-
045-4805-69
Application for Reduction in Long-Term Care Home Basic Accommodation - Schedule A: Spouse DependantTo 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.045-4804-69
Application for Reduction in Long-Term Care Home Basic Accommodation Resident Receiving ODSP FormTo 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.045-4803-69
Application for Reduction in Long-Term Care Home Basic Accommodation - Resident with a Notice of Assessment and Transitioning to new Government Benefit(s)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.045-2308-69
Profile of Long-Term Care FacilityPart of Nursing Home Inspection Kit045-4767-69-lhin
Application for Determination of Eligibility for Long-Term Care Home Admission (Home and Community Care Support Services)To be filled out by 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 Home and Community Care Support Services (HCCSS) as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).045-4768-69e-lhin
Health Assessment - Local Health Integration Network (LHIN)To be used for completion of the assessment required under the Long-Term Care Homes Act, 2007 when a person applies for a determination of eligibility for long-term care home admission. This form is for use effective the date when LHINs become designated as the placement co-ordinators for long-term care homes by the Ontario Ministry of Health and Long-Term Care.5082-69
Application for Reduction in Long-Term Care Home Basic Accommodation – Consent to Collection, Use and Disclosure of Information for Automated Income Verification with the Canada Revenue AgencyPursuant 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.5083-69
Withdrawal of Consent for Automated Income Verification with the Canada Revenue Agency –Long-Term Care Rate Reduction ProgramPlease 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).on00478
Statement of ReadinessThe purpose of this form is to identify projects that have already received conditional bed allocations (whether or not they have received a funding approval for the project) that are ready and reasonably expect to start construction on the project, subject to required ministry approvals, by August 31, 2023.on00324
2021 Application for Long-Term Care Home Development2021 Application for Long-Term Care Home Development