Whether you are a member of the “sandwich generation” with young children and older parents or you are a senior yourself, sooner or later you will need to understand the residential care options in Saskatchewan for individuals who can no longer live at home, and how much they cost.  Typically, residential facilities are characterized as either retirement homes or government-subsidized nursing homes. In the discussion below we distinguish between the two, the services provided and how much they cost.

Retirement home/residence 
A retirement home in Saskatchewan is a multi-residence housing facility that provides accommodation and services such as meals and cleaning for older people. Retirement homes in the province are privately owned and operated and not administered by the provincial government. Each facility usually provides a private or semi-private room or complete living suite as well as common living quarters, including a lounge area, a common dining room, recreation rooms, cleaning services, social and/or religious programs and some basic health care services.

The unit can be paid for on a monthly fee basis, like an apartment, or can in some instances be bought the same way as a condominium. Admission, fees and waiting lists for retirement homes are controlled by the homes themselves, not by the government. Admission usually depends on the ability to pay and absence of serious medical conditions that require professional nursing care. Residents are responsible for paying their own fees and government subsidies are not available for accommodation in a retirement residence.

Costs for Retirement Homes*

Type of Accommodation	Provincial Median	Provincial Range	Regina Median	Regina Range	Saskatoon Median	Saskatoon Range
Private Rooms(per month)	$2,475	$1,500 – $5,500	$2,850	$1,800 – $5,500	$2,425	$1,600 – $4,000
1 Bedroom Suites (per month)	$3,415	$1,580 – $4,170	$3,750	$3,500 – $4,100	$3,150	$1,580 – $4,042

*As reported in Long Term Care in Saskatchewan 2016

Government-Subsidized Nursing Homes**
Nursing homes or special care homes, as they are called in Saskatchewan, are residential long term care facilities that provide 24-hour professional nursing care and supervision for people who have complex care needs and can no longer be cared for in their own homes.

These facilities are owned and operated by municipalities, religiously affiliated organizations and private, for-profit organizations. However, nursing home fees are set by the Saskatchewan Ministry of Health.

Admissions to residential long term care facilities are managed by local Regional Health Authorities (RHAs). An intake coordinator or social worker from the RHA conducts an in-home assessment with clients and their families to assess care needs and program options, to coordinate access, explain fees and coordinate placement into long-term care facilities.

A report of the assessment is sent to the Regional Committee, who decides on acceptance. Clients who are eligible for access to a long term care bed generally access the first available bed in the system and then transfer to a facility of choice. A chronological wait list is maintained by the RHA to ensure fair and equitable access to a facility of choice.

Eligibility/Requirements for Admission 
To be eligible for subsidized care services, a client must:

• Be a Canadian citizen or permanent resident over 18 years of age.
• Require ongoing care (usually 24 hour care, seven days a week) due to age, disability, injury from accidents, or long-term illness.
• Hold a valid Saskatchewan Health Services card, or be in the process of establishing permanent residence in Saskatchewan and have applied for a Saskatchewan Health Services card.

Income/Asset Test
The client’s income is assessed by Saskatchewan Health.  Income Tax returns of applicants are reviewed once the Regional Committee has approved the admission of the client into a nursing home. The client’s application is sent by the RHA to the nursing home, which in turn sends it to Saskatchewan Health for income assessment.

A resident pays the standard resident charge ($1,086 at July 1, 2017) plus 57.5% of the portion of their income between $1,413 and $4,200. For married residents, including common law couples, the couple’s income is combined, divided equally and then the above formula is applied.

The resident and spouse (if applicable) are required to provide:

• The most recent year’s Notice of Assessment(s) from CRA, or
• Pages 1 to 3 of Income Tax Return(s) upon admission and annually thereafter.

If income information is not provided, the resident charge will be assessed at the maximum rate.

A resident admitted for temporary care must pay the income-tested resident charge if their stay is more than 60 consecutive days.

Examples of resident charges at various income levels

Monthly Income	Monthly Resident Charge
$1,413	$1,086 (minimum)
$2,000	$1,423
$2,500	$1,711
$3,500	$2,286
$4,200	$2,689 (maximum)

 

Married residents living in separate special care homes 
Married residents who live in separate dwellings for reasons beyond their control may choose to complete an Optional Designation Form.

