitation services for residents in nursing homes.
Can I get financial assistance to help pay the costs?
If you can afford to pay your nursing home room and board costs from income, you must do so. If you feel you cannot afford the costs, you can apply to the Department for a subsidy. The first step in getting a subsidy is to ask for a financial assessment. You can do this any time after the Department has evaluated your situation.
What if I need help right away?
Until the Department completes your financial assessment, you must pay your nursing home room and board costs.
THE FINANCIAL ASSESMENT
How do I get a financial assessment?
Ask your staff person from the Department for a Financial Declaration Form. This form asks for information about your family income. It will state the name and phone number of the person who will do the financial assessment. This person is called a Financial Assessor.
After you fill out your application, call and set up an appointment with the assessor. If you can't attend, a family member can go to the meeting for you. The assessor will give you a list of all the documents to bring to the financial assessment. The list is at the back of this booklet (see Appendix). Bring these documents to the meeting, as well as documents showing who lives with you. The assessor will review your application form and documents.
How is my ability to pay assessed?
The financial assessor looks at net family income to calculate the contribution toward your nursing home room and board costs (see Terms to Know). What is considered depends on whether you:
- Live alone
- Live with a spouse or a dependent(s)
- Have a spouse who also needs long term care services
APPLICANTS LIVING ALONE
The Department decides how much you must contribute to the nursing home costs by
- calculating your monthly net income (See Terms to Know)
- subtracting this amount from the monthly room and board costs for nursing home services
If the amount you are able to pay each month is less than the monthly cost of the room and board services, the government can give you a subsidy to offset the full cost of the services.
If the amount you are able to pay each month is more than the monthly cost of room and board at the nursing home, you will have to pay these costs.
APPLICANTS WITH SPOUSE OR DEPENDENTS AT HOME
If you have a spouse or dependents at home (See Terms to Know), the Department decides how much you must pay by looking at your net family income (See Terms to Know). Your contribution to the nursing home is based on a graduated income scale reflecting the number of dependents.
If your contribution from net family income is not enough to cover nursing home room and board costs, you may be eligible for a subsidy. This method protects a significant portion of your income to support your spouse and dependents at home.
APPLICANTS NEEDING LONG TERM CARE SERVICES
If your spouse or dependent is already getting, or later qualifies for, an approved long term care service, the cost of their services will be added to your nursing home costs.
The Department would calculate only one family contribution on the total cost of all services. Generally, you would pay the amount of your contribution directly to the nursing home.
What if my financial situation changes after the financial assessment?
A change in your financial situation could affect your eligibility for a government subsidy. For example, if you enter the nursing home as a private payer, you could become eligible for financial assistance if your income decreases. If you are already subsidized, the Department would have to reassess you if your income increases or decreases.
It is your responsibility to let the Department know if your financial situation changes. If it does, please contact your local Department of Social Development office (see Section L for phone numbers) and ask to speak to the financial assessor.
TERMS TO KNOW
Net Income/Net Family Income - This is your income after deductions for income tax. If you are single, the Department considers 100% of your income. If you have a spouse (married or common-law) or dependents, the Department considers the net income of the family unit on a graduated scale. In either case, you are allowed a monthly comfort and clothing allowance. Income includes: wages, allowances, income from investments, income, pensions (ex. Old Age Security and Canada Pension), etc.
Dependent - A dependent is a financially dependent child of, or a person under the guardianship of, the client entering the nursing home or that person's spouse. The dependent must be under 19 years of age, or under 25 years of age and enrolled full-time in an educational institution, or over 18 years and disabled.
DECIDING WHAT TO DO WITH YOUR HOUSE
Must I sell my house when I enter the nursing home?
What you do with your house is your decision. The value of your house is not included when the financial assessor calculates your contribution to your nursing home costs.
What if I rent my house?
If the government is subsidizing your nursing home room and board costs and you decide to rent your house, even to a family member, you must contribute 75% of the rental income toward your room and board costs at the nursing home. You can use the remainder for the upkeep of the house.
OAS AND GIS PAYMENTS
What happens to our OAS and GIS payments if only one spouse enters a nursing home?
When you enter a nursing home and your spouse does not, Social Development Canada (SDC), formerly Human Resource Development Canada, considers this to be an involuntary separation. This does not mean a legal separation. It simply means that in the eyes of SDC, you and your spouse may each be eligible for the same monthly financial assistance as single pensioners. This allows both of you to possibly receive an increase in Old Age Security (OAS) and Guaranteed Income Supplement (GIS) monthly pension amounts.
Contact the federal Income Security office. Ask about getting your OAS/GIS payments at a better rate. The toll free number is 1-800-277-9914. Do not press any buttons after you dial, just wait and the operator will eventually come on line and talk to you.
What if I am single?
A nursing home resident without dependents who gets financial assistance must use his or her OAS and GIS payments to help cover the nursing home room and board expenses.
Can I keep some money for personal expenses if I get assistance?
Yes. You can keep your G.S.T. rebate and your Low-Income Seniors Benefit. You can also keep your comfort and clothing allowance each month from your OAS and GIS. These amounts may change. If you have no income, the Department will give you a comfort and clothing allowance.
If I get a subsidy, will all my expenses be covered?
You will still be responsible for some personal expenses. For example, everyone must arrange their own transportation when they enter the nursing home. Residents in a nursing home, even those on financial assistance, are responsible for:
- clothing and personal items, such as dry cleaning, barber/hairdresser
- telephone and cable T.V. expenses
- participation fees for eye glasses/examinations and dentures/dentist
- cost of certain personal care items if the brand is not provided by the nursing home
- cost of any medication not covered by the Prescription Drug Program
- cost of transportation, other than to the hospital
- making funeral and burial arrangements
Where can I get more information?
To get more information about nursing homes and their policies in your area, call them and arrange to visit. Ask about their policies. To find out more about programs, nursing home admissions and government subsidies, contact your regional office of the Department of Social Development. The numbers are:
You can also find the full details about nursing home legislation, regulations and policies free online at:
Standard Family Contribution Policy
Nursing Homes Act
Nursing Homes Act Regulations
Documents Needed for A Financial Assessment for Nursing Home Subsidy
- Two pieces of identification. (Your social insurance number is compulsory. Other identification could be your medicare card, birth certificate, or driver's license.)
- Written proof of all income for both spouses. This includes cheque stubs or photocopies of Canada Pension, Old Age Security (OAS), Guaranteed Income Supplement (GIS), Registered Income Funds, Annuities, Worker's Compensation, other pension plans (cheque stubs or, if direct deposit, photocopies of recent bank statement may be requested), income earned on investments, and any other source of monthly income.
- Rental income from all properties.
- Income tax returns for both spouses for the last 2 years.
- Documentation for Power of Attorney or Trustee.
- Legal documents, where appropriate, for separations, divorce, custody.
Public Legal Education and Information Service of New Brunswick (PLEIS-NB) is a non-profit, charitable organization. Its goal is to provide the public with information about the law. PLEIS-NB receives funding and in-kind support from the Department of Justice Canada, the New Brunswick Law Foundation and the New Brunswick Office of the Attorney General.
We gratefully acknowledge the contribution of members of the Law Society of New Brunswick and staff of the Department of Social Development. We also thank the Third Age Centre and the seniors who helped us to better understand the information needs of seniors in this area. The booklet does not contain a complete statement of the law or the policies in this area. Both may change from time to time and anyone needing specific legal advice should contact a lawyer.
Public Legal Education and
Information Service of New Brunswick
P.O. Box 6000
E3B 5H1 CANADA
Revised August 2011
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