Long-Term Care Homes & Services is a leader in excellence and ground-breaking services for healthy aging, providing a continuum of high-quality long-term care services to eligible adults in both long-term care homes and the community. Long-Term Care Homes & Services (LTCHS) is responsible for maintaining 10 long-term care homes, with an asset book value of $248.829 million, in a state of good repair to meet Ministry of Health and Long-Term Care requirements and to ensure the safety and comfort of our residents.

These homes operate 24 hours a day, 365 days a year, providing permanent, convalescent, and short-stay admissions. LTCHS also provides community support programs, including adult day programs, supportive housing services, and homemakers and nursing services which provide a support system to help clients maintain their independence and live in their own home.

Long-Term Care Homes & Services delivers the following services:

  • Long-Term Care Homes
  • Community-Based Programs

Download the Budget Analyst Notes for Long-term Care Homes and Services for detailed information on service levels, key initiatives, challenges and performance measures. You can also review budget highlights below.

The need for long-term care services is becoming increasingly important as the population ages, as acuity and complexity of resident care needs rise and the demand for specialized services increases.

Long-Term Care Homes & Services supports healthy aging strategies by providing increasingly complex interventions for responsive behaviour, associated dementias and mental illness. In the community, LTCHS services enable residents to maintain independence either in their own home or in supportive housing.

Download the Long-Term Care Homes & Services Program Map to better understand the services and activities LTCHS delivers on behalf of the City.

Operating Budget

The total cost to deliver these services to Toronto residents is $268.5 million gross and $49.4 million net.


  • 0.8% Budget decrease compared to the 2018 Approved Net Operating Budget.
  • $0.248M Base Expenditure Changes from inflationary increases in salary and non-salary budgets.
  • $0.615M Efficiency savings achieved through streamlining, transformation and modernization of care model by using new technology and restructuring of administrative support.
  • $1.892M New/enhanced funding to meet Provincial accountability requirements required to respond to the emerging needs within the long-term care system. 100% Provincially funded.
  • 2020/2021 Increases primarily for known inflationary adjustments for salaries and benefits.

Key Challenges

  • Aging demographic, acuity and complexity of resident care needs continue to rise, requiring additional specialized services.
  • Maintaining the City’s ten (10) LTC homes in a state of good repair to ensure the safety, security and comfort of residents; mitigate risk to the City; and comply with all legislated requirements.
  • Advance the Provincially mandated redevelopment of five (5) of the ten (10) City operated long-term care homes (1,232 of its 2,641 Ministry approved beds) to meet new design standards.

Priority Actions

  • Additional funding is included to meet the rising resident acuity and to maintain service level standards ($2.363 million gross, $0 net) and to add specialized staff to provide behavioural support programs to residents ($1.892 million gross $0 net).
  • Implement new Approach of Care to transform the provision of services by promoting best nursing practices at the bedside, inter-professional collaboration, and seamless coordination of care to improve resident outcomes and satisfaction with care.
  • Funding is included to advance the capital maintenance plan to continue to maintain all ten (10) City operated long-term care homes in a state of good repair until redevelopment is possible.

Capital Budget and Plan

The 10-year Capital Plan is $83.9 million and is critical to maintaining the City’s 10 long-term care homes, ensuring the safety, security and comfort of residents; mitigating risk to the City; and meeting compliance with all legislated requirements.

Highlights – 1 Year

  • $2.052M Continue the implementation of the service improvement project, Electronic Health Record System to enable electronic documentation of health records.
  • $0.144M Begin the service improvement, Work Order Management System project to investigate the feasibility of leveraging SAP functionality to automate and modernize the existing work order tracking and asset management process.
  • $4.265M Continue to implement projects to ensure that long-term care homes remain compliant with provincial health and safety standards.
  • $4.425M Complete health and safety projects including building upgrades, electrical, mechanical and specialty system repairs to maintain the long-term care homes in a state of good repair.

Highlights – 10 Years

  • $30.922M Health & Safety projects to ensure the 10 long-term care homes are in compliance with Ministry of Health and Long-Term Care (MOHLTC) requirements.
  • $50.387M State of Good Repair projects which include building upgrades, electrical, mechanical and specialty systems repairs and upgrades to the existing homes to prevent major capital costs through regular maintenance.
  • $2.780M Service Improvement projects that will modernize service delivery by integrating technology solutions; electronically documenting resident health care records and support case-based decisions; and undertaking a feasibility study to automate tracking of work orders to better manage City’s assets.

Find more information on specific City issues, opportunities and challenges in the briefing notes and reports prepared by City staff. Documents will be posted as they become available.

Presentations made to committee and City Council provide an overview of the 2019 City budget. Documents will be posted as they become available.