Developer:
Executive Director;
Manager of Seniors
Residence; Directorof Care
Effective Date:
June 2020
Last Reviewed:
March 2020

Category:
Operations

Domain:Seniors
Residence

Policy #:OPS-MSR-(#)

Subject Title:
Tenancy in Momiji Seniors
Residence
Next Review:
Supersedes:
NEW
January 2023

Approval:Management
Committee
Pages:
10

PURPOSE:

Momiji Seniors’ Residence (MSR) is intended for seniors who require some care in order to remain
living independently. It is funded by government assistance to provide accommodation as well as
pre-defined types/amount of care to our tenants.
This policy has been established to enable shared understanding of the types and amount of MSR
tenants’ care needs that might be safely met within the limitations of Momiji’s resources. It also
provides explicit guidelines for when recommendation is to be made to a tenant to consider
accessing alternative accommodation and care services when his/her need for care becomes too
great or complex to be safely met in an independent living environment.
POLICY:I.

Admission and Tenancy
Momiji’s mission is to assist seniors to live independently in their own homes for as long aspossible. However, when subsequent to moving into MSR a tenant develops care needs that
Momiji’s Assisted Living Program is unable to meet (e.g. requiring two Momiji staff
members to transfer, or requiring 24-hour supervision or nursing care), or displays
behaviours that could be harmful to themselves or to others (E.g. wandering, aggressive
behavior, inability to follow emergency protocol) efforts are to be made to explore alternatemeans for meeting such care needs. Momiji’s obligation to ensure the safety of all tenants inthe building.

II.

The Admission and Tenancy Committee (ATC) is an ad hoc staff committee whose
members include the Director of Care, Manager of Seniors’ Residence, Client Intervention
Worker, and Coordinator(s) – Support Services. The ATC has the responsibility fordecisions regarding offering of tenancy at the Momiji Seniors’ Residence, and planningtowards facilitating for tenants to access more suitable accommodation/care arrangements
when necessary.

(Last Revised: March/2020)

1

PROCEDURES:

1. Anyone wishing to become a tenant at MSR must first submit a Tenancy Application. Oncethe application has been received and approved by the Client Intervention Worker, theapplicant will join the Waiting List for housing in the MSR. Housing applicants must beaged 60 or older (in the case of a couple, only one partner need be 60 or older), and must beeither Canadian citizens or legally allowed to reside in Canada.
2. From the full Waiting List of all those who have submitted Tenancy Applications to MSR,
the Client Intervention Worker is responsible for maintaining a Short List of applicants whoare prepared to move into MSR when a unit becomes available. To be eligible for the Short
List, applicants must: Complete an InterRAI-CHA Assessment with Momiji staff, which is to be updated
annually at minimum;
 Submit a form, called “Form B”, completed by their doctor within the past year, or more
recently if there have been significant changes to their health condition;
 Be cognitively intact, as per their doctor’s evaluation, to be able to keep living
independently, but require some level of care within the scope of services that Momiji
can provide (see Appendix A);
 Satisfy the eligibility guidelines for living independently and safely in Momiji’s AssistedLiving Setting (see Appendix B);
 Submit required financial documentation, and have resided in Ontario for at least oneyear if they intend to apply for Rent Geared to Income (RGI). Applicants who meet theRGI eligibility but have not been living in Ontario for more than one year may moveinto Momiji as market rent tenants for the first year; Be ready to move into MSR when an apartment is available (generally notice ofavailability is provided one month in advance); Be a non-smoker;
 In addition, we strongly recommend that all MSR tenants have designated someone asPower of Attorney or Substitute Decision Maker (POA/SDM), and would be willing toact for and in the best interest of the individual taking up residence at MSR whenneeded.
3. When an apartment becomes vacant, the ATC will meet as soon as possible to review theShort List, identify suitable applicant(s) and offer the tenancy opportunity. There are four
major factors the Committee must consider in making this decision:
 Rent Geared to Income (RGI) vs. Market Rent status: MSR is required by theMinistry of Housing to reserve 65% of its apartments to RGI households, regardless ofthe number of applicants on hand who can pay Market Rent. Unless there is a crisis case
(Last Revised: March/2020)

