Long Term Care Facilities Survey - 2013

Business and contact information (LTC1) - Question identifier:LTC1_R01

Please verify the business name and correct where needed.

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C001

Legal Name

Long Answer Length = 64

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C002

Operating Name

Long Answer Length = 64

Business and contact information (LTC1) - Question identifier:LTC1_R02

Please verify the information for this business's contact person and correct where needed.

The contact person is the person who should receive this survey. The contact person may not always be the one who actually completes the questionnaire.

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C013

First Name

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C054

Last Name

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C014

Title

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C018

Email Address

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C004

Address (number and street)

Long Answer Length = 64

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C005

City

Long Answer Length = 32

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C006

Province, Territory or State

• 01: Alabama
• 02: Alaska
• 03: Arizona
• 04: Arkansas
• 05: California
• 06: Colorado
• 07: Connecticut
• 08: Delaware
• 09: District of Columbia
• 10: Florida
• 11: Georgia
• 12: Hawaï
• 13: Idaho
• 14: Illinois
• 15: Indiana
• 16: Iowa
• 17: Kansas
• 18: Kentucky
• 19: Louisiana
• 20: Maine
• 21: Maryland
• 22: Massachusetts
• 23: Michigan
• 24: Minnesota
• 25: Mississippi
• 26: Missouri
• 27: Montana
• 28: Nebraska
• 29: Nevada
• 30: New Hampshire
• 31: New Jersey
• 32: New Mexico
• 33: New York
• 34: North Carolina
• 35: North Dakota
• 36: Ohio
• 37: Oklahoma
• 38: Oregon
• 39: Pennsylvania
• 40: Rhode Island
• 41: South Carolina
• 42: South Dakota
• 43: Tennessee
• 44: Texas
• 45: Utah
• 46: Vermont
• 47: Virginia
• 48: Washington
• 49: West Virginia
• 50: Wisconsin
• 51: Wyoming
• 52: Newfoundland and Labrador
• 53: Prince Edward Island
• 54: Nova Scotia
• 55: New Brunswick
• 56: Quebec
• 57: Ontario
• 58: Manitoba
• 59: Saskatchewan
• 60: British Columbia
• 61: Yukon
• 62: Northwest Territories
• 63: Nunavut

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C007

Postal Code or ZIP code

Long Answer Length = 9

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C009

Country

• 01: Canada
• 17: United States
• 98: RF
• 99: DK

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C017

Telephone number (including area code)

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C027

Extension number (if applicable)

Long Answer Length = 8

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C016

Fax number (including area code)

Long Answer Length = 50

Business and contact information (LTC1) - Question identifier:LTC1_Q00_C010

Preferred language of communication

• 1: English
• 2: French
• 8: RF
• 9: DK

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q12_C031

Please indicate your type of organization.

• 01: Sole proprietorship
• 02: Partnership
• 03: Incorporated company
• 04: Co-operative
• 05: Joint venture
• 06: Government business entity
• 07: Government
• 08: Non-profit organization

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q13_C040

Does your business have a GST Registration Account Number or a Business Number (BN)?

• 1: Yes
• 2: No

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q13_C041

Please report your GST number or Business Number.

Long Answer Length = 9

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q14_C050

Are you reporting for more than one facility?

- For facilities that operate more than one location under a single legal entity and for which a single consolidated income statement only is available, please answer 'Yes' and report for the number of locations.
- If you are reporting for one or more facilities that are distinct legal entities with individual income statement, please answer 'No' and respond individually for each facility.

• 1: Yes
• 2: No

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q14_C051

Number of locations included with this form.

Min = 0; Max = 100

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_R01

Please report your fiscal period.

- For the purpose of this survey, please report information for your 12-month fiscal period for which the final day occured on or between April 1, 2013 and March 31, 2014.
- For example, if your fiscal period ended December 31, 2013, please report for the period January 1, 2013 to December 31, 2013

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q15_C011

Please provide the starting date of your reporting period.

