Long-Term Care and Assisted Living Directory – Glossary of Terms
If you have questions about the data in the Long-Term Care Directory, contact our office at 1-877-952-3181.
When looking at the information and comparing facilities/residences, it is important to understand terms and the data an indicator represents. The following glossary provides information on key indicators in the directory.
Accreditation – Some care facilities/residences are voluntarily accredited. Accreditation is an ongoing audit process to identify where facilities/residences do well, and where they can make improvements. Peer reviewers visit the organization on a regular basis to evaluate the extent to which it is meeting standards and assigns a rating. For the assisted living residences, accreditation standing may apply to the organization and not to the assisted living residence itself: the public are encouraged to inquire further with the operator on specific details.
Beds (Long-term care) – Private beds are not subsidized and may or may not be available at all facilities (call facility to find out); publicly funded beds in long-term care may be short-term (respite, palliative, rehabilitation) or long-term (intended for permanent residents that require 24-hour complex care).
Complaint (Assisted living residence) – A resident or anyone with a concern about the health or safety of a resident can make a complaint to the assisted living registrar. Registry staff will assess all complaints to determine if they fall within the registry’s mandate to investigate. The registrar will investigate complaints related to the health and/or safety of residents and determine if the compliant is substantiated – that is, if the residence was found to have valid concerns.
Councils – A facility/residence may have a family and/or resident council. The council is a group of people who either live in the facility/residence or are the representative or relative of residents. They meet to discuss issues of importance to residents.
COVID-19 vaccination – COVID-19 is an infection of the airways and lungs caused by the SARS-CoV-2 coronavirus. While some people with COVID-19 may have no symptoms or only mild symptoms, others can require hospitalization and may die. Serious illness is more common in older people and those with certain chronic health conditions. The vaccination helps prevent infection. The Directory uses the term ‘fully vaccinated’ which means a resident who has had the initial vaccination series dose and at least one booster dose.
Direct care hours – This statistic reflects the number of hours of care services that health authorities fund each long-term care facility per resident, per day. It does not include hospitality services such as meals, laundry, or housekeeping. It includes nursing care and allied health hours:
• Nursing care hours include registered nurse, licensed practical nurse and care aide hours.
• Allied health includes physical, occupational, recreation, speech and language therapies, social work services and dieticians.
The care hours reported represent an average number for the entire facility, not how many hours of care each resident receives. The decision to fund care hours is made by the health authority, not the individual facility.
Facility fees – The Directory highlights where additional costs are charged by long-term care facilities. Provincial policy indicates the cost of receiving subsidized residential care services in B.C. is calculated at 80% of an individual’s after-tax income, subject to a minimum and maximum amount. Temporary rate reductions are available for people in financial need. Additional fees may be charged for preferred personal hygiene and grooming supplies not included in the monthly client rate, such as special denture cleaner, soap or facial tissues that are different from what the facility provides. General hygiene supplies such as shampoo, incontinence supplies and toilet paper are included in the client rate.
Flu vaccination – With diminished immune systems and often multiple co-existing chronic conditions, residents in long-term care or assisted living are at a high risk of influenza-related complications. One of the ways to increase protection for vulnerable individuals is to vaccinate them against influenza as well as everyone close to them. In long-term care, this includes the residents and the health care workers caring for them. In assisted living, only the vaccination rate for residents is reported.
Food – Food may be provided by either the operator of the facility/residence or a contractor and could be prepared either offsite and re-heated or cooked on-site.
Food cost – Food cost includes the daily food and dietary supplements for the residents of facilities/residences and is calculated per bed/unit per day. The cost of preparing and serving the food is not included. Facilities/residences may spend more on food than they are funded for from the health authority. Amounts reported in the Directory are actual expenditures.
