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A profile of nursing and residential care facilities, 2019

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Released: 2021-09-16

During the COVID-19 pandemic, a great number of facilities responded to the Nursing and Residential Care Facility Survey. The survey results provide governments and researchers with a profile of the industry in 2019, and help inform policy making for this industry, which has been especially hard-hit by the COVID-19 pandemic.

Of the 9,368 facilities represented by the survey, 2,098 were nursing care facilities, 2,852 were residential developmental handicap, mental health and substance abuse facilities, 3,167 were community care facilities for the elderly, and 1,251 were other residential care facilities, such as transition homes for women.

More than half of nursing and residential care facilities are not-for-profit

Nursing and residential care facilities are owned and operated by either the public or private sector and can be divided into three designations: private for profit, government not-for-profit and non-government not-for-profit. Of facilities in scope for the survey, 4,061 (43.3%) were for profit, 2,435 (26.0%) were government not-for-profit, and 2,872 (30.7%) were non-government not-for-profit.

The type of facility designation varied among each of the four nursing and residential care industry groups. Nursing care facilities were 44.5% for profit and 39.8% government not-for-profit, while roughly half (49.0%) of residential developmental handicap, mental health and substance abuse facilities were non-government not-for-profit. Roughly three-quarters (73.3%) of community care facilities for the elderly were for profit, while the designation of other residential care facilities was more evenly distributed with 32.9% for profit, 24.6% government not-for-profit, and 42.5% non-government not-for-profit.

Chart 1  Chart 1: Nursing and residential care facility designation, by industry, Canada, 2019
Nursing and residential care facility designation, by industry, Canada, 2019

Nursing and residential care facilities employed roughly 1.7 times the number of personnel than community care facilities for the elderly

In total, nursing and residential care facilities employed roughly 530,000 staff with almost half (48.0%) of employees working in nursing care facilities, and over a quarter (28.1%) working in community care facilities for the elderly. Full-time (43.7%) and part-time (35.9%) employees made up the vast majority of staff in the industry, with casual (16.4%) and contract (4.0%) workers making up the remainder. This distribution was fairly consistent among the provinces with a few noted differences. Manitoba and Alberta reported having more part-time than full-time employees, Newfoundland and Labrador reported more casual than part-time employees, and British Columbia reported that 7.5% of its workforce in this industry was on contract.

Many of the provinces had a similar number of nursing care facilities and community care facilities for the elderly. However, the proportion of community care facilities for the elderly in Quebec was nearly three times the proportion of nursing care facilities (Chart 2). The proportion of community care facilities for the elderly in Alberta was over twice that of its nursing care facilities, while the number of nursing care facilities in Manitoba was just over twice the number of community care facilities.

Chart 2  Chart 2: Distribution of the number of nursing care facilities (6231) and community care facilities for the elderly (6233), by selected geographies, 2019
Distribution of the number of nursing care facilities (6231) and community care facilities for the elderly (6233), by selected geographies, 2019

Over 40% of nursing care facility residents were located in Ontario

In 2019, nursing care facilities in Canada offered roughly 197,000 long-term licensed and approved beds as well as short-term stay beds. Ontario's 642 facilities accounted for 42.4% of nursing care beds in Canada. The province with the second largest proportion of nursing care beds, Quebec, had 489 nursing care facilities, accounting for 18.7% of Canada's total nursing care beds. The remaining provinces and territories had 967 facilities accounting for 38.9% of care beds.

Facilities reported having 193,655 residents in their facilities on the last day of their fiscal period, 42.2% of whom were located in Ontario and 20.0% in Quebec. Canadian facilities offered over 69.4 million days of resident care. Among nursing care residents, 64.7% were female and 34.9% were male.

Nursing care facilities employed roughly 254,500 staff, 39.3% of whom were full-time employees and 38.9% part-time. Nurses, physicians and therapists accounted for 66,540 (26.1%) of these employees, direct care support workers at 166,785 (65.5%), while 21,150 (8.3%) were indirect care employees. Meal services, housekeeping and help with activities of daily living were among the most commonly reported services offered by nursing care facilities, while addiction or substance use counselling, other counselling and mental health services were among the least reported services offered.

More than two-thirds of employees of community care facilities for the elderly were direct care support workers

Community care facilities reported having 251,830 residents on the last day of their fiscal period. These facilities reported having 218,077 long-term licensed and approved beds and short-term stay beds, and as a result offered 84.7 million days of care to their residents throughout 2019. Long-term stay beds that were not licensed and approved beds were not included in the survey. This could explain why the number of residents and the number of beds available in facilities do not align. By gender of residents, community care facilities for the elderly had similar occupancy rates with 67.6% of nursing care facility residents being female and 31.5% male. Of their 149,035 employees, 45.4% were full-time and 35.4% were part-time. The majority of employees—105,305 (70.7%)—were direct care support workers, while 20,480 (13.7%) were nurses, physicians and therapists, and 23,250 (15.6%) were indirect care employees.

The proportion of community care facilities for the elderly that offered services was lower than that of nursing care facilities for each service type, with the exception of some services such as security (+14.6 percentage points) and other personal care and well-being (+2.9 percentage points), which were offered at a higher proportion at community care facilities than at nursing care facilities.

  Note to readers

These are the first full dataset results from the 2020 Nursing and Residential Care Facility Survey, which collected basic information on facility characteristics, such as employee and resident counts for the fiscal year ending between April 1, 2019, and March 31, 2020, as well as information on the COVID-19 pandemic up to and including December 31, 2020.

This survey was a partnership between Statistics Canada, Health Canada, the Public Health Agency of Canada, and the Canadian Institute for Health Information.

A microdata file available for analysis allows governments, policy makers and researchers to understand the links between facility characteristics and operations, employees, health outcomes of residents, and system-level performance.

The response rate for public facilities in Quebec was less than 10%.

For financial estimates on public nursing and residential care facilities please refer to table 13-10-0101-01. Please see table 13-10-0102-01 for financial estimates of private nursing and residential care facilities.

Results of this survey pertaining to COVID-19 were released in June in an article entitled "Impacts of the COVID-19 pandemic in nursing and residential care facilities in Canada."

Information on the pandemic experience in the long-term care sector can be found at the Canadian Institute for Health Information.

Contact information

For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; STATCAN.infostats-infostats.STATCAN@canada.ca) or Media Relations (613-951-4636; STATCAN.mediahotline-ligneinfomedias.STATCAN@canada.ca).

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