Documentation Checklist for Out-of-Province Long Term Care (PCH) Applicants
The following are required to be completed when applying for a Northern Regional Health (NHR) Authority Personal Care Home Bed in Manitoba.
1. The Manitoba Panel Application and Assessment
- Health Care staff member complete the application in collaboration with client, family or Alternate Decision Maker.
- The client applying for placement must sign their own application, as this acts as voluntary consent for placement.
If the client is incapable to consent, another individual may sign on their behalf, but this must be explained and documented. For example, a copy of Power of Attorney documents should be included. - A manual may be provided to guide you with its completion.
2. A copy of a chest x-ray report within the last year. If the physician feels that one is not medically indicated, this must be stated by the physician on the Medical Data Sheet in the application.
3. All relevant supporting documentation must be included. Examples include results of cognitive testing, behaviour care plans, or upcoming medical appointments.
4. A Manitoba Health Card Number must be applied for once the client is living in Manitoba. There is often a three (3) month waiting period.
- The Province of Manitoba pays a significant portion (approximately 80%) of the cost to live in a Personal Care Home for Manitoba taxpayers. Not every province has a reciprocal agreement with Manitoba to cover the government portion of the cost. Please confirm with your health authority regarding the same, or clients will be charged the full rate. (100%)
5. Handouts can be provided such as the Welcome Guide to Long Term Care Living and A Guide to Services and Charges in Manitoba.
6. For more information, please see the resources below.
https://www.gov.mb.ca/health/pch/residential.html
https://www.gov.mb.ca/health/pcs/guide.html
https://www.gov.mb.ca/health/mhsip/healthcoverage.html#section-four