Frequently asked questions about the new Level 3B admission policy:

1.) Are these brand new beds the Department of Social Development has announced?

Level 3B (L3B) facilities have existed in NB since 1996. In 2012 the Department of Social Development (DSD) issued an RFP for 704 additional beds. These new beds have the designation of “Specialized Care Beds” (SCB) and a requirement of dementia diagnosis to be admitted. Later DSD changed the criteria to advanced dementia only. Simultaneously DSD did away with the L3B assessment and mandated that all facilities previously operating as L3B now operate under SCB rules.

2.) Does this affect L3B facilities that have already been running for many years?

Yes. The Department of Social Development has changed the mandate entirely for all existing L3B facilities in the province. Even those not applying for the new RFP.

3.) Has Level 3B always been exclusively for residents with dementia?

No. It is true that a large portion of L3B residents had dementia to some degree, generally mild to moderate, most had other conditions also that required the need for L3 service.

4.) What is the difference between Level 3B and 3A?

Level 3B and 3A have both always had the option of nursing home placement. The main difference is in the amount of nursing care required (Level 3B requiring less) and the need for 3B residents to be ambulatory (mobile with minimal assistance). In short 3B residents are a lighter care load than 3A residents.

5.) If both 3B and 3A are nursing home level of care why do we need 3B facilities?

L3B beds were pioneered by a few Level 2 operators who could continue looking after their residents with some more staffing in place, including a nurse. This additional staffing would require more funding so the province allowed a greater per diem rate than L2 to make up the additional care hours needed. This rate was still substantially less than nursing homes. This made it a much more affordable option for the province than nursing homes and provided more choice for frail seniors. Nursing home beds cost the province $6500-$8000/month per bed minus the portion the family contributes.

6.) I thought nursing home care only cost $3100/month?

This is a common myth. Residents who are admitted to a nursing home personally have to pay up to a maximum of about $3100/month depending on their income. The province tops up the remaining amount to meet the current nursing home rate of $6500-$8000 depending on the nursing home. The government monthly sanctioned rate for L3B facilities is $3685/month.

7.) What has happened to those who would previously have been a 3B but don’t have advanced dementia?

This question gets to the heart of the matter. If you were previously assessed as a 3B but don’t have a sufficiently advanced dementia you are now a 3A, curiously a higher care needs assessment yet on the low end of the former 3B care spectrum, and remain on a nursing home wait list.

8.) Does this mean if a person has no dementia, they can’t be admitted to a Specialized Care Bed facility?

No. They can still be admitted, albeit with no funding assistance from the province that every other Level 3 resident in the province receives. Minister Madeleine Dube’s exact response to this is:

“Following a meeting on March 25, 2013, and further discussions, Social Development has agreed to establish a Special Admission Policy which will permit the admission of seniors without a diagnosis of dementia into specialized care beds. The Special Admission Policy will be effective September 16, 2013 and will apply to all licensed specialized care bed homes throughout the province. This access will only be provided under the following conditions:

  • The operator of the facility has a vacant bed but there are no seniors assessed at a level 3B waiting for the placement in a specialized care bed facility and wanting to reside in this operator’s home.
  • In such situations, an operator may admit into a specialized care bed a senior who does not have a diagnosis of dementia.
  • The individual in question has been assessed as requiring level 3 (high) care but is ambulatory and does not require access to daily nursing care.
  • The individual is admitted under the new Special Admission Policy.
  • The individual will be responsible for the entire cost of the placement, including any surcharge implemented by the operator, in any, for as long as they reside in the home.
  • Both the resident and the operator will be required to sign waivers stating their understanding that the admission is in accordance with Social Development’s Special Admission Policy.”

9.) Would those formerly 3B residents not fitting the new policy be assessed as a Level 2 (L2)?

No.  Remember that all L3’s require some degree of nursing care. L2 facilities are not required to have any nursing staff. Therefore a L3 person is not permitted to be admitted to a L2 facility. Their only option is to remain where they are, usually in a hospital bed, until a nursing home bed opens up for them. According to the new policy these people are now 3A simply because they have no dementia.

10.) What is a Level 2 assessment?

Level 2 (L2) is for seniors who require 24 hour supervision but are ambulatory, medically stable and require no ongoing nursing support.

11.) What about home care services?

Home care is a wonderful service, everyone’s ideal, however as people approach L3 care the hours of care needed become cost prohibitive.

12.) What is this I hear about Specialized Care Homes charging a top up fee?

It is next to impossible to provide L3B service at the current government per diem rate of $3685/month. A so called “top up” is simply a reflection of the services being offered.

13.) Is a person with advanced dementia a high care needs individual?

Yes. A person with advanced dementia is indeed a very high care needs individual, much more so than residents who have historically been admitted to L3B facilities. In fact a person who requires L3 care because of their advanced dementia is by definition not medically stable. This individual is exactly the person who needs nursing home level of care.

14.) Will this increase the costs further for L3B service?

Yes. As the care needs, nursing needs and equipment needs will all go up for L3B facilities, they will need to increase their rates to continue providing quality care. In fact with this new SCB criteria, DSD appears to be expecting L3B facilities to care for residents with advanced dementia who would have formerly been 3A, at about half the cost paid to nursing homes. 

If you have any additional questions you would like answered please ask in the comment section below.


2 thoughts on “FAQ’s

  1. Sarah

    Your information on the 3B beds is inaccurate. these beds have not been in existence since 1996. it has only been the past few years that 23 b beds have been in existence. At least make sure your information is accurate.

    1. admin Post author

      Hi Sarah, we have made sure all our information is accurate. Level 3B service was first provided in New Brunswick in 1996 by 3 facilities: Protem Health Services, McNair Manor and The Grass Home. Level 3B was started because of the recognized care gap between Level 2 homes and nursing homes. Since 1996 several more 3B facilities have come in existence as well as nursing homes also serving Level 3B seniors. In 2012 DSD issued an RFP for more 3B beds to be developed in the province however they were not upfront with the rule and subsidy changes implemented with the new RFP until over a year after the RFP was issued.


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