How Shalom Village Funds the AT HOME Approach to Care

The Ministry of Health & Long Term Care allows us a flat amount per resident per day. This amount is adjusted by our CMI (case mix index) which is determined through the classification process. Every year a team of classifiers reviews our resident's charts and determines the level of care required by each resident based on a fairly rigid set of criteria. There is a general feeling in long term care that the criteria used are not necessarily the best reflection of a resident's actual care needs.

Part of this funding comes from the residents themselves. Those with lower incomes may qualify for a subsidized rate based on their income. The difference between what the resident pays and the approved funding is paid by the MOH & LTC. Residents in private rooms pay an additional $18.00 per day "preferred premium" and do not qualify for any subsidies. This "preferred premium" is not included in the base per diem and goes directly to the LTC facility.

The MOH & LTC breaks the funding into "envelopes", allocating portions to nursing costs, raw food costs, program costs and admin costs. It is interesting to note that amount paid for food is approximately half what the government pays for food for inmates in correctional facilities.

There is a detailed reconciliation and audit process to ensure that the funding is spent in the appropriate envelope. If any envelopes are underspent the funds must be returned to the ministry. Shalom Village has always overspent all of the envelopes, especially nursing. This is mainly due to our higher than average staffing levels. We also spend significantly more on food.

Shalom Village is a not for profit organization that is fortunate to be supported by a charitable foundation. Our foundation has traditionally provided funding for capital projects (buildings and equipment.) The government also provides some funding for capital projects. For example, Shalom Village Too was awarded 64 LTC beds that received partial funding. The Shalom Village Charitable Foundation also contributed several million dollars raised by the community. The balance of the cost was covered by a mortgage which is paid back from operating funds.

Sometimes the government provides special funding for equipment under specific programs. For example, there was recently special funding available to help us purchase lifts. It is important that we be aware of various programs so that we can take advantage of them when possible. Shalom Village belongs to OLTCA (The Ontario Long Term Care Association) which not only lobbies for the interests of the LTC community, but also provides information and advice to members