Additional care costs in senior residences: 2026 fee schedule

The advertised price of a residence rarely covers everything. Additional care — bathing assistance, medication distribution, nursing services — adds to the bill and can represent $500 to $1,500/month in extra charges. Here is a realistic schedule to 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

Typical fee schedule in Montréal (2026)

Real budget example: a semi-autonomous resident

Madame Tremblay, 81, moves into a residence advertised at $2,100/month. Her actual needs:

• Accommodation + meals + activities: $2,100/month
• Bathing assistance 5x/week: +$220/month
• Medication distribution 2x/day: +$160/month
• Dressing assistance every morning: +$200/month
• Actual total: $2,680/month — $580 more than the advertised price

Over a year, this gap represents $6,960 in unexpected costs if the family doesn't ask the right questions from the start.

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 — this can reduce your care costs by $200 to $500/month.

Home support tax credit

Québec's home support tax credit (CMD) applies to several services in RPAs. For 2026:

• Base rate: 35% of eligible expenses
• Enhanced rate for modest incomes: up to 38%
• Credit ceiling: approximately $2,000/year depending on expenses

Consult an accountant or your CLSC to optimize your tax 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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