• With this designation, only the resident’s income is considered when calculating the charge.
• Choosing this designation does not change a couple’s marital status.

Additional charges
In addition to the resident charge, there is an additional cost for prescriptions, medications, incontinence supplies, and certain medical and personal supplies and services.

There is also a $21.25 monthly supply charge for personal hygiene items, such as shampoo, conditioner, soap, denture cream, toothpaste, mouthwash, etc. This charge is adjusted annually based on increases to Old Age Security and Guaranteed Income Supplement benefits

** As reported in Special Care Homes

Written by Sheryl Smolkin
	Sheryl Smolkin LLB., LLM is a retired pension lawyer and President of Sheryl Smolkin & Associates Ltd. For over a decade, she has enjoyed a successful encore career as a freelance writer specializing in retirement, employee benefits and workplace issues. Sheryl and her husband Joel are empty-nesters, residing in Toronto with their cockapoo Rufus.

By Sheryl Smolkin

I’ve been thinking about the cost of health and long term care a lot lately because my 88- year old Mom recently had a bad fall and cracked five ribs. She is recovering at home but she is in a lot of pain, and requires 24/7 care for the foreseeable future.

The plan has always been to keep her in her own apartment as long as possible. Fortunately her wonderful, privately-paid caregiver (a registered practical nurse) who normally works 40 hours/week has virtually moved in and is helping us to take excellent care of her. But as costs mount up over the short run, we are beginning to wonder if this will be a luxury she soon can’t afford.

Access to public resources varies across the country, but in Thornhill, Ontario where she lives , I’ve been told that a maximum of one hour a day (and most probably only two hours a week) will be offered to her on the government dime. But I’m grateful that 22 in-house physiotherapy sessions to get her up and moving better and train her to avoid future falls have been approved.

So if health and long-term care are not in your retirement planning radar yet, I have put together a few recent articles that may get you thinking about what you can expect.

On Retire Happy, Donna McCaw writes about Your Health in Retirement: Asking for Help. She cites staggering statistics from the Vancouver based Canadian Men’s Health Foundation about men and heart disease, cancer, diabetes, obesity, alcohol-related deaths as well as suicide. She interviewed recently-retired men who made it their first priority to get healthy and get rid of their “ring around the waist” by embracing fitness and learning to eat healthy.

Life after retirement: Health care costs require careful planning in the Financial Post is by Audrey Miller, the Managing Director of  http://www.eldercaring.ca/. She cites home care costs by the week and by the year (albeit in Ontario) and says as family members and professionals, we need to be better prepared. The cost of care is only going to become more expensive, especially as our public and private resources are reduced. Not only will we soon have more seniors than young people under 15, but our pool of those who are willing to be paid to do this work will also become smaller.

The coming health benefits shock for retirees by Adam Mayers at the Toronto Star reminds us that contrary to what many people believe, glasses, drugs and nursing homes will not in most cases be paid for by our universal health care. He quotes Kevin Dougherty, president of Sun Life Financial Canada who says one reason for the disconnect may be that we form an opinion of the health system through our use of it. Most of us are covered by workplace health plans and we don’t need much from these plans during our earlier years, and into middle age what we do need is covered.

Navigating Retirement healthcare is a comprehensive report from CIBC Wood Gundy discussing health care cost considerations in retirement. The study notes that long-term care is classified as an extended healthcare service under the Canada Health Act but the role of publicly-funded LTC facilities is changing as provincial governments limit the expansion of these facilities by reducing the number of registered nurses, maintaining or decreasing the number of available beds, and tightening the qualifications for acceptance into a facility.

Even if these policies were reversed, an individual’s current wait time of one year will likely increase unless significant expansion of the LTC provision occurs. The result is that a greater number of seniors are paying to enter more expensive for-profit private or semi-private facilities that can cost up to $7,000 or more a month.

Finally, Long-term care costs in Saskatchewan 2014 by Sun Life discusses how residential facilities, retirement homes/residences, government-subsidized home care, adult day care and private home care operate. Government subsidized options including home care are administered by the Regional Health Authority (RHA). As RHA resources are limited, many seniors don’t get the care they need from RHA services and have to rely on private home care services. The provincial tariff for skilled nursing ranges from $42-$70/hour while 24 hour live-in care can cost from $21-30/hr.

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