To be filled out by long-term care (LTC) home applicants as part of the process for determination of eligibility for admission to a LTC home. This completed form is for use by Ontario Health atHome, as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment from the year when they were 64 years of age.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This form is to be used by applicants who do not have a Notice of Assessment.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This form is to be used by applicants who have a Notice of Assessment.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This schedule should be used with one of the four main forms. An applicant should use this schedule if they would like to request a deduction to support an eligible child living in the community.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This schedule should be used with one of the four main forms. An applicant should use this schedule if they would like to request a deduction to support an eligible spouse living in the community.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who do not have a Notice of Assessment.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This form is to be used by applicants who are receiving benefits from the Ontario Disability Support Program.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This form is to be used by applicants who have a Notice of Assessment from the year when they were 64 years of age.
To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This schedule should be used with one of the four main forms. An applicant should use this schedule if their LTC home has notified them that they are eligible for a “Continuation of Previous Dependant Deduction”.
Please complete this form if you wish to withdraw your consent to the Ministry of Long-Term Care (MLTC), Ministry of Finance and the Long-Term Care Home Licensee (LTCH Licensee) collecting your income information from the Canada Revenue Agency (CRA) using an Automated Income Verification (AIV) service for the purpose of MLTC assessing and administering your Application for Reduction in Long-Term Care Home Basic Accommodation (Application).
Pursuant to section 187 of the Fixing Long-Term Care Act, 2021, the Director may directly or indirectly collect the information provided in this application to determine the reduced amount payable by the resident for basic accommodation in accordance with section 303 of O. Reg. 246/22 made under the Fixing Long-Term Care Act, 2021. Pursuant to subsection 303(4) of O. Reg. 246/22, the licensee is required to submit this application and retain a copy.