Renovation Program for Long-Term Care Homes

Overview

The Renovation Program for Long-Term Care Homes (the Renovation Program):

• helps upgrade older long-term care (LTC) homes so they meet current or adapted design standards
• supports repurposing existing buildings — including closed former long-term care homes — for long-term care use

The Renovation Program is for existing and potential long-term care operators who are unable to undertake traditional redevelopment under the 2025 Long-Term Care Home Capital Funding Policy (CFP).

Operators approved for the program receive:

• capital funding to renovate an existing LTC home or a vacant building that could become a LTC home
• consideration for a licence to operate the LTC beds renovated through this program, subject to the requirements of the Fixing Long-Term Care Act, 2021 (FLTCA).

Capital Renovation Policy for Long-Term Care Homes

The Renovation Program, a component of the broader Capital Funding Policy, is administered under this funding policy, the Capital Renovation Policy for Long-Term Care Homes.

Eligibility

Two types of projects are eligible for the Renovation Program.

1. Renovating an existing long-term care home

   The home must meet all of the following requirements:

   • The operator is unable to undertake traditional redevelopment of the property under the CFP due to land or financial constraints.
   • The home has beds with “C”, “D” or “upgraded D” structural classifications.
   • The home’s current licence expires on or before December 31, 2035 and there is no viable option for undertaking traditional redevelopment of the home.

2. Renovating or repurposing another building

   The building must be one of the following:

   • a former long-term care home that has closed
   • another building owned or leased by the operator that the Ministry of Long-Term Care (the ministry) deems acceptable to be repurposed for use as a long-term care home

Building condition assessment (BCA)

Before funding is approved or a Renovation Program development agreement (DA) is executed, applicants must provide an acceptable building condition assessment (BCA), completed within 24 months of submitting the application.

The BCA must be prepared by a qualified third-party professional, as approved by the ministry and include:

• an evaluation of the remaining useful life of key building systems (HVAC, electrical, plumbing, fire protection, elevators and building envelope) and anticipated annual maintenance costs
• an estimate of when full redevelopment would be required or whether renovation is more suitable than replacement
• an assessment of essential repairs or upgrades to allow the building to operate for up to 15 years
• any other information required by the ministry

Operator requirements

Operators must attest that:

• the renovated home will be able to operate for up to 15 years or other agreed-upon period (the “renovated project useful life”)
• the operator is able and committed to operating the home for at least that period following the completion of the renovation

Operators must also demonstrate to the ministry’s satisfaction, that they can meet the requirements to receive a licence or approval under Part IX of the Fixing Long-Term Care Act, 2021 (FLTCA) for the entire renovated project useful life.

Note: Approval for funding and entering into a DA does not bind the Minister or Director to issue a licence or Part IX approval to the applicant.

Legal requirements

Renovations must comply with applicable laws, including:

• Fixing Long-Term Care Act, 2021
• Ontario Regulation 246/22, including s. 356(2) of that regulation.

Eligible funding

Funding under this policy and the terms and conditions applicable to this funding are the same as CFP funding, except as specified in this policy, or as clarified by the ministry.

Funding percentages and the timing of funding vary by operator type. The operator types defined in the CFP also apply to the Renovation Program.

Eligible renovation costs are based on eligible project costs under the CFP, with the addition of costs associated with conducting a BCA.

The ministry will fund 85% of eligible renovation costs, based on a 15-year licence term and subject to the maximum amounts for each market segment.

Maximum funding amounts for this program differ from the CFP. The market segments for projects under the Renovation Program are the same as the market segments set out in the CFP.

The program will not cover any project costs that exceed the funding maximums.

Renovation Program funding elements may be reduced proportionately if the renovated project useful life or licence term is less than 15 years.

To receive and retain funding under this policy an operator must:

• have an executed DA with the ministry
• meet all applicable conditions and requirements under the DA, this policy and the CFP (as applicable)
• ensure the project complies with the adapted design standards
• have a licence or an approval under the Fixing Long-Term Care Act, 2021 to operate the renovated beds for at least the renovated project useful life and agree to operate the beds for that full period

Determination of funding

Only projects with an executed DA specifying this funding policy may be eligible for Renovation Program funding (that is, the executed DA for the project contains the Capital Renovation Policy for Long-Term Care Homes).