2



that takes more urgent priority, we try to replace RGI vacancies with RGI applicants,
and Market Rent vacancies with Market Rent applicants.
Length of Time on Waiting List: With all other factors being equal, we will choose
the applicant who has been on the waiting list for a greater length of time.
Age: With all other factors (including Care Needs) being equal, we will choose an older
applicant over a younger one.
Care Needs: All persons living in the MSR have some level of care needs as aprerequisite for admission. Any applicant with care needs or behavioral presentationthat Momiji cannot safely manage will not be considered for admission. For example, if
an applicant meets the eligibility criteria for a long-term care facility, he or she will not be
considered for tenancy at MSR which only have “Assisted Living” level support
available. All care needs must be feasible for meeting with scheduled services. Under theAssisted Living Program Momiji is not able to provide care on an “as needed” basis (e.g.
toileting assistance).

Once the Committee has made a decision, the Manager of Seniors’ Residence will offer thevacant unit to that applicant. If for any reason the applicant turns it down, an offer will bemade to the next eligible applicant on the Short List. Applicants who refuse an offer aregenerally allowed to remain on the Short List, unless they choose to withdraw theirapplication. However, after refusing three offers, their wait status will be reassigned to thebottom of the list.
4. As part of the procedure for moving into MSR, all new tenants must sign an Indemnity
Agreement in addition to the Tenancy Agreement.
5. If a tenant of MSR develops care need(s) beyond that which the Momiji assisted living
program is able to meet, or presents behaviours that could be harmful to him/herself orothers the situation will be addressed in a timely fashion.
As a first step, a care consultation meeting will be called by the Director of Care with thetenant, his/her family or POA/SDM as appropriate to discuss Momiji’s concerns and decideon how to mitigate the risks. This might involve the family-

Increasing their attendance at MSR to support the resident;-

Applying for other government-funded home support service if eligible;-

Retaining private-duty nurses or personal support workers; or-Hiring a private caregiver;in order to meet the tenant’s additional care needs, and/or accessing an alternative form ofcare and accommodation.
While Momiji staff might provide guidance or assistance in completing an application for
long-term care or another residential setting this is the responsibility of the tenant, his/her(Last Revised: March/2020)3

family or POA/SDM to do so. While the tenant is waiting to move to a different residential
setting the POA/SDM must provide the extra care necessary to ensure that the tenant cancontinue to live safely at Momiji in the interim.
6. In the event that safety for the tenant, care staff and others at Momiji is put at risk from thecontinued stay of the tenant at MSR Momiji staff will make every effort to work
cooperatively with the tenant’s family or POA/SDM to ensure a timely transfer to a more
appropriate care setting including to a hospital.

(Last Revised: March/2020)

4

APPENDIX A

Available service list
Assited Living services available at Momiji
Personal Care
 Daily checks (phone/visit) on agreed schedule Medication Reminders on agreed schedule: the tenant must be able to arrange the medication by
picking up by her/himself or arranging delivery by the pharmacy of her/his choice.
 Assistance with bathing, maximum twice per week, on a scheduled day and time Assistance with personal hygiene: morning and night for basic activities such as changing
clothes, oral care assistance, changing incontinence pads. Maximum care time per tenant isapproximately 15 minutes per visit.
 Escorting to Medical and Non-Medical appointments: escorting is done by one PSW only. This
service is available only when POA/Family cannot accompany the tenant. The escorting must be
requested and accepted in advance.
Home Making
 Light housekeeping (only for the areas that the tenant cannot clean by her/himself)
 Light meal preparation (if the tenant cannot purchase Momiji’s meal program or community
meals on wheels service for an acknowledged reason). Allocated service hours by PSW areapproximately 15 minutes per meal.
 Grocery shopping: a PSW is able to shop for tenants and deliver groceries to the apartment. Thetenant must be able to prepare the grocery list and manage the cash transaction for each
shopping trip.
Participating in various programs
 The tenant must be able to make appointments, remember them, and transport him/herself toappointments within the facility, make cancellations with adequate notice, and make payments
accordingly.
Other needs
 The tenant must be able to recognize his/her own needs and obtain the help he/she requires tolive independently at Momiji, for example, dealing with apartment-related issues such as
flooding, fire hazards, or garbage disposal, or ensuring that they have enough necessities such as
cash, food and proper clothing.