Long Answer Length = 10

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q15_C012

Please provide the ending date of your reporting period.

Long Answer Length = 10

Section A: Administrative Characteristics (LTCA) - Question identifier:LTCA_Q16_C102

Please indicate your type of ownership.

• 1: Proprietary
• 2: Religious
• 3: Lay (not for profit, non-profit voluntary associations, societies)
• 4: Municipal
• 5: Provincial or Territorial
• 6: Federal
• 7: Regional Health Authority, Board, District, Corporation
• 8: RF
• 9: DK

Section B: Number of beds (LTCB) - Question identifier:LTCB_R01

Please report the number of beds for all locations licensed or approved by provincial or municipal authorities and the total number of beds available for use for all locations, as of the last day of the fiscal period, including respite beds.

Section B: Number of beds (LTCB) - Question identifier:LTCB_Q17_C121

Licensed or approved

Min = 0; Max = 9997

Section B: Number of beds (LTCB) - Question identifier:LTCB_Q17_C122

Staffed and in operation (in use or vacant)

Min = 0; Max = 9997

Section C: Total days of care (LTCC) - Question identifier:LTCC_R01

Please report the number of days of care by responsibility for payment.

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C131

Provincial Health Department or Ministry (e.g., Provincial Health Insurance Plan, Regional Health Authority)

Min = 0; Max = 9999997

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C132

Provincial Social Services Department or Ministry (e.g., Provincial Social Services Plan)

Min = 0; Max = 9999997

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C133

Other Provincial Department or Ministry

Min = 0; Max = 9999997

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C134

Municipalities, regional or district administration

Min = 0; Max = 9999997

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C135

All other, including federal government and self-pay by residents

Min = 0; Max = 9999997

Section C: Total days of care (LTCC) - Question identifier:LTCC_Q18_C136

TOTAL NUMBER OF DAYS

Min = 0; Max = 9999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_R01

Please report the number of residents in each of the following categories:

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C151

In facility on the first day of the fiscal period

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C152

Admissions during the reporting period

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C153

TOTAL UNDER CARE

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C154

Discharges during reporting period

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C155

Deaths during reporting period

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C156

TOTAL SEPERATIONS

Min = 0; Max = 999997

Section D: Movement of residents (LTCD) - Question identifier:LTCD_Q19_C157

IN FACILITY ON THE LAST DAY OF THE FISCAL PERIOD (TOTAL UNDER CARE MINUS TOTAL SEPARATIONS)

Min = 0; Max = 999997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_R01

Please report the number of residents in facility on the last day of the fiscal period for each of the following age and sex grouping.

Count each person once only.

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C201

Males - Less than 10 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C202

Females - Less than 10 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C203

Males - 10 to 17 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C204

Females - 10 to 17 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C205

Males - 18 to 44 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C206

Females - 18 to 44 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C207

Males - 45 to 64 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C208

Females - 45 to 64 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C209

Males - 65 to 69 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C210

Females - 65 to 69 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C211

Males - 70 to 74 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C212

Females - 70 to 74 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C213

Males - 75 to 79 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C214

Females - 75 to 79 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C215

Males - 80 to 85 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C216

Females - 80 to 84 years

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C217

Males - 85 years and over

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C218

Females - 85 years and over

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C219

MALES - TOTAL RESIDENTS

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q20_C220

FEMALES - TOTAL RESIDENTS

Min = 0; Max = 9997

Section E: Age and sex of residents in facility on the last day of the fiscal period (LTCE) - Question identifier:LTCE_Q21_C221

GRAND TOTAL OF RESIDENTS

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_R01

Please report the number of residents per type of care received on the last day of the fiscal period, counting each person once only.

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C228

Room and board only

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C229

Room and board with guidance or counselling with respect to social, employment, addiction problems, or parental guidance with skilled counselling (e.g. child care homes)

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C230

Room and board with custodial care and/or special school, sheltered workshop, etc.

