Nunavut Level 4 and Level 5 Care: What They Mean and Where to Find Them

How Nunavut Classifies Care Needs

When a registered nurse or home care supervisor assesses your parent using the RAI/MAPLe evaluation, the result is a care level that determines which services and facilities are appropriate. Levels 1 through 3 qualify for home care or Elders' Home placement. Levels 4 and 5 trigger referral for Continuing Care Centre or long-term care facility placement consideration — and that is where the system's capacity constraints become acute.

Level 4 care means your parent has complex, ongoing nursing needs that cannot be managed safely at home or in a basic Elders' Home. This includes advanced wound care, unstable medical conditions requiring clinical monitoring, two-person transfers, and moderate cognitive impairment that creates safety risks without constant supervision.

Level 5 care means your parent requires secure 24-hour supervision, typically for advanced dementia with exit-seeking behaviour, severe behavioural symptoms, or complex medical conditions that demand continuous nursing presence. This is the highest level of care in the territorial classification system.

Where Level 4 Beds Exist

Level 4 care is available at four in-territory facilities:

• Igloolik Continuing Care Centre — 10 beds (Levels 3–4)
• Gjoa Haven Continuing Care Centre — 10 beds (Levels 3–4)
• Kitikmeot Regional Health Centre Long-Term Care Unit, Cambridge Bay — 8 beds (Levels 3–4)
• Kivalliq Long-Term Care Centre, Rankin Inlet — 24 beds (Levels 3–5)

Total in-territory Level 4 capacity: approximately 52 beds shared across Level 3 and 4 residents. These facilities serve the entire territory.

Where Level 5 Beds Exist

Until May 2025, Level 5 care was historically unavailable in-territory, so elders requiring secure dementia care were generally placed in southern facilities, including Embassy West Senior Living in Ottawa.

The Kivalliq Long-Term Care Centre in Rankin Inlet, which opened in May 2025, is now the only in-territory facility providing Level 5 care. It has 24 beds total across Levels 3 through 5.

Two more facilities with Level 5 capacity are planned: a 24-bed home in Cambridge Bay (projected 2028) and a 48-bed home in Iqaluit (design phase). Until those open, demand for Level 5 beds massively outstrips in-territory supply.

As of mid-2024, 71 Nunavut elders were living at Embassy West in Ottawa. That number reflects decades of structural underinvestment in northern continuing care infrastructure.

What a Level 4 or 5 Assessment Triggers

When the clinical assessment classifies your parent at Level 4 or 5, the process shifts from local care management to territory-wide coordination:

1. Your parent's file is referred to the Single Entry Access system
2. The regional care team and Territorial Continuing Care Coordinator review the case
3. A waitlist priority is assigned — Priority 1 (crisis), 2 (urgent), or 3 (stable)
4. When a bed opens anywhere in the territory (or at Embassy West), a placement offer is made

The offered facility may be in a different community than where your parent lives. Declining an offer can result in being moved to the bottom of the waitlist. The 48- to 72-hour acceptance window is short, and families often have to make a wrenching decision — accept a distant placement or wait indefinitely for something closer.

The Nunavut Elder Care Guide explains the full Level 4 and 5 pathway, including what to document before the assessment, how the priority system works, and how to evaluate a placement offer when the bed is far from home.

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