Nova Scotia Care Home Contract: What to Check Before Signing
Bed-Hold Policy
When a resident is temporarily hospitalized — a fall, a respiratory infection, a planned surgery — the critical question is whether the nursing home holds their bed. Licensed nursing homes in Nova Scotia must hold a resident's bed for up to 30 days during an acute hospital stay. If the hospitalization extends beyond 30 days, the family can request a written medical extension.
Verify this clause in the contract. Some facilities state the bed-hold policy in general terms; you want the specific number of days and the extension process in writing. Losing a bed during a hospital stay can create a serious placement problem.
Also confirm who pays during the bed hold and what rate applies; do not assume the contract's billing treatment without checking.
Discharge Billing Rules
Facilities are prohibited from charging accommodation fees on the day of discharge. If your parent is transferred to another facility or discharged to hospital, verify that the contract applies this rule; ask the facility how it handles billing when a resident passes away.
Watch for clauses that impose an additional "move-out fee" or administrative charge on discharge. Licensed homes operating under the Continuing Care system should not be charging anything beyond the standard accommodation rate, and that rate ends the day before discharge.
Auxiliary Charges
The standard accommodation charge covers room, meals, housekeeping, and laundry. Everything beyond that is classified as an auxiliary personal expense and billed separately. These typically include:
- Non-covered prescription drugs (most are covered by Nova Scotia Seniors' Pharmacare, but some brand-name drugs are not)
- Dental care
- Hearing aids and batteries
- Eyeglasses
- Specialized clothing or adaptive equipment
- Personal grooming (haircuts, nail care)
- Specialized transportation beyond routine medical appointments
The contract should clearly list which services are included in the base accommodation charge and which are billed as extras. If the contract is vague on this point, ask for a written schedule of auxiliary charges before signing.
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What Licensed Homes Cannot Charge For
Under provincial Continuing Care policies, licensed nursing homes cannot require upfront deposits. If a facility asks for a security deposit, entrance fee, or "community fee" before admission, that is a warning sign. Deposits are prohibited in the publicly funded system.
Dietary services, routine housekeeping, and basic laundry are included in the accommodation charge. If a contract tries to bill these separately, it conflicts with the provincial rate structure.
Private Care Home Contracts Need Extra Scrutiny
Private retirement homes and assisted living facilities are not licensed by the Department of Seniors and Long-Term Care. Their contracts are governed by general tenancy law, not Continuing Care policy. This means families need to verify everything that the public system guarantees by default:
- Active liability insurance
- Vulnerable sector police checks for all staff
- Clear separation of suite rental from care-service charges
- Notice periods for each component (a resident can terminate care services with 10 days notice even if the suite lease requires 30 days)
- No hidden "care tier" escalation clauses that allow unlimited fee increases
The Nova Scotia Long-Term Care Costs and Subsidies Guide includes a care home contract audit checklist that covers both licensed and private facility contracts, with the specific clauses to verify and the red flags to catch.
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Download the Nova Scotia — Long-Term Care Cost Checklist — a printable guide with checklists, scripts, and action plans you can start using today.