How to Get Into Long-Term Care in BC: A Step-by-Step Guide for Families

Getting into publicly funded long-term care in BC isn't as simple as calling a facility and booking a room. It's a structured process that runs through your regional health authority. Knowing the steps ahead of time makes a stressful situation much easier to navigate.

The process usually starts in one of two ways. Either your family doctor refers you to Home & Community Care, or the hospital care team starts it if your loved one is an inpatient. The goal is to get a clinical assessment that determines the right level of care. Many families find this step helpful to take early.

A case manager from your health authority conducts an InterRAI assessment. This is a standardized clinical evaluation used across Canada. The assessment covers:

• Physical health: Mobility, chronic conditions, pain, nutrition, skin integrity
• Cognitive function: Memory, decision-making ability, orientation
• Activities of daily living: Bathing, dressing, eating, toileting, transferring
• Behavioural health: Mood, social engagement, any responsive behaviours
• Current supports: What home care or family support is currently in place

Based on this assessment, the case manager decides whether your loved one qualifies for long-term care, assisted living, or enhanced home care. Not everyone who applies is approved for long-term care. The assessment must show that the person's needs go beyond what can be safely provided at home or in assisted living. It's okay if the outcome isn't what you expected. Your case manager can guide you to the right level of support.

Once approved for long-term care, you can typically request up to three preferred facilities in your health authority region. Take time to research your options. This step matters.

• Visit facilities in person before adding them to your preference list
• Check CareCompare's facility profiles for quality data, staffing levels, and Google reviews
• Ask your case manager about average wait times at each facility
• Consider how close each facility is to family members who will visit often
• Ask whether the facility has specialized units if needed (dementia care, complex care)

Your case manager can guide you toward facilities with shorter waits. They'll also help you find the best fit for your loved one's specific needs.

After choosing your preferred facilities, your loved one goes on a waitlist. Wait times vary across the province. It's common to feel frustrated by these timelines. Here's what to expect:

• Provincial average: 290 days (~10 months), up 98% from 146 days in 2018
• Metro Vancouver: Months to well over a year for popular facilities. Fraser Health places 53.1% of applicants within 30 days, but preferred homes take much longer.
• Greater Victoria / Island Health: Popular homes: 18–24 months. High demand, limited beds.
• Interior Health: Popular facilities: 18–24 months. Smaller communities may be shorter.
• Northern Health: Often exceeds 365 days due to limited capacity.

As of 2024, over 7,212 seniors are on the provincial waitlist. That number has tripled since 2016. BC now has only 58 beds per 1,000 seniors aged 75+ (down from 77 in 2015). There's a projected shortfall of 16,000 beds by 2036. Currently, 16% of hospital beds in BC are occupied by ALC (alternate level of care) patients. These are people who are medically stable but have nowhere to go.

While waiting, your case manager should arrange interim support. This may include enhanced home care, adult day programs, or respite stays. If your loved one is waiting in hospital as an ALC patient, the hospital team will continue providing care.

You can also ask to join the waitlist for facilities beyond your top three. If faster placement is a priority, discuss this option with your case manager.

When a bed opens at one of your preferred facilities, you'll receive an offer. Here's what to expect:

• Response time: You typically have 24 to 48 hours to accept or decline
• Declining an offer: You can decline once without losing your place. Declining multiple offers may move you down the list. Policies vary by health authority.
• First choice vs. first available: BC uses a "first available bed" policy. You may be offered a bed at a facility outside your top three. You can accept and request a transfer to your preferred facility later. Declining may affect your prioritized status.
• Move-in: Once you accept, move-in usually happens within a few days. The facility will send a welcome package with what to bring and what to expect.

The 24-48 hour window can feel rushed. But if you've done your research ahead of time, the decision becomes easier. Visit your preferred facilities early in the process. That way you'll feel prepared when the call comes. For practical advice on the move, read our guide on what to expect when moving a parent into long-term care.

The wait for a long-term care placement can be the hardest part. You're not alone in finding this stressful. Here are supports available during this period:

• Home care: Your health authority can arrange professional home care visits. These cover personal care, nursing tasks, and medication management.
• Adult day programs: Structured daytime programs that provide social engagement and caregiver relief
• Respite care: Short-term stays (typically up to 30 days) at a care facility. These give family caregivers a much-needed break.
• Private home care: You can supplement health authority services with privately hired care aides ($35–$75/hour depending on care type — companion care from $35, personal care from $40, specialized nursing from $55+)
• Caregiver support: Contact the BC Caregiver Support Line (1-877-520-3267) for emotional support and practical advice

If your loved one's condition gets worse while waiting, contact your case manager right away. A change in health status can move you higher on the priority list.

Can I choose which long-term care home I go to?

You can request up to three preferred facilities. But placement depends on bed availability. You may be offered a bed at a different facility first. You can accept and request a transfer to your preferred home later.

How long is the waitlist for long-term care in BC?

The provincial average is 290 days (~10 months). That's up 98% since 2018. Metro Vancouver and Victoria waits can be 18–24 months for popular homes. Northern Health often exceeds a year. Over 7,212 seniors are currently on the waitlist. Ask your case manager for current wait estimates at your preferred facilities.

What happens if I decline a bed?

You can typically decline one offer without penalty. Declining multiple offers may affect your waitlist position. Policies differ by health authority. Talk to your case manager about your specific situation.