About Alternate Levels of Care

It is important that staff who manage ALC wait times understand key definitions and concepts:

Provincial ALC Definition

ALC Wait Time Measurement

ALC wait times are measured as follows: an ALC wait time is the number of days from ALC Designation Date to a specified point in time. Refer to the ALC Reference Manual for additional information (ATC Information Site).

Important: All Acute Care Episode (ACE) periods are subtracted from a patient’s ALC Wait Time.

Acute Care Episode (ACE) Period

When a patient requires the intensity of resources/services provided in their current bed type, they are not considered to be ALC. If a patient who has been designated ALC, has a change in their medical condition such that the ALC definition no longer applies, the patient’s ALC waitlist entry should be discontinued using the Discontinuation Reason of ‘Change in Medical Status’. Selecting this discontinuation reason places a temporary pause on ALC wait days assigned to the patient, referred to as an ‘Acute Care Episode (ACE) period.’

The start date of an ACE period is equivalent to the Discontinuation Date when the ‘Change in Medical Status’ ALC Discontinuation Reason is selected. The ACE period ends, if and when the patient’s condition has been stabilized enough to meet the ALC provincial definition and the physician or delegate makes the decision to re-designate the patient ALC. Please Note that a patient can only be re-designated ALC if their wait-list entry was discontinued using the ALC Discontinuation Reason of ‘Change in Medical Status.’ A waitlist entry may have more than one ACE periods.

ACE System Application

In the WTIS, a patient’s ALC wait list entry can be discontinued using the ALC Discontinuation Reason of ‘Change in Medical Status’ and be re-designated ALC multiple times. However, there is a system rule that prevents a waitlist entry to be re-designated after 40 days have passed between the discontinuation date and the date when the waitlist entry is updated for re-designation. In this scenario, a new waitlist entry would be created where the original ALC Re-designated Date will be the used as the new waitlist entry’s ALC Designation Date.

ACE example

A patient designated ALC has experienced a Change in Medical Status on June 1, 2018, such that they no longer meet the requirements to be designated ALC. On June 10, 2018, the patient’s condition stabilized and the physician re-designated the patient’s ALC status. While the patient’s associated ALC waitlist entry was discontinued on the day that the patient has experienced a Change in Medical Status, the ALC Re-designation was not successfully submitted to WTIS until the issue was discovered on August 1, 2018. As more than 40 days have lapsed between June 1 and August 1, the waitlist entry can no longer be re-designated and a new waitlist entry will be created using June 10, 2018 as the ALC Designation Date.