Overview of the industry

In 2003/2004, the residential care facility industry consisted of 4,185 facilities across Canada, serving 219,472 residents and employing 109,182 full-time and 85,113 part-time workers, who accumulated 382 million hours of paid work. The industry generated $11.6 billion in revenue and expenses.

Growth in activity in residential care facilities remained stable when measured in terms of the number of residents, increasing by 1% over the 217,078 residents in 2002/2003. However, expenses and revenues grew by 6% compared to the $10.9 billion in 2002/2003.

In 2003/2004, most of the activity of residential care facilities centred in the 1,941 homes for the aged, which served some 179,424 residents and generated $9 billion in revenue.

Facilities for persons with mental disorders were the second largest group. The number of facilities (1,936) in this category is very close to that of homes for the aged but the level of activity is less. These facilities had 32,036 residents and generated $2 billion. The other facilities included in the “Other” category served slightly fewer than 8,000 residents and reported just under $500 million in revenue.

Senior citizens

Homes for the aged accounted for most of the activity of residential care facilities.

In 2003/2004, the 1,941 homes for the aged accounted for 47% of residential care facilities but 81% of residents and 78% of the revenue generated.

Over 90% of residents in homes for the aged live in facilities with at least 50 beds, and more than 70% of these facilities have 100 or more beds. These 1,223 facilities represent 63% of the homes for the aged but account for 91% of their revenue and expenses.

Distribution by age and sex is not available for the province of Quebec. In the other provinces, 71% of residents in homes for the aged are women and 53% of them are older than 84 years. Men represent 42,374 of the 145,870 residents in homes for the aged for which we have the distribution by age and sex. Approximately 36% of them are older than 84 years.

Residents older than 65 years in residential care facilities represented 4.5% of the population of persons aged 65 and older in provinces other than Quebec. However, this percentage varies by sex, age group and province.

The proportion of seniors who live in residential care facilities increases with age. While less than 1% of the population between the ages of 65 and 74 years are in residential care facilities, this percentage climbs to 20% for persons aged 85 years and older.

There are approximately 2.5 women for every man in residential care facilities, but the higher proportion of women in the population is not the only factor affecting this difference. Regardless of age group, men are less likely to live in residential care facilities. While 5.8% of women aged 65 and older live in such facilities, only 2.8% of men in this age group do.

The difference between the proportion of men and women living in residential care facilities increases with age. While the proportion is 0.9% for men and 1% for women between 65 and 74 years, it increases to 3.6% and 5.5% respectively for the 75 to 84 age group, and to 14% and 23.1% for persons 85 years and older. The situation is the same in all provinces.

The percentage of the senior population in residential care facilities also varies by province. The highest rate is in the Maritimes, where it ranges from 4.7% in Nova Scotia to 7.8% on Prince Edward Island.

British Columbia has the lowest rate with 3.2% of the population aged 65 years and older in facilities. The rates in the other provinces are in the middle, ranging from 4.1% in Alberta to 5.6% in Manitoba.

Data from Quebec is not available by ownership. In the other provinces, the private sector operates 77% of the homes for the aged and serves 74% of residents. The public sector represents 23% of the facilities and 26% of residents.

For profit facilities account for 52% of all the homes for the aged and 48% of residents. Non-profit facilities, which are religious and lay facilities, account for 25% of the homes for the aged and 26% of residents. In the public sector, proportions for municipal and provincial facilities were respectively 8% and 15% of all the homes for the aged. However, the proportion of residents in each group was the same at 13%.

Facilities for persons with mental disorders

Facilities for persons with mental disorders formed the second largest group of residential care facilities. The number of facilities (1,936) in this category is very comparable to that of homes for the aged, but the activity is less. They served some 32,036 residents and generated $2 billion in revenue. The other facilities included in the “Other” category served slightly fewer than 8,000 residents and reported just under $500 million in revenue.

Facilities with fewer than 20 beds accounted for 76% of facilities for persons with mental disorders and 460 facilities for persons with mental disorders had 20 or more beds. However, these 460 facilities accounted for two-thirds of the residents and 70% of the revenue.

The private sector is the main service provider of facilities for persons with mental disorders accounting for 90% of facilities and 91% of residents. The provinces provide most of the remaining services, accounting for 7.7% of facilities and 15.6% of residents.

The population of facilities for persons with mental disorders is divided into 19,281 men and 12,148 women. There were 4,318 people under the age of 18 years and 3,005 over the age of 65 years.

Expenses

Homes for the aged reported average expenses of $4.6 million annually. One resident cost on average $50,126, or $136.76 per day. Facilities for persons with mental disorders spent about $1 million annually to operate. One resident in such a facility cost $64,538 per year, or $175.76 per day.

Expenses varied by the size of the facility. In homes for the aged with fewer than 20 beds, a resident day costs an average of $91. It costs $118 in a facility with between 20 and 49 beds, $135 in facilities with 50 to 99 beds and $143 in facilities with 100 or more beds. A similar situation exists in facilities for persons with mental disorders: facilities with fewer than 20 beds report expenses per resident day of $159 on average compared to $184 for other facilities.

Data on the level of care is not included in the publication but exist in the database. Differences in expenses based on the size of the facility appear to reflect the level of care offered by the residential care facility. Indeed, these two variables appear to be closely linked. Over 90% of homes for the aged with 50 or more beds provide at least medical or nursing supervision, while over 80% of homes for the aged with fewer than 50 beds do not offer nursing supervision.