Additional care costs in senior residences in Montréal

Last updated: June 23, 2026

The advertised price of a residence rarely covers everything. Additional care — bathing assistance, medication distribution, nursing services — adds to the bill and can raise the monthly cost significantly. The amounts vary widely from one residence and one level of care to another: there is no single, standard rate across Montréal. Here is how these fees are structured and the questions to ask so you can budget without surprises.

What is additional care in an RPA?

In a private senior residence, the typically included base services are: accommodation, meals, housekeeping, and activities. Everything beyond this baseline is billed separately according to the RPA's category.

• Bathing assistance (bath, shower, intimate hygiene)
• Daily dressing assistance
• Medication distribution and monitoring
• Nursing care (dressings, injections, catheters)
• Assistance getting up/going to bed
• Accompaniment to medical appointments
• Enhanced night-time monitoring
• Incontinence management

How additional care is billed

Each residence sets its own rates and billing method; there is no common official fee schedule in Montréal. Two broad billing approaches are common:

• Per act — a charge for each one-off service (for example an assisted bath, a dressing change, an accompanied medical outing).
• Monthly package — a fixed amount bundling recurring services (medication distribution, daily dressing assistance, help getting up or going to bed).

The cost of additional care depends on the level of care required, how often it is provided, and the residence itself. The only reliable way to know the real cost is to ask for a written fee schedule specific to the residence you are considering, before you sign. Be wary of verbal estimates: get the amounts in writing.

Why the advertised price is not enough

The advertised rate of a residence usually covers only the base package (accommodation, meals, housekeeping, activities). For a semi-autonomous person who needs bathing assistance, medication management, or dressing help, the real monthly bill can be noticeably higher than the starting price.

The gap depends entirely on the person's needs and on each residence's pricing: it can be modest or substantial. That is why you should have the actual needs assessed and obtain a written estimate, service by service, before comparing two residences on the advertised price alone.

What the CLSC covers free of charge

The CLSC offers certain home care services free of charge, including in private residences:

• Basic nursing care (dressings, wound assessments)
• Limited physiotherapy
• Occupational therapy for environmental adaptation
• Autonomy assessment (Multi-Client Assessment Tool)

The residence cannot prevent you from receiving CLSC services. Request a CLSC assessment upon admission: some care covered by the public system can reduce what you pay the residence. What is covered depends on your assessment, so check the details with your local CLSC.

Home support tax credit for seniors

Québec's refundable tax credit for home support for seniors (administered by Revenu Québec) may apply to certain services received in a private senior residence, including part of the costs tied to care and support. The applicable rate, the eligible expenses, and the ceilings are set by Revenu Québec and can change from year to year.

Check the current rate and conditions directly with Revenu Québec, and have an accountant or your CLSC confirm the amounts eligible in your situation before filing your return.

Questions to ask before signing

1. Can you provide a written fee schedule for all additional care?
2. Can rates increase during the stay? With what notice?
3. Do you bill per act or by monthly package? Is there a less costly option?
4. If my care needs increase, can I stay here or will I have to leave?
5. Can the CLSC intervene in your residence? Do you have a formal partnership?
6. Are your nursing services provided by registered nurses or licensed practical nurses?

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