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C232

Type I (e.g., supervision and/or assistance with daily living and meeting psycho-social needs)

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C234

Type II (e.g., medical and professional nursing supervision, etc.)

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C236

Type III (e.g., medical management, skilled nursing care, etc.)

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C238

Higher type

Min = 0; Max = 9997

Section F: Type of care (LTCF) - Question identifier:LTCF_Q22_C240

TOTAL RESIDENTS

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_R01

Please report the number of residents in facility on the last day of fiscal period by the most appropriate principal characteristic, counting each person once only.

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C261

Aged (65 years and over)

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C262

Physically Challenged and/or Disabled

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C263

Developmentally Delayed

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C264

Psychiatrically Disabled

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C265

Emotionally Disturbed Children

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C266

Addictions

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C269

Transients

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C271

Others

Min = 0; Max = 9997

Section G: Principal characteristics of residents (LTCG) - Question identifier:LTCG_Q23_C272

TOTAL RESIDENTS

Min = 0; Max = 9997

Section H: Personnel (LTCH) - Question identifier:LTCH_R01

Please report all personnel whose time is mainly spent on direct care to residents in the following categories:

- Report personnel employed on the last day of the fiscal period (excluding casuals).
- Report total accumulated paid hours during reporting period (including casuals).
- Hours reported for salaries and wages should have corresponding dollar values in question 26.

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C301

Registered nurses - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C302

Registered nurses - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C303

Registered nurses - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C307

Registered qualified nursing assistants or licensed practical nurses - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C308

Registered qualified nursing assistants or licensed practical nurses - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C309

Registered qualified nursing assistants or licensed practical nurses - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C316

Physiotherapists or occupational therapists - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C317

Physiotherapists or occupational therapists - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C318

Physiotherapists or occupational therapists - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C319

Other therapists - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C320

Other therapists - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C321

Other therapists - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C322

Activity or recreation staff - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C323

Activity or recreation staff - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C324

Activity or recreation staff - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C328

Other direct care staff not included above - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C329

Other direct care staff not included above - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C330

Other direct care staff not included above - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C331

TOTAL DIRECT CARE STAFF - FULL-TIME PERSONNEL

Min = 0; Max = 9997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C332

TOTAL DIRECT CARE STAFF - PART-TIME PERSONNEL

Min = 0; Max = 99997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q24_C333

TOTAL DIRECT CARE STAFF - ACCUMULATED PAID HOURS

Min = 0; Max = 999999997

Section H: Personnel (LTCH) - Question identifier:LTCH_R02

Please report all personnel offering general services in the following categories:

- Report personnel employed on the last day of the fiscal period (excluding casuals).
- Report total accumulated paid hours during reporting period (including casuals).
- Hours reported for salaries and wages should have corresponding dollar values in question 27.

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C351

Administration (Include: unit or ward clerks) - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C352

Administration (Include: unit or ward clerks) - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C353

Administration (Include: unit or ward clerks) - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C354

Dietary (e.g., kitchen or food services) - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C355

Dietary (e.g., kitchen or food services) - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C356

Dietary (e.g., kitchen or food services) - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C357

Housekeeping and laundry - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C358

Housekeeping and laundry - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C359

Housekeeping and laundry - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C363

Plant operation, maintenance and security (e.g., janitorial services) - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C364

Plant operation, maintenance and security (e.g., janitorial services) - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C365

Plant operation, maintenance and security (e.g., janitorial services) - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C366

Other general services staff - Full-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C367

Other general services staff - Part-time personnel employed on the last day of the fiscal period (excluding casuals)

Min = 0; Max = 997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C368

Other general services staff - Total accumulated paid hours during reporting period (including casuals)

