Visits to Long-Term Care Facilities

All medically necessary visits for assessment and treatment of residents in long-term care facilities are covered by OHIP.

In addition, routine visits are also covered as follows :

• to a total of eight visits per month for patients in chronic care and convalescent hospitals;
• to a total of four visits per month for patients in nursing homes and other institutions covered by long-term care legislation.

OHIP does not cover routine visits in excess of the limits described above.

As well, it is a condition of payment that all visits include a direct physical encounter between the physician and the patient. This includes any appropriate physical examination and ongoing monitoring of the patient's condition.

Physicians are paid for routine visits to residents of long-term care facilities and nursing homes. However, more routine visits than the above limits are considered excessive.

Formerly, physicians were permitted to visit a long-term care facility and be paid for reviewing the medical records. Now physicians will also be required to visit patients face-to-face.