Residential Care Facilities Survey (RCF)

Detailed information for 2010-2011

This is a survey that collects information concerning residential care facilities in Canada.

Data release - July 17, 2012. This is the final release of the Residential Care Facilities Survey. The survey has been cancelled.

• Questionnaire(s) and reporting guide(s)
• Description
• Data sources and methodology
• Data accuracy

Description

The survey collects data from residential care facilities across Canada. The data are used by all levels of government, health organizations, owners of such facilities and related organizations for the purpose of program analysis, policy development, planning and research.

Reference period: Data years 1975 to 1976: Calendar year; Data year 1976/1977 to present: Fiscal year

Collection period: April 1st to the Fall following the reference period

Subjects

• Disability
• Health
• Health and disability among seniors
• Health care services
• Older adults and population aging (formerly Seniors)

Data sources and methodology

Target population

The target universe includes all residential care facilities in Canada.

Provincial and territorial ministries of health and/or social services are annually requested to update the inventory of residential care facilities.

The term "residential care facilities" refers to facilities which have four beds or more and which are approved, funded or licensed by provincial/territorial departments of health and/or social services. Among the facilities included are homes for the aged, persons with physical disabilities, persons who are developmentally delayed, persons with psychiatric disabilities, persons with alcohol and drug problems, emotionally disturbed children, transients, young offenders and others.

Some of these facilities are maintained for chronically ill or disabled people who reside there more or less permanently. This is in contrast, for example, to a hospital where patients are accommodated on the basis of medical need and are provided with continuing medical care and supporting diagnostic and therapeutic services. Generally, residential care facilities provide a level of care that is below that found in hospitals, although there is some overlap.

Other residential care facilities keep their patients for shorter periods, though they still provide a care program.

Hospitals are not part of the target population for this survey. Facilities for young offenders that are administered by a provincial/territorial department of justice are not included in this survey, if residency in such a facility is the result of a court-imposed sentence. Facilities such as group homes for troubled or at-risk youth, or for young offenders who are no longer incarcerated, are included. These typically are administered by the provincial/territorial department of social services. Transition homes for women and children, who were victims of violence, are no longer part of the survey after 1990/1991.

Instrument design

The collection of data on residential care facilities began with an inventory in 1974 using an address list from Health Canada based on facilities receiving benefits from the Canada Assistance Plan (CAP). Statistics Canada has expanded this inventory. The target universe now includes all residential care facilities in Canada. Provincial and territorial ministries of health and/or social services are annually requested to update the inventory of residential care facilities.

Sampling

This survey is a census with a longitudinal design.

Data are collected for all units of the target population, therefore, no sampling is done.

Data sources

Data collection for this reference period: 2011-04-21 to 2011-11-30

Responding to this survey is mandatory.

Data are collected directly from survey respondents and extracted from administrative files.

This is a combination survey of self-completed mail-out/mail-back questionnaire and administrative data from Quebec. Generally, only facilities which have four beds or more are surveyed. The exception is some composite reporting, where a head office reports on all of its residential care facilities, some of which may have fewer than four beds.

Outside of Quebec, facilities providing self sufficient, minimal or Type I care with less than 10 beds receive an abbreviated form. These facilities represent 50% of the universe. These facilities report totals for personnel (direct care services and general services) and expenses (direct care services, general services and other expenses).

The remainder of facilities -- those providing Type I care with ten beds or more and those providing Type II care or higher -- receive the standard form. These facilities report totals and detailed breakdown for personnel (direct care services and general services) and expenses (direct care services, general services and other expenses).

For Quebec facilities, Statistics Canada receives administrative data files from the Ministère de la Santé et des Services sociaux. These are obtained from public and private facilities through the M-30 system for financial data and from forms AS-478, AS-480, AS-484 and AS-485 for statistical data.

View the Questionnaire(s) and reporting guide(s).

Error detection

Survey forms are edited in groups by province, principal characteristic and the number of beds in the facility to ensure consistency in reporting. Each form is compared section-by-section to previous years' reports from the facility. Significant changes such as an increase or decrease of 20% with no change in the number of beds are referred to the supervisor. If there is no indication that there has been a change in funding in the province, the supervisor arranges for a follow-up call to the facility. If a financial statement is included with the survey return, an effort is made to use the information in the editing.

The Quebec electronic data are reformatted into individual files which are then submitted to the same manual editing procedures as the survey forms.

There are a number of on-line edits, most relating to an acceptable range for the cell and/or its relationship to data in another cell. Columns are automatically summed so that they can be compared with the total provided by the facility. Consistency checks are also built into the process.

A query is produced when a value falls outside the range specified in the edits. The supervisor handles queries by contacting the facility, or the provincial contact.

Once the editing is completed the data are produced in 12 standard tables by principal characteristic and type of care. These tables are manually compared with the previous year's tables.

Imputation

Imputation for each facility in a total or partial non-response situation was done by imputing the predicted value of a multi-variate regression using the GLM procedure in SAS for total income, expenditures and hours worked. Independent variables are the characteristics of the facility as provided by the provincial department of health. These characteristics include type of service, type of property, region or province, level of care and rated-bed capacity. The other cells were imputed by assigning them a weight corresponding to their percentage of these totals in similar facilities. Great care was taken to ensure that incomplete answers given by facilities were not replaced by estimates and that the overall results remained consistent.

