Launch a Hamilton Nursing Care Facility (Skilled Nursing) Today

Detailed Requirements

Here are the specific requirements for starting a nursing care facilities (skilled nursing facilities) in Hamilton:

• Long-Term Care Home License Required
  Long-term care homes must be licensed under the Fixing Long-Term Care Act and comply with staffing, care standards, residents rights, and inspection requirements. Apply to Ministry of Long-Term Care (MLTC). License valid up to 30 years for new builds. Must meet Fixing Long-Term Care Act, 2021 requirements. Staffing: 4 hrs direct care/resident/day by March 2025. Design per LTC Design Manual. Call for Applications process for new licenses. Public consultation for transfers/new issues. Contact MLTC.
• Nursing and Personal Support Worker Standards Required
  Registered nurses, RPNs, and PSWs in care facilities must maintain professional licensure with CNO and comply with practice standards, continuing education, and accountability requirements. Register with College of Nurses of Ontario (CNO). Code of Conduct updated April 2024 (6 principles). April 1, 2025: new Transition to Practice requirement for new applicants. RN, RPN, NP all regulated. Annual renewal required. HSCPOA for PSWs. Canadian degree/diploma within 3 years OR Canadian registration within 3 years satisfies transition requirement. Contact CNO: 416-928-0900.
• Business Licence Required
  General business licence required to operate a business in City of Hamilton. Apply to City of Hamilton for Business Licence: 1. Determine business category 2. Complete business licence application 3. Submit required documents (ID, lease, zoning confirmation) 4. Pay application and annual fees 5. Await approval and receive licence Contact City of Hamilton Business Licensing for specific requirements. Home-based businesses may have different requirements. Annual renewal required.
• Business Number (BN) Registration Required
  A 9-digit Business Number is required for most businesses operating in Canada. It is used to interact with the Canada Revenue Agency and other federal programs. Required for GST/HST, payroll, corporation income tax, and import/export accounts. Register FREE online through Business Registration Online (BRO) at canada.ca. Takes 15-30 minutes. As of November 3, 2025, online registration is MANDATORY for new BNs - phone registration no longer available. You'll need: business name, address, owner SIN, business type, and start date. BN (9-digit number) issued INSTANTLY online. Available 21 hours/day, 7 days/week (closed 3-6am ET for maintenance).
• Retirement Home License Required
  Retirement homes must be licensed by the Retirement Homes Regulatory Authority (RHRA) and comply with care standards, safety requirements, and resident contracts. Apply through Retirement Homes Regulatory Authority (RHRA). Required since July 2012 for homes meeting definition under Retirement Homes Act, 2010. Annual fee: $14.98/suite/month (April 2025, up $0.39). License not transferable - new owner must reapply. Fire sprinklers mandatory since Jan 2019. License valid as long as fees paid and compliant. Contact: 1-855-275-7472.
• Ontario Business Name Registration (ServiceOntario) Required
  Businesses in Ontario operating under a name other than the owner's legal name must register with Ontario Business Registry through ServiceOntario. This includes sole proprietorships, partnerships, and business names for corporations. Registration provides legal protection for the business name within Ontario and is required for banking, licensing, and business operations. Registration can be completed online through Ontario Business Registry. Business name registrations must be renewed every 5 years. Register business name with Ontario Business Registry: 1. Search Ontario Business Registry (free) for name availability 2. Consider NUANS name report ($25) for thorough search 3. Register online through Ontario Business Registry 4. Pay registration fee ($60 for sole proprietorship/partnership) 5. Receive 9-digit Ontario Business Identification Number (BIN) 6. Registration valid for 5 years 7. Renew before expiry
• Ontario Long-Term Care Home Licence Required
  Long-term care homes (nursing homes) providing 24-hour nursing care must be licensed by provincial health ministries. Licensing ensures comprehensive regulatory oversight for vulnerable residents requiring significant medical and personal care. Requirements include facility construction standards, nursing and physician coverage requirements, staff-to-resident ratios, medication management systems, and infection control programs. Homes must implement resident care protocols, dietary standards, recreation programs, and family involvement policies. Licensing standards address resident rights, restraint use, falls prevention, and skin and wound care. Long-term care homes undergo regular inspections (scheduled and surprise), resident quality indicator monitoring, and complaint investigations. Staffing includes registered nurses, licensed practical nurses, and personal support workers with mandatory training. Violations result in compliance orders, administrator penalties, public postings of inspection results, fines up to hundreds of thousands of dollars, and potential license revocation. To obtain a long-term care home licence in Ontario: 1. Confirm eligibility (non-profit, for-profit, hospital, Indigenous, or new with partner) 2. Review Long-Term Care Home Design Manual 2015 3. Review 2025 Long-Term Care Home Capital Development Funding Policy 4. Submit application to Ministry of Long-Term Care 5. Complete capital and licensing approval process 6. Receive licence (valid up to 30 years)
• Occupational Health and Safety Act Compliance Required
  All Ontario workplaces must comply with the Occupational Health and Safety Act to ensure safe working conditions. Requirements include workplace safety policies, training, hazard assessments, and incident reporting. No registration - compliance law. Must post OHSA in workplace. JHSC required for 20+ workers (or 6+ in designated industries). Nov 2025: New administrative penalty scheme, defibrillator reimbursement. Telework now covered. Fines: up to $500K individuals, $1.5M corporations. 27 regulations under OHSA. Must conduct safety audits, maintain training records. Contact: 1-877-202-0008.
• Vulnerable Sector Screening Conditional
