Terrahills delivers long-term care homes, retirement residences, medical office buildings and community health facilities across Ontario. Group B institutional construction under OBC Part 3, designed to the Ministry of Long-Term Care Capital Funding Program, built with the infection-control discipline of our EU-GMP pharmaceutical work.
As of April 2026 Ontario has 165 long-term care projects completed, under construction or approved, representing 26,421 new and redeveloped beds, and the province has acknowledged it is unlikely to reach its 58,000-bed target by 2028. That is a capital program that will run well past this decade, concentrated where the aging population is. It is also a program with a specific delivery logic: the Capital Funding Program funds to 800 sq ft per bed at a maximum eligible cost per bed set by location tier, and the Construction Funding Subsidy that repays the capital is paid per bed per day for 25 years after first admission. Schedule to admission matters as much as build cost.
A long-term care home is Group B institutional occupancy: non-combustible construction at the building areas typically involved, fire-resistance-rated separations, sprinklered throughout, with the Ministry's Design Manual layered on top for resident home areas, dining and bathing. Where the project is a redevelopment on an occupied campus, Infection Control Risk Assessment protocols govern how construction and residents coexist. Our regulated-environment experience (cleanable surfaces, zoned areas, documentation prepared for inspection during construction rather than after) translates directly.
Terrahills manages the design team, the Ministry submission and the municipal site plan in parallel rather than in sequence, and carries the whole scope under one contract: land, approvals, servicing, structure, envelope, fit-out and commissioning to first admission.
Healthcare construction in Ontario operates under overlapping oversight: Ontario Building Code Part 3 institutional requirements, Ministry of Long-Term Care standards, Ministry of Health facility guidelines, and Infection Control Risk Assessment protocols for occupied facilities. We manage those requirements within one contract, including healthcare fit-outs and regulated-environment construction.
Our EU-GMP certified pharmaceutical facility in Ramara is the proof: a regulated environment with infection-control-grade finishes, zoned production and documentation delivered for regulatory sign-off during the build. The same discipline a long-term care home requires.
Six stages, one contract
The same delivery model as every Terrahills project (land, approvals, servicing, structure, envelope, handover) applied to what a healthcare building actually requires.
Confirm the Capital Funding Program tier for the site, the bed count the parcel and servicing can support, and the schedule to first admission that the Construction Funding Subsidy depends on.
Coordinate the architect and engineers to the MLTC Design Manual and OBC Part 3 Group B requirements; run the Ministry design review and municipal site plan in parallel, not in sequence.
Site plan, conservation authority sign-off, and the water and sanitary allocation an institutional building needs, carried as one track with the Ministry milestones.
Non-combustible construction and rated separations built to the classification the design establishes; envelope and mechanical designed for a 24-hour occupied building.
Resident home areas, dining, bathing and clinical spaces to the Design Manual; ICRA protocols and phased separations where the campus stays occupied through construction.
Life safety, mechanical and nurse-call systems commissioned and documented for the Ministry and the municipality, so licensing and first admission are not waiting on paperwork.
Markets we know building by building
One sector in one market, with the soils, approvals, funding tiers and pipeline that actually change the job.
Healthcare cost bands, Ontario 2026
| Building type | Hard cost, $ / sq ft | Basis | What moves it |
|---|---|---|---|
| Long-term care home | ≈ $545 – $940 | MLTC 2025 policy, derived | Funding tier: $436,000/bed (southern Ontario) to $750,000/bed (GTHA) at 800 sq ft/bed, capped at $1,100/sq ft eligible |
Derived from the Ontario Ministry of Long-Term Care 2025 Capital Funding Policy: maximum eligible project cost per bed by tier, funded on 800 sq ft per bed with an eligible-cost ceiling of $1,100/sq ft. Medical office and retirement residences are priced per project. Hard costs only.
Questions clients ask about healthcare & long-term care construction
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