In April 2026, the Alberta government announced a $400 million expansion of new facility-based continuing care spaces, including long-term care and supportive living.

With the addition of 1,100 new continuing care spaces, this is one of the largest expansions of seniors’ care in the province’s history. In Alberta, the broader category of facility-based continuing care includes long-term care, designated supportive living, and hospice care.

This analysis takes a closer look at the province’s Continuing Care Capital Program (CCCP), which was created to provide capital funding grants to developers and operators of existing and new facilities. The CCCP has received little scrutiny, even though it involves the transfer of significant public dollars into private hands.

Key facts

  • Alberta’s Continuing Care Capital Program was established in 2021 with three streams: the new capacity stream; modernization stream; and Indigenous stream.
  • In April 2026, the first round of capital grants under the new capacity stream were awarded to 11 providers for “shovel-ready” projects. 
  • While nine of the 11 operators were publicly disclosed or could be obtained through public searches, there is no publicly available information for the recipients of two large grants (Belle Rive Multi-Generational Housing, $62.3 million, and Evergreen Care Village, $40.5 million). 
  • The government of Alberta did not respond to multiple emails regarding the government’s Continuing Care Capital Program and did not provide basic information about the names of the operators receiving grant funding.
  • From the limited information available publicly, the first round of public capital grants under the new capacity stream favour for-profit operators, which will receive 38 to 64 per cent of new capital funding. 
  • The government will provide 38 per cent of funding ($154.2 million) to for-profit operators, alongside 26 per cent of the new funding to unknown operators—likely also for-profits based on land title and rezoning applications.
  • In Alberta and across high-income jurisdictions where seniors’ care has been marketized, investors are interested in facility-based seniors’ care facilities as financial commodities because it is real estate intensive and provides consistent and significant government revenue.
  • This is a significant transfer of public wealth into for-profit seniors’ facilities where the research has shown that care outcomes are generally inferior to care provided in public and not-for-profit facilities. 

Relevant background

The Continuing Care Capital Program (CCCP) was established in 2021 with three streams: the new capacity stream; modernization stream; and Indigenous stream. The CCCP followed the Facility-Based Continuing Care Review, conducted by the private sector consulting firm MNP, and released in May 2021. That review made 42 recommendations, including phasing out shared occupancy rooms and a greater emphasis on home care over facility-based care. 

The review was not aligned with a large body of research evidence that has found that facility ownership (public, non-profit, or for-profit) is a key determinant of care quality. 

The MNP-commissioned review made passing mention of the empirical research from the beginning of the COVID-19 pandemic showing that for-profit facilities had higher death rates than public and non-profit facilities, but the review went on to make the unfounded claim that “[a] diversity of ownership types … uniquely contribute[s] to the diversity, efficiency, and effectiveness of the Alberta continuing care system.”

The Facility-Based Continuing Care Review did, however, recommend that the Alberta government increase the number of direct care hours provided in long-term care and designated supportive living (also called assisted living in some provinces).

In 2022, the Alberta government introduced new continuing care legislation, and this new framework came into effect in April 2024. The new Continuing Care Regulation eliminated previous legislation that required provision of a minimum of 1.9 hours of nursing and personal care per day to residents. 

The Alberta government also established new categories for facility-based continuing care services, which were named Type A (formerly continuing care homes and auxiliary hospitals), Type B (formerly designated supportive living), and Type C (hospice care). 

The broad effect of these changes has been greater deregulation of seniors’ facility-based continuing care. It has opened the door for greater profit-taking opportunities and blurred the boundaries between different forms of facility-based care, which historically had distinct staffing level requirements. 

For decades, Alberta has been on the forefront of deregulating seniors’ facility-based care through the original creation of “designated supportive living”—which was adopted in B.C. in 2002 as its assisted living model with minimal staffing requirements. These recent changes further reduce care standards.

In 2023, the provincial government awarded two charitable non-profit facilities with $240 million through the modernization capital grant stream to modernize their facilities, including phasing out shared rooms.

In April 2026, the province awarded the first round of capital grants under the new capacity stream to 11 providers for “shovel-ready” projects (Table 1). While nine of the 11 operators were publicly disclosed or could be obtained through public searches, there is no publicly available information for the recipients of two large grants (Belle Rive Multi-Generational Housing and Evergreen Care Village). The Alberta government’s Continuing Care Capital Program failed to respond to multiple emails requesting basic information about the names of the operators receiving grant funding. 

Together, these two projects represent 26 per cent of the $402 million capital funding. Review of land title searches and rezoning applications suggest that these will be for-profit facilities built as part of new residential developments.

Notably, none of the capital grant funding is going to publicly owned facilities as Alberta Health Services has been entirely excluded from this round of capital grant funding. This is concerning because a large research study using administrative data in B.C. showed that publicly owned facilities had better outcomes than for-profit and even non-profit long-term care homes (see subsequent section for more detail).