Upon approval to begin construction of a project, the ministry will inform the operator in writing of the total expected ministry funding. The amount of total expected ministry funding is based on the:

• approved design plans
• cost estimates
• Building Condition Assessment

Funding may be adjusted later based on final approved total eligible renovation costs in the final statement of disbursements (FSD) and is subject to applicable limitations and conditions in accordance with the terms outlined in the DA. This applies to all funding elements.

Design and planning grant

The design and planning grant is subject to the same terms and conditions as under the CFP, except for the maximum funding. BCA costs are eligible costs for this grant.

Funding is 5% of the estimated renovation funding for the project, as determined by the ministry, up to a maximum of $250,000 per eligible project.

Apply for the Renovation Program for Long-Term Care Homes

To apply for the Renovation Program, download and complete the application.

Program payments

Capital per-diem payments

Capital per-diem payments will be paid in accordance with the operator type and the terms and conditions in the CFP. Under the Renovation Program, capital per-diem payments are provided over a 15-year period (or other number of years as set out in the DA) starting on the applicable first resident date. Amounts are determined in accordance with this policy and the applicable DA.

Capital progress payments

Capital progress payments will be paid in accordance with the operator type and terms and conditions in the CFP, with amount(s) determined in accordance with this policy and the applicable DA.

Funding repayment

The CFP’s funding repayment terms also apply to this policy, except that any reference to “30 years” shall refer instead to the renovated project useful life, starting on the first resident date.

If the project has multiple phases, first resident date applies to the final phase of the project.

Design standards

The Long-Term Care Home Design Manual (DM) contains the ministry’s design standards for developing and redeveloping long-term care homes in Ontario, which are also subject to applicable law. The DM includes design variance standards, which are defined or permitted exceptions that may be applied to eligible redevelopment projects when physical constraints in renovating an existing long-term care home prevent full compliance with standard requirements. These design variance standards, as defined in the DM (page 10), are permitted without ministry permission only for projects that qualify as a “renovation” (within existing building footprint) and only with respect to the seven design variance standards specifically listed in the DM.

Adapted design standards for the Renovation Program for Long-Term Care

For the purposes of the Renovation Program only, the ministry may approve additional design variance standards for specific projects that are outside of the definition of renovation in the DM. These standards are referred to as “adapted design standards”.

Projects using adapted design standards are not considered to meet DM requirements for CFP or the Regulation, unless the ministry approval for the design variance standard explicitly states that the variance will be considered to be compliance with the DM.  To ensure resident comfort and quality of care, the ministry will not approve deviations from the following minimum design requirements:

• Bedroom and washroom occupancy limits — no more than 2 beds per bedroom and 2 residents per washroom.
  • Private accommodation: one bed per resident room with one washroom
  • Semi-private accommodation: one bed per resident room with a shared washroom between the 2 rooms
  • Basic accommodation: 2 beds per resident room with one washroom
• Minimum bedroom size (usable net floor area) — 120 square feet for a one-bed room and 210 square feet for a 2-bed room
• Ensuite washrooms must include a toilet, a sink, and be barrier-free with a 5-foot turning circle.

Licensing

The ministry will consider issuing a licence after the renovation is complete, in accordance with all statutory requirements and considerations under the FLTCA and any other applicable laws. For greater certainty, licence undertakings may be issued subject to FLTCA requirements.

At the end of the 15-year licence term, operators may request an extension or replacement licence. The ministry will review the request and may issue further licensing, subject to applicable laws.

Entering into a DA does not obligate the ministry or any statutory officer to issue or renew a licence or approval to operate long-term care home beds or to commit to doing so in the future. It also does not constitute any determination, consent or approval required under the Fixing Long-Term Care Act, 2021 or any other applicable laws.

Any currently licensed long-term care beds that will be unavailable for occupancy during the renovations are subject to FLTCA, s. 107 and the licensee or operator must apply to the Director for written permission for them not to be available for occupancy (also known as placing the beds in abeyance), or the beds may be removed from the licence under FLTCA, s. 107(3).

Additional terms and conditions

The following sections of the CFP also apply to this policy:

• bed transfers to another operator
• an operator cannot meet financial obligations
• limitations and clarifications
• other relevant funding programs

Funding under this policy shall be considered CFP funding, (including for the purposes of the sections referred to in this policy) and is subject to this policy, the DA and any clarifications or interpretation bulletins provided by the ministry.