Min = 0; Max = 9999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C369

TOTAL GENERAL SERVICES STAFF - FULL-TIME PERSONNEL

Min = 0; Max = 9997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C370

TOTAL GENERAL SERVICES STAFF - PART-TIME PERSONNEL

Min = 0; Max = 99997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C371

TOTAL GENERAL SERVICES STAFF - ACCUMULATED PAID HOURS

Min = 0; Max = 999999997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C381

TOTAL STAFF - FULL-TIME PERSONNEL

Min = 0; Max = 9997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C382

TOTAL STAFF - PART-TIME PERSONNEL

Min = 0; Max = 99997

Section H: Personnel (LTCH) - Question identifier:LTCH_Q25_C383

TOTAL STAFF - ACCUMULATED PAID HOURS

Min = 0; Max = 999999997

Section I: Expenses (LTCI) - Question identifier:LTCI_R01

Please report the costs of operating and maintaining the facility that are attributed to direct care to residents in the following categories:

- Dollar values reported for salaries and wages should have corresponding hours reported in question 24.
- Financial information should be reported for the most recent fiscal year that ended at anytime between April 1, 2013 and March 31, 2014.
- Round to nearest dollar. When precise figures are not available, please provide your best estimates.
- Employee benefits for all employees regardless of occupation should be reported in the middle box of line a.

For additional information in completing this section, select the following link: IMDB <http://www23.statcan.gc.ca/imdb-bmdi/pub/indexti-eng.htm>
This information will help you map the data from financial statements to the corresponding question field.

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C401

Registered nurses - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C402

Registered nurses - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C405

Registered qualified nursing assistants or licensed practical nurses - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C406

Registered qualified nursing assistants or licensed practical nurses - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C411

Physiotherapists or occupational therapists - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C412

Physiotherapists or occupational therapists - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C413

Physiotherapists or occupational therapists - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C414

Other therapists - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C415

Other therapists - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C416

Other therapists - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C417

Activity or recreation staff - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C418

Activity or recreation staff - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C419

Activity or recreation staff - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C423

Other direct care staff not included above - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C424

Other direct care staff not included above - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C425

Other direct care staff not included above - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C426

Drugs (Include: oxygen or medical gases) - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C427

Drugs (Include: oxygen or medical gases) - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C428

Medical and surgical supplies - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C429

Medical and surgical supplies - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C430

Other supplies - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C431

Other supplies - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C432

TOTAL DIRECT CARE EXPENSES - SALARIES AND WAGES

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C433

TOTAL DIRECT CARE EXPENSES - ALL OTHER EXPENSES

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q26_C434

TOTAL DIRECT CARE EXPENSES - TOTAL

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_R02

Please report the costs of operating and maintaining the facility that are attributed to general services in the following categories:

- Dollar values reported for salaries and wages should have corresponding hours reported in Section I.
- Financial information should be reported for the most recent fiscal year that ended at anytime between April 1, 2013 and March 31, 2014.
- Round to nearest dollar. When precise figures are not available, please provide your best estimates.
- Employee benefits for all employees regardless of occupation should be reported in the middle box of line a.

For additional information in completing this section, select the following link: IMDB <http://www23.statcan.gc.ca/imdb-bmdi/pub/indexti-eng.htm>
This information will help you map the data from financial statements to the corresponding question field.

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C441

Administration - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C442

Administration - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C443

Administration - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C444

Dietary (e.g., kitchen or food services) - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C445

Dietary (e.g., kitchen or food services) - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C446

Dietary (e.g., kitchen or food services) - Total

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C449

Housekeeping and laundry - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C450

Housekeeping and laundry - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C451

Housekeeping and laundry - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C455

Plant operation, maintenance and security (e.g., janitorial services) - Salaries and wages

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C456

Plant operation, maintenance and security (e.g., janitorial services) - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C457

Plant operation, maintenance and security (e.g., janitorial services) - Total

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C458

Other - Salaries and wages

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C459

Other - All other expenses

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C460

Other - Total

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C461

TOTAL GENERAL SERVICES EXPENSES - SALARIES AND WAGES

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C462

TOTAL GENERAL SERVICES EXPENSES - ALL OTHER EXPENSES

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q27_C463

TOTAL GENERAL SERVICES EXPENSES - TOTAL

Min = 0; Max = 9999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_R03

Please report all other expenses such as interests and taxes.