Public capital funding favours the for-profit industry

From the limited information available publicly, the first round of capital grants under the new capacity stream favour for-profit operators, which will receive 38 to 64 per cent of new capital funding (Figure 1). At least 38 per cent of funding ($154.2 million) will be provided to for-profit operators, but another 26 per cent of the new funding has been awarded to unknown operators—which are likely for-profits based on the locations, land titles, and rezoning applications. In sum, $257 million of $402 million in public capital funding will likely flow to investor-owned facilities. 

This is a significant transfer of public wealth into for-profit seniors’ facilities where the research has shown that care outcomes are generally inferior to care provided in public and not-for-profit facilities. 

For-profit and chain ownership associated with inferior quality

A large body of academic research demonstrates that staffing levels and staffing mix are key predictors of resident health outcomes and care quality, and that care provided in for-profit long-term care facilities is generally inferior to that provided by public and non-profit-owned facilities. High staff turnover, which is linked to lower wages and the heavy workloads demanded by inadequate staffing levels, is associated with lower-quality care in for-profit facilities.

The government’s decision to exclude publicly owned facilities from the Continuing Care Capital Program is a political decision not aligned with the research evidence, and means that Alberta taxpayers are getting poorer value for public dollars invested. 

A large research study using administrative data in B.C. showed that publicly owned facilities had better outcomes than for-profit and even non-profit long-term care homes. In that study of 49,799 residents in 304 long-term care facilities (116 publicly owned, 99 for-profit, and 89 non-profit), risk of hospitalization was higher for residents in for-profit facilities (i.e., when care home residents are transferred to hospital due to deteriorating health status or adverse events like falls).

This study suggests that investment in publicly-owned facilities is better for care home residents and a more prudent financial decision. Investment in publicly-owned facilities, then, provides better value for money because of the lower relative risk of hospitalization and lower relative costs to the health care system. When hospitalizations can be prevented, it also reduces hospital overcrowding, which is already a serious problem in Alberta.

A 2023 report by the Office of the BC Seniors’ Advocate found considerable differences in how publicly funded non-profit and for-profit-owned long-term care facilities allocated resources on staffing, which helps explain why outcomes are likely to be worse in for-profit owned facilities. In B.C., non-profit  facilities spent 25 per cent more per resident on direct care than for-profit facilities, and non-profit facilities delivered 93,000 hours more care than they were funded to deliver while for-profit facilities delivered 500,000 less hours than they were funded to deliver. This raises serious questions about the business model underpinning for-profit care delivery.

Another key finding from research on B.C.’s long-term care sector is the considerable differences in how non-profit and for-profit facilities allow public funding on capital expenses.  For-profit facilities spent 42 per cent more per bed on capital building costs than non-profit facilities, demonstrating that public dollars are disproportionately going towards the real estate portfolios of investors. 

It is not only the for-profit status of facilities, but for-profit facilities that are part of corporate chains have been shown to have worse outcomes. While the growth of chains has received less attention in the health services research in Canada, a prominent U.S. study found that “the top 10 for-profit chains received 36 per cent higher deficiencies and 41 per cent higher serious deficiencies than government facilities, [with] [o]ther for-profit facilities also [having] lower staffing and higher deficiencies than government facilities.”

Alberta’s capital funding program is a gift to real estate investors

In Alberta, across Canada, and in high-income countries where seniors’ care has been marketized, investors are interested in facility-based seniors’ care facilities as financial commodities because it is real estate intensive and provides consistent and significant government revenue.

Corporate chain involvement and concentration in seniors’ care is a reflection of financialization in facility-based seniors’ care. Financialization occurs when ownership of continuing care facilities by companies that have a mandate to maximize returns for external shareholders. These may include publicly traded companies, real estate investment trusts, private equity firms, pension funds, and other privately-held firms that treat seniors’ care as a commodity and an asset class.

As of 2020, financialized corporations in Canada owned approximately 33 per cent of seniors’ facility-based care/housing in the country, including 42 per cent of retirement units (typically no direct care provided) and 22 per cent of long-term care beds. Alberta’s CCCP is a significant expansion of for-profit continuing care beds owned by financialized chains. 

Up to 64 per cent—or $257 million—of new capital funding will be a direct transfer of public dollars into private real estate portfolios. Considering the potential corruption associated with public procurement of private health care services in Alberta, the provincial government should, at a minimum, provide basic ownership information about the companies receiving these significant public funds. 

Full transparency is a starting point, but still does not resolve the fundamental problem that for-profit long-term care is inferior to care provided in publicly owned facilities. It is a poor use of public tax dollars. We must ask why would Albertans foot the bill for inferior care that the evidence shows also increases health care costs through increased hospitalizations.

The large expansion of for-profit care will, however, benefit a handful of increasingly powerful corporate players and their real estate portfolios.

About the author

Andrew Longhurst

Andrew Longhurst is a senior researcher and political economist, with a focus on health policy, at the Canadian Centre for Policy Alternatives. His work has been published in academic journals and by research institutes, including Canadian Journal on Aging, Political Geography, the CCPA, and the Parkland Institute.