Quebec data come from administrative sources. Initially, the data had to be reformatted to establish conceptual equivalents to the cells of the questionnaire. In addition, Quebec facilities report financial data at the corporation level. A corporation is an economic and administrative unit that may include various components, each with its own objectives. For example, a corporation whose primary objective is residential care may include facilities whose activities relate to outpatient or hospital care. This means that financial data from this type of corporation may include a significant number of activities unrelated to residential care. The inclusion of these activities in the accounts of residential care facilities could artificially inflate them. To reduce this bias, an attempt was made to differentiate, in administrative documents, activities purely attributable to residential care facilities from other activities and to report only the former in the accounts. Weighting was performed on common activities, as well as those that could not be differentiated (such as administrative activities or research). In this sense, Quebec data from 1996 are an estimate of residential care activities. This adjustment was not made for historical data prior to 1994/1995. Hence, those data refer to complete data for corporations deemed to be residential care facilities regardless of the division of activities within the corporations. They may therefore include a significant portion of activities that are outside the scope of residential care.For the period for which the adjustements were applied, the estimates for "Homes for the Aged" are satisfactory. However, because of the small number of facilities for "Persons with mental disorders" and especially of facilities in the category "Other", estimates may still include some external activities.


In 2004, many residential-care facilities in Quebec became part of a newly created Centre de santé et de services sociaux (CSSS). Since many of these CSSS likely included a variety of other services, such as hospital out-patient services and social services facilities, estimation and imputation methods had to be changed from that used in the previous year. Hence, data for Quebec and Canada for 2004/2005 and subsequent years are not comparable with data for previous years.

Estimation

Since the imputation is done for each facility and this is a census, data estimation is merely the sum of imputed or reported data for each published category. These categories are generally province, type of service and characteristics of the residents.

Variations in the estimates can be the result of occasional changes in the definition of the universe of Residential Care Facilities. Since the Residential Care Facilities Survey is facility-based, it cannot collect information about residential care given in other types of institutions, such as long-term care or chronic care provided in hospitals, even if an entire unit of the hospital provides such treatment. If such activities are transferred from a hospital to an independent institution, they will become part of the residential care facilities universe. Conversely, if a residential care facility merges with a hospital, the activities may disappear from the universe. For the same reason, the survey captures activities that are outside the scope of residential care but are performed in a residential care facility. An exception to this rule is Quebec: its data for 1996/1997 and subsequent years are such that the residential care portion can, to some extent, be distinguished from the rest of the activities of health care institutions and hence estimated.

Amalgamation or de-amalgamation of residential care activities with other activities or institutions is an administrative decision of health-care authorities. Since the survey depends on provincial sources as the primary sources of the sample frame, the survey population may vary with such changes. For example, some psychiatric institutions in Ontario were included in the list of residential care facilities until 1992/1993. Then the province redefined them as hospitals and they were removed from the frame. Similarly, a substantial number of auxiliary hospitals in Alberta were on the list of residential care facilities between 1989/1990 and 1993/1994. Some of them have since been merged with hospitals and are no longer in the residential care facilities universe.

Quality evaluation

Year-to-year comparisons are done for some variables like response rate, revenues and expenditures, cost-per-resident day etc. As well, comparisons are also made within the file on key variables like type of residents versus type of facility.

Ratio evaluation (in addition to cost-per-resident day) is performed to ensure that key variables are within reasonable ranges (for example, the number of accumulated hours divided by the number of personnel yields hours per employee).

Data for several variables that were provided by the respondent, such as approved beds and principal characteristics of residents, are also compared with provincial data to ensure consistency.

Disclosure control

Statistics Canada is prohibited by law from releasing any information it collects that could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.

In order to prevent any data disclosure, confidentiality analysis is done using the Statistics Canada Generalized Disclosure Control System (G-Confid). G-Confid is used for primary suppression (direct disclosure) as well as for secondary suppression (residual disclosure). Direct disclosure occurs when the value in a tabulation cell is composed of or dominated by few enterprises while residual disclosure occurs when confidential information can be derived indirectly by piecing together information from different sources or data series.

Revisions and seasonal adjustment

The survey data were published unadjusted for non-response for the period from the 1984/1985 fiscal year to the 1993/1994 fiscal year. The new publication includes data adjusted for non-response for all fiscal years since 1984/1985 except 1994/1995 and 1995/1996, for which no publishable data are available. To maintain comparability with published data, few changes were made to the historical data for the period from 1984/1985 to 1993/1994. However, a number of seniors residences that had erroneously been included with residential care facilities in Alberta were removed from the data for all periods.

Data accuracy

Completion of the survey is a legal requirement under the Statistics Act. The survey's response rate was 72% of all residential care facilities between 1984/1985 and 1993/1994, 77% between 1996/1997 and 1999/2000, and 80% and higher since 2000/2001.Respondent facilities accounted for 79%, 82% of all beds in the first two periods and more than 82% of all beds in the last period. In 2009/2010, respondent facilities accounted for 77% of all facilities and 82% of all beds. There are no published data for 1994/1995 and 1995/1996. These general statistics sometimes conceal situations that vary widely depending on the province and the type of service provided. In particular, the response rate for homes for the aged in Manitoba ranged from 2% to 12% of all institutions between 1984/1985 and 1990/1991, and then jumped to more than 80%.