- Dollar values reported for salaries and wages should have corresponding hours reported in Section I.
- Financial information should be reported for the most recent fiscal year that ended at anytime between April 1, 2013 and March 31, 2014.
- Round to nearest dollar. When precise figures are not available, please provide your best estimates.
- Employee benefits for all employees regardless of occupation should be reported in the middle box of line a.

Section I: Expenses (LTCI) - Question identifier:LTCI_Q28_C483

Other (Include: interest, rent, taxes, overhead (head office), depreciation, etc.) - All other expenses

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q28_C484

Other (Include: interest, rent, taxes, overhead (head office), depreciation, etc.) - Total

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q28_C495

TOTAL EXPENSES - SALARIES AND WAGES

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q28_C496

TOTAL EXPENSES - ALL OTHER EXPENSES

Min = 0; Max = 999999999

Section I: Expenses (LTCI) - Question identifier:LTCI_Q28_C497

TOTAL EXPENSES - TOTAL

Min = 0; Max = 9999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_R01

Please report the revenues by their source.

- Financial information should be reported for the most recent fiscal year that ended at anytime between April 1, 2013 and March 31, 2014.
- Round to nearest dollar. When precise figures are not available, please provide your best estimates.

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C501

Provincial Health Department or Ministry (e.g., Provincial Health Insurance Plan, Regional Health Authority)

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C502

Provincial Social Services Department or Ministry (e.g., Provincial Social Services Plan)

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C503

Other Provincial Department or Ministry

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C504

Municipalities, regional or district administrations

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C505

All other (e.g., federal government and WCB)

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C506

Residents - co-insurance or self-pay

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C507

Differential - preferred accommodation

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C508

TOTAL REVENUE FROM ACCOMODATION

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C509

Other Sundry earnings

Min = 0; Max = 999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C510

TOTAL REVENUE

Min = 0; Max = 9999999997

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C497

TOTAL EXPENSES

Min = 0; Max = 9999999999

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C511

SURPLUS (TOTAL REVENUE MINUS TOTAL EXPENSES)

Min = 0; Max = 9999999997

Section J: Revenue (LTCJ) - Question identifier:LTCJ_Q29_C512

DEFICIT (TOTAL EXPENSES MINUS TOTAL REVENUE)

Min = 0; Max = 9999999997

Document submission/Feedback (LTCK) - Question identifier:LTCK_Q30

Were you able to complete the requested revenue and expense information for April 1st, 2013 to March 31st, 2014?

• 1: Yes, the information provided is complete as requested.
• 2: No, I was unable to complete all the necessary information and I will mail my financial statements covering the reference period of April 1st, 2013 - March 31st, 2014 to Statistics Canada.

Document submission/Feedback (LTCK) - Question identifier:LTCK_Q31

Statistics Canada may need to contact the person who completed this questionnaire for further information. Is the best person to contact _____?

• 1: Yes
• 2: No

Document submission/Feedback (LTCK) - Question identifier:LTCK_Q32_C9910

How long did it take to complete this questionnaire (Include: time spent gathering the necessary information.)

Hours:

Long Answer Length = 3

Document submission/Feedback (LTCK) - Question identifier:LTCK_Q32_C9909

How long did it take to complete this questionnaire (Include: time spent gathering the necessary information.)

Minutes:

Long Answer Length = 2

Document submission/Feedback (LTCK) - Question identifier:LTCK_Q33

Statistics Canada reviews all feedback. We invite your comments about this questionnaire.

Long Answer Length = 255