Ontario home care program pushed to January as hospitals strain under flu surge

(Luca Bruno/The Associated Press)

Ontario’s rollout of its new High-Intensity Bundled Home Care program—intended to free up hospital beds by moving Alternate Level of Care (ALC) patients into the community—has been quietly delayed until early January.

The initiative is now scheduled to run from early January until March 31, 2026, a spokesperson with Ontario Health atHome told CTV News Toronto. The delay coincides with sharp increases in influenza and other respiratory illnesses that are causing patient volumes to rise rapidly in hospitals across Ontario.

“Bundled high-intensity home care is part of our broader strategy to support health system capacity and ensure patients receive the right care, in the right place, at the right time,” the spokesperson stated in an emailed statement.

“Implementation planning begins in December 2025 and we look forward to partnering with our teams, health system partners, patients, and their families/caregivers to begin the roll-out in early January 2026.”

The delayed date was also provided inside documents shared with home-care providers on Nov. 17 and obtained by CTV News. Those documents were not released publicly. The program’s initial goal was to start moving patients into the community by Dec. 8, freeing up beds before the winter season.

Public Health Ontario’s respiratory virus surveillance tool shows infection trends climbing steadily as the winter season approaches. Hospitals are also warning that beds will be urgently needed.

Dr. Alan Drummond, an emergency physician in Perth, Ont., previously told CTV News Toronto that any measure that frees inpatient beds is critical.

Province-wide, more than 4,500 Ontario patients are categorized as ALC—medically stable but unable to be discharged due to a lack of available long-term care, rehabilitation, or mental health/addictions beds.

Inside the updated bundled home care plan

The documents circulated to service providers outline the latest parameters of the program—an aggressive effort to rapidly move at least 570 high-needs patients out of hospitals at the height of respiratory virus season.

The key expectations of the program include 100 per cent acceptance of referrals, 15-minute response time to accept patients and flexible service duration cased on patient’s needs.

Other expectations include zero percent avoidable hospital readmissions and check-ins by provincial ‘Health at Home’ coordinators.

The program states that service providers must carry $5 million in commercial general liability insurance, with Ontario Health at Home named as an additional insured party.

The first cohort includes 570 high-needs patients, many requiring two-person lifts, 24-hour supervision, dementia care and complex chronic disease management.

The project will run January 6, 2026 to March 31 and will pay home care teams a flat rate per patient, to cover all care, equipment supplies, transportation, 24/7 on call coverage and remote monitoring. Those rates are:

• $5,000/week – LTC-stream seniors/complex patients
• $2,500/week – Reactivation/ rehabilitation patients
• $1,500/week – Mental Health & Addictions patients

Hospitals facing a winter crisis

Hospitals across Ontario are entering flu/RSV/COVID season with occupancy already stretched. Some rural hospitals report up to 40 per cent of beds are filled with ALC patients.

High-pressure regions—including Toronto Central, Mississauga Halton, and areas in central, eastern, and northern Ontario—will be prioritized when discharges begin Jan. 6.

Patient volumes by region:

• Toronto Central: 145 (LTC)
• Central: 80 (LTC)
• Central West: 35 (LTC)
• Mississauga Halton: 80 (LTC)
• Central East: 80 (LTC)
• South East: 80 (LTC)
• Champlain: 100 (Reactivation)
• North West: 35 (LTC) + 50 (Reactivation)
• North Simcoe Muskoka: 70 (Mental Health)