(Last Revised: March/2020)

5

APPENDIX B

Eligibility guidelines for living independently and safely in Momiji’s assisted living setting
A tenant living in the Momiji Seniors Residence should not be:






A person who is at risk of harming themselves or others.
A person who cannot recognize an emergency e.g. fire, chemical spill etc. and follow activating
alarm, evacuation and other response protocols.
A person who cannot call for help in an emergency situation by using the telephone or theirduress button.
A person who needs 24/7 nursing care or monitoring daily.
A person who has a moderate or advanced level of cognitive impairment, defined as having anMMSE score lower than 20/30, or certain check marks on the Form B, section “CognitiveFunction”. (Appendix C)
The check marks concerned in Form B are:o “Cognitive Function” – Impaired Judgemento “Memory Loss” – Long Termo “Orientation” – Place and Timeo “Overall Impact on ADL” – Moderate or Severe.
o A person who falls under the “Very High Needs” or “High Needs” categories based on theirInter-RAI CHA outcome score. The needs analysis tool is attached under Appendix D.
o A person whose clinical frailty score is level 6 and higher (Momiji uses the Clinical Frailty
Scale suggested by Dalhousie University – see Appendix E).
o A person whom the ATC has determined to be not eligible.

(Last Revised: March/2020)

6APPENDIX CMOMIJI HEALTH CARE SOCIETY - - MOMIJI SENIORS CENTRE
FORM B: HEALTH ASSESSMENT(TO BE COMPLETED BY YOUR DOCTOR)

Name

Birth Date

Mr.
Mrs.
Miss

_____________________________________________
SurnameFirst

Second____________________ Health Card No. _ ____________________PLEASE ATTACH
1. Current list of medications
2. Chest x-ray report taken within the past 6 months
3. Other relevant reports (i.e. CT, MRI etc.) (if available)
MEDICAL HISTORY
Current medical diagnosis(es) and present condition
History of significant illnesses in the past 10 years:
History of surgery in the past 10 years:
COGNITIVE FUNCTION
1. Cognitive Function

Unimpaired

Impaired Judgement

2. Memory Loss

RecentLong Term

3. Disorientation

No issue

PersonPlaceTime

4. Overall Impact on ADLNoneMild

ModerateSevereMMSE score (/30)

or/andMoCA score :(/ 30)

Comments:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________(Last Revised: March/2020)7

Mobility issues and Risk of Falls
Comments:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Risk Factors (Include behavioural risk to self and to others and paranoia): please describe any
current behaviour and behaviour during the past 12 months.
Comments:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Vaccination record:
Yes

Date(yyyy/mm/dd)

1.

Pneumovax

(//)

2.

TB Results (Chest X-Ray)

(//)

3.

Tetanus, Whooping cough, Diphtheria

(//)

4.

Zostavax / Shingrix

(//)

5.

Other(((//////)))

NoGENERAL COMMENTS
Length of time you have been attending this applicant _______________________________________________________________
Doctor’s signature_________________________________
Please print doctor’s name_______________________________
Address_________________________________
Phone Number_________________
Date(Last Revised: March/2020)

Please forward form to:

Momiji Seniors Centre
3555 Kingston Road
Toronto, Ontario M1M 3W48

APPENDIX D

Inter-RAI CHA Score result analysis tool – Momiji Health Care Society**Given the nature of Assisted Living (an independent living setting), we primarily consider MAPLe,
IADL, ADL, and CPS to determine a client’s needs.
1. Very High Needs:
MAPLe score 4-5, and one of the following:
IADL 15-21 or ADL >3 or CPS >3
2. High Needs:
MAPLe 5 – automatically categorized as high needs
MAPLe 4 & IADL > 8 or CPS >3MAPLe 3 & IADL > 15MAPLe 3 & IADL > 8 & ADL >2 or CPS >2MAPLe 3-5 & CPS >33. Moderate Needs:
MAPLe score 2-4, IADL 0-15, ADL >2, CPS >1MAPLe 4 & IADL 0-7 & CPS < 2MAPLe 3 & IADL 0-14 & CPS < 2MAPLe 2 & IADL > 8 & CPS < 2MAPLe 1 & IADL > 84. Low Needs:
MAPLe score 1-2 & IADL < 7MAPLe
IADLADLCPSDRSCHESSPAINSRI(Last Revised: March/2020)

1-5
0-21
0-6
0-6
0-6
0-5
0-40 or 1

9

APPENDIX E(Last Revised: March/2020)10