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Healthcare Construction

Long-Term Care Home Construction in
Toronto, the GTA & Hamilton

Back to Healthcare & Long-Term Care Construction

The Greater Toronto and Hamilton Area carries the highest long-term care capital funding tier in Ontario (up to $750,000 eligible project cost per bed under the 2025 Capital Funding Policy) because it carries the highest land and construction costs. Terrahills delivers long-term care homes and retirement residences across the GTHA under one contract, from site plan through Ministry sign-off and first admission.

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 pipeline that will run well past this decade, concentrated where the aging population is, and the GTHA is the largest share of it. Hamilton alone expects roughly 208 new beds in 2026, another 224 in 2028 and 438 more by 2033.

A long-term care home is Group B institutional occupancy under OBC Part 3: non-combustible construction at the building areas involved, fire-resistance-rated separations, sprinklered throughout, and the Ministry's Design Manual layered on top: resident home areas, dining, bathing, and the 800 sq ft per bed that the Capital Funding Program funds to. Our regulated-environment experience from EU-GMP pharmaceutical work translates directly: infection control, documentation in parallel with construction, and a design team coordinated under one point of accountability.

What is specific to long-term care construction in the GTHA

  • Capital Funding Program: maximum eligible project cost $750,000 per bed in the GTHA, with CFP funding to $637,500 per bed; funded on 800 sq ft per bed and capped at $1,100 per sq ft of eligible cost
  • Construction Funding Subsidy paid per bed per day over 25 years after first admission. The operating model that makes the capital stack work, so the schedule to admission matters as much as the build cost
  • Group B occupancy under OBC Part 3: non-combustible construction, rated separations, full sprinkler protection, and the MLTC Design Manual for resident home areas
  • Infection Control Risk Assessment (ICRA) protocols where the build is a redevelopment on an occupied campus
  • GTHA land cost pushes projects to multi-storey and to tight urban sites; structural steel or concrete with non-combustible cladding at short limiting distances
  • Site plan through the local municipality, with Ministry design review running in parallel. Sequence them, do not stack them

What it costs here

Ontario Ministry of Long-Term Care 2025 Capital Funding Policy: maximum eligible project cost $750,000 per bed in the Greater Toronto and Hamilton Area and $436,000 per bed across the rest of southern Ontario, funded on a maximum of 800 sq ft per bed with an eligible-cost ceiling of $1,100/sq ft. That implies roughly $545–$940/sq ft all-in eligible cost depending on tier.

Proof of delivery

EU-GMP certified pharmaceutical facility, Ramara. Regulated-environment construction with infection-control-grade finishes and documentation delivered for inspection sign-off. CBRE corporate facility management, Toronto: occupied-building construction management.

Healthcare & medical facility construction

FAQ

Questions clients ask about healthcare & long-term care

The Ministry's 2025 Capital Funding Policy sets the maximum eligible project cost at $750,000 per bed in the Greater Toronto and Hamilton Area, funded on 800 square feet per bed and capped at $1,100 per square foot of eligible cost. That implies an all-in eligible cost approaching $940 per square foot for the tier. We produce a Class C estimate against the full scope so the number reflects the site, not just the building.
Group B institutional occupancy under Ontario Building Code Part 3, which brings non-combustible construction at the building areas typically involved, fire-resistance-rated separations and full sprinkler protection. The Ministry of Long-Term Care Design Manual sets the functional requirements on top. The architect of record determines the specifics with the authority having jurisdiction; we build to them.
Yes. Phased construction with Infection Control Risk Assessment protocols, temporary separations, and sequencing that keeps resident areas isolated from construction dust and noise. It is slower than a greenfield build and has to be planned that way from the start.