Last year, during the holiday season, Jack MacTavish, aged 92, was admitted to Foothills Medical Centre in Calgary for treatment of congestive heart failure, a urinary tract infection, and later, pneumonia. At that time, he was residing in a seniors’ home in northwest Calgary with his 93-year-old wife, according to his daughter, Joan MacTavish.
Joan mentioned that hospital staff informed her after weeks of care that her father would need to be transferred to a supportive living facility. She was asked to sign a form agreeing to pay nearly $70 per day while her father awaited an available spot.
Expressing her frustration and disappointment, Joan questioned the necessity of the fee, as she believed her father’s care in the hospital should be covered by Alberta health care.
The Alternative Level of Care (ALC) Accommodation Charge, implemented in Alberta since 2015, applies to patients who no longer require acute care, are medically stable, and are awaiting placement in continuing care facilities. The daily fee, currently set at $69.20 for a shared room by the Alberta government, is intended to cover costs similar to those in a continuing care setting.
University of Calgary health policy researcher Lorian Hardcastle sympathized with Joan’s concerns, describing the charge as a difficult situation for patients who are essentially paying to stay in a place they do not wish to be. Hardcastle emphasized the importance of better planning to address the growing demand for continuing care facilities.
While the ALC charge serves to offset accommodation expenses, critics argue that it may also discourage unnecessary hospital stays. Jason Sutherland, a health policy expert from the University of British Columbia, noted that the fee aims to recover costs and deter patients who do not require hospital-level care.
In Alberta, ALC patients accounted for about 14% of hospitalizations in 2025. Sutherland highlighted various reasons for delayed placements, such as lack of suitable community spaces or necessary home modifications.
Despite the government’s efforts to increase continuing care spaces, Edmonton-based health policy consultant Stephen Samis emphasized the need for effective coordination among various care providers. Samis pointed out the challenges in transitioning patients due to the diverse ownership of continuing care homes.
While the Alberta government has seen progress in reducing the number of ALC patients waiting for continuing care, Joan remains unsatisfied with the situation. She feels uncertain about the purpose of the fees and believes she is being unfairly charged without clarity on what the payments cover.