  Required if working with vulnerable persons. All staff and volunteers working with children, seniors, or vulnerable populations must undergo police vulnerable sector checks (VSC) for criminal records. Apply through local police service. Required for work/volunteering with vulnerable persons (children, seniors, those requiring care). Police Record Checks Reform Act, 2015 governs process. Need: agency letter describing position. Includes criminal convictions + findings of not criminally responsible. Jan 2025: Broad Record Check via LE213 pathway. Only valid for specific employer/position. Contact local police.
• Group Home and Supportive Housing Regulations Conditional
  Required for group home operations. Group homes and supportive housing facilities must comply with zoning, safety, staffing ratios, care standards, and inspection requirements for residential care settings. Various Acts govern based on population served. Children's residences: CYFSA licensing. Developmental services: MCCSS approval. RHRA for retirement homes (65+). Building Code and Fire Code compliance. Municipal zoning as single family (Human Rights Code). Staff training requirements. Contact MCCSS or specific regulatory body.
• Employment Standards Compliance Conditional
  Applies if you have employees. Covers minimum wage, hours of work, vacation pay, public holidays, termination notice, etc. All Ontario employers must comply with the Employment Standards Act, covering minimum wage, hours of work, overtime, vacation, termination, severance, and other workplace rights. No registration required - compliance-based requirement. Follow Employment Standards Act (ESA) for minimum wage, hours of work, overtime, vacation, leaves, and termination. Post ESA poster in workplace (free download from ontario.ca). Keep employment records for 3 years. NEW for 2025: Employers with 25+ staff must provide written employment info to new hires by July 1, 2025. Job postings must include salary ranges by Jan 1, 2026. Call 1-800-531-5551 for help.
• GST/HST Registration Conditional
  Required if annual taxable revenue exceeds $30,000 (small supplier threshold). Taxi/ride-share drivers must register regardless of revenue. Businesses with gross revenues over $30,000 in any single quarter or over four consecutive quarters must register for, collect, and remit GST/HST. Small suppliers (under $30,000) may register voluntarily. Register FREE online through Business Registration Online (BRO) when your revenue exceeds $30,000 in any 4 consecutive quarters (small supplier threshold). Takes 15-30 minutes. You MUST register within 29 days of exceeding threshold and start charging GST/HST immediately on the sale that made you exceed it. Need your BN (or get one simultaneously). As of Nov 3, 2025, online registration is mandatory. Voluntary registration available anytime for input tax credits.
• Payroll Deductions Registration Conditional
  Required if you pay salaries, wages, or other remuneration to employees. Must register before first pay period. Required if you have employees. You must withhold Canada Pension Plan (CPP), Employment Insurance (EI), and income tax from employee wages and remit to CRA. Register FREE online through Business Registration Online (BRO) when you hire your first employee. Takes 15-20 minutes. You'll need your Business Number (BN) or can get one simultaneously. Payroll account (RP) added to your BN instantly. Register BEFORE your first pay date. Required to deduct CPP, EI, and income tax from employee wages. For 2025: CPP rate 5.95%, EI employee rate $1.66/$100 insurable earnings.
• WSIB Registration and Coverage Conditional
  Required within 10 days of hiring first employee, including family members and subcontractors. Workplace Safety and Insurance Board (WSIB) registration is mandatory for most Ontario businesses with employees. Provides compensation and support for workplace injuries and illnesses. Sole proprietors and partners can apply for optional coverage. Register FREE online at wsib.ca in 15-20 minutes. MANDATORY for most Ontario employers within 10 calendar days of hiring first worker. You'll need: CRA Business Number, payroll estimate, business activity description, owner/director info. Account number issued INSTANTLY online. Construction industry has expanded compulsory coverage. Premium rates vary by industry classification. Must display WSIB safety poster in workplace.
• PHIPA Compliance (Extended Healthcare) Conditional
  Required for specific regulated activities. Healthcare providers, social services, and care facilities must comply with Personal Health Information Protection Act for privacy, consent, security, and disclosure of health information. PHIPA (Personal Health Information Protection Act) applies to health information custodians. First penalties Oct 2025 ($5K-7.5K). New de-identification guidelines. Privacy impact assessments for new initiatives. Consent management. Breach notification to IPC. Retention schedules. Contact IPC: 416-326-3333 or Ontario Health.

Funding & Grants

Available funding programs that may apply to your nursing care facilities (skilled nursing facilities):

• The HIPP provided up to $200,000 over 9 months for Stage 1 proof-of-concept, with Stage 2 covering up to 75% of eligible expenses over up to 3 years (minimum 25% applicant cost-share). Eligible applicants included Alberta post-secondary institutions, government entities, health delivery agents, and for-profit or not-for-profit organizations. The program …
• SUAP provides contribution funding for a wide range of projects including substance use prevention, harm reduction, treatment, and recovery. Individual project awards have ranged from approximately $1.6 million to $6.3 million in recent announcements. Eligible recipients include not-for-profit health organizations, universities, Indigenous organizations, and other levels of government. For-profit organizations …
• CIHR Catalyst Grants are short-term seed grants (up to 1 year) designed as a first step toward larger, longer-term research projects. The Digital Health stream specifically targets early and mid-career researchers and Indigenous Health researchers working on digital health technologies. Application deadline: March 17, 2026. Total pool: $1,000,000 (approximately 10 …

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