Incident (Long-term care facility) – Licensed facilities governed by the Community Care and Assisted Living Act (CCALA) are required to report incidents as defined under the Residential Care regulation. This Directory includes incident types which have been reported to health authority licensing offices. (See also: Serious adverse events)
Inspection (Assisted living residence) – The assisted living registrar inspects residences to determine if the registrant is complying with the standards and requirements outlined in the Community Care and Assisted Living Act (CCALA), the Assisted Living regulations or the conditions of the registration. Within a prescribed period after completing an inspection, the registrar must publish a report summarizing the findings and the actions, if any, taken or to be taken, in response to those findings by the registrar and the registrant and publish it on an official website.
Licensing complaint (Long-term care facility) – A formal complaint to the facility’s health authority regarding a perceived violation of the licensing regulation. Licensing officers inspect the facility to determine if the complaint is substantiated – that is, if the facility was not in compliance with the licensing regulation.
Licensing inspection and infractions (Long-term care facility) – Licensing officers inspect facilities to verify that they are complying with the standards and requirements outlined in the Community Care and Assisted Living Act (CCALA) and the Residential Care regulation. There are several licensing inspection types and purposes, including: routine inspections conducted on a semi-regular basis, an inspection following a complaint, a non-visit follow-up that could be conducted by phone to ensure a required change has been made, or to monitor compliance with licensing standards. If the facility is found to be in non-compliance, an infraction is incurred. The facility is given time to correct the issue and the Licensing Office will follow up with another inspection.
Operator Type – A facility/residence can be run by the health authority, a for-profit organization or a not-for-profit organization.
Per Diem rates – The total contracted funding amount per bed per day for the provision of care and service at each contracted long-term care facility. Funding amounts include health authority funding and resident co-payment. The per diem rates include items such as staffing costs, food and supply costs, administration, repair and maintenance, housekeeping and landscaping services, property costs and capital costs. Per diem rates are not reported by health authority owned and operated facilities at this time because it is challenging to separate costs from global budgets.
Personal spending account – Residents in long-term care and their families can deposit up to a set amount to this account from which the resident can make cash-free purchases of items not covered in their monthly client rate, such as a haircut or group outing.
Regulation/Legislation – Long-term care facilities are governed by either the Community Care and Assisted Living Act (CCALA) or the Hospital Act and their respective regulations. All assisted living residences are governed by the Community Care and Assisted Living Act (CCALA).
Reportable incident (Assisted living) – Registered assisted living operators have a duty to report incidents as defined in Schedule E of the Assisted Living regulation within 24 hours. This Directory includes incident types which have been reported to assisted living registrar.
Residence fees – The Directory highlights where additional costs are charged by assisted living residences. Provincial policy indicates the cost of receiving publicly subsidized assisted living services in B.C. is calculated at 70% of an individual’s after-tax income (and the income of a spouse, if applicable), subject to a minimum and maximum amount. Temporary rate reductions are available for people in financial need. Additional fees may be charged for preferred personal laundry and grooming services, cable and personal telephone connection, transportation, etc.
Risk Rating –The long-term care facility risk rating is based on the risk assessment score and is measured at low (3-13), medium (14-20) or high (21-40).
Risk Score – Licensing officers conduct risk assessments periodically and these assessments are calculated based on a facility’s inspections. The risk assessment uses a non-biased method for classification of infractions observed during routine inspections which are assessed to determine the degree of potential harm.
Rooms (Long-term care facility) – Semi-private rooms are shared by two residents; multi-person rooms are shared by three or more residents.
Serious adverse event – Facilities governed by the Hospital Act define incidents in one broad category – “serious adverse events”. A serious adverse event is an incident which was not expected or intended to occur, was not caused by or related to an underlying medical condition of a patient or was the likely cause of, or likely contributed to, severe harm to or the death of a patient. As Island Health does not require Hospital Act facilities to report on the same incidents as CCALA sites, serious adverse events are used for facilities within Island Health in the directory.
Units (Assisted Living) – In assisted living, the residence will have a specific number of units (not beds) which may be home to an individual or a couple. Publicly subsidized units provide rental accommodation, hospitality services and personal care assistance.
Wait time – The wait time is the time it took for the resident to be placed into a facility/residence and is measured from the time a resident is accepted for service until they are admitted to the facility/residence. The wait time is calculated for all residents that were admitted within the fiscal year.