The Big Picture
Facility-based care takes place in buildings designed to provide health care, treatment, and support services. Hospitals and long-term care homes are two important examples, but they serve different needs.
Hospitals often care for people with illnesses or injuries that need timely treatment. Long-term care facilities provide a home, nursing care, and ongoing support for people who cannot care for themselves at home.
Support workers work as part of a health care team in these settings. Their exact duties depend on the setting, their training, supervision, and facility policies.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- A hospital often provides short-term care for people with acute illnesses or injuries.
- An inpatient stays in the facility overnight or longer. An outpatient does not stay overnight.
- A long-term care facility provides accommodations, 24-hour nursing care, and support services for people who cannot care for themselves at home but do not need hospital care.
- Support workers in facilities work as team members and usually report to a nurse. In a recreation department, they may report to the recreation supervisor.
- Never perform a procedure you have not been taught to perform or one you are unsure you can perform safely.
- Privacy, dignity, professional boundaries, respectful care, and facility policies remain important during everyday work.
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Course Notes: Key Ideas You Need to Know
What Facility-Based Care Means
Facility-based settings are workplaces that provide accommodations, health care, and support services.
A health care facility is designed or established to provide specific types of care, treatment, and support. Different facilities provide different services.
Hospitals and long-term care facilities are both facility-based settings, but their purposes and the needs of the people receiving care differ.
Hospitals and Short-Term Care
A hospital provides care for people with acute illnesses or injuries, usually on a relatively short-term basis.
An acute illness starts suddenly and lasts for a short period, usually less than 3 months.
People in hospitals often have serious illnesses or injuries that require:
- timely treatment
- skilled professional care
- complex equipment
Not every hospital hires support workers. When hospitals do employ them, support workers usually report to and receive supervision from a nurse.
Depending on the region and the hospital’s hiring policies, support workers may work in areas such as:
- critical care units, or CCUs
- emergency departments, or EDs
- pediatrics
- hemodialysis
- maternity units
Inpatients and Outpatients
Hospitals provide services to both inpatients and outpatients.
| Term | Meaning |
|---|---|
| inpatient | A client who has a bed and stays in the facility overnight or longer |
| outpatient | A client who does not stay overnight in the facility |
The difference depends on whether the person stays overnight.
Support Worker Duties in Hospitals
A hospital support worker’s role may include basic care such as:
- feeding
- transporting people
- taking specimens to the laboratory
- measuring vital signs
In some hospitals, support workers may assist nurses before, during, or after medical or surgical procedures.
A support worker may perform other tasks when the nurse requests and supervises those tasks.
Role limit: Support workers usually do not provide care to clients whose conditions are unstable. In areas such as the CCU or ED, they may assist the nurse with moving, turning, or bathing a client.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition uses the broader term support worker when describing hospital roles. In Nova Scotia, the Continuing Care Assistants Registry Regulations use the term care team assistant (CTA) for a person employed in a collaborative acute care team within a health authority to support patients with activities of daily living and instrumental activities of daily living. The regulations include care team assistants in the definition of a certified continuing care assistant. (novascotia.ca)
This definition is specific to employment in a collaborative acute care team within a health authority. (novascotia.ca)
Why this matters in Nova Scotia: You may see the term care team assistant in Nova Scotia acute care, while Sorrentino uses the more general term support worker.
Official source: Continuing Care Assistants Registry Regulations
Last checked: August 30, 2026
Services Found in Hospitals and Other Facilities
Hospitals may provide several types of care, including:
- acute care
- subacute care
- complex continuing care
- respite care
- rehabilitation services
- palliative care
- mental health services
Not every hospital offers every service. Some communities provide these services through separate facilities that specialize in particular types of care.
Some specialized facilities require additional education and also provide that education.
Complex Continuing Care and Subacute Care
Complex continuing care is comprehensive inpatient care for people recovering from:
- surgery
- injury
- an acute illness
- an exacerbation of a disease process
Complex continuing care is also called:
- subacute care
- convalescent care
- transitional care
Some long-term care facilities have subacute care units. A person might stay in one of these units while recovering after surgery when they are not yet able to return home.
Respite Care
Respite care provides temporary care for a person who needs a high level of care, supervision, and support.
Its purpose is to give caregivers a break from their caregiving duties.
Respite care may be available through a hospital, a specialized facility, or some long-term care facilities.
Palliative Care
Palliative care supports clients and families when an illness cannot be cured.
Its goal is to improve the client’s quality of life by managing pain and other distressing symptoms.
Palliative care services may be available in hospitals and some long-term care facilities.
What Long-Term Care Provides
A long-term care facility provides:
- accommodations
- 24-hour professional nursing care
- support services
It serves people who cannot care for themselves at home but do not need hospital care.
Long-term care facilities are also known by names such as:
- nursing homes
- homes for the aged
- long-term care homes
- special care homes
Other names include chronic care facility and continuing care facility. In some provinces, the term complex care facility is also used.
The term long-term care refers to medical, nursing, and support services provided over months or years to people who cannot care for themselves. It is also known as chronic care or continuing care. In some provinces, it is also called complex continuing care.
Long-term care facilities provide a higher level of care than retirement residences and assisted-living facilities.
Who Lives in Long-Term Care?
Most long-term care residents are frail older people who have several health issues.
Some residents are young or middle-aged adults living with severe chronic health conditions or disabilities.
The goals of long-term care include maintaining each resident’s health and independence as much as possible. Facilities also work to meet residents’:
- physical needs
- emotional needs
- social needs
- intellectual needs
- spiritual needs
Living Spaces and Services
Residents may live on a ward or in private or semi-private bedrooms.
Rooms usually have a toilet and sink. Tubs and showers are generally located in shared bathrooms.
Long-term care facilities provide nursing care and access to medical and rehabilitative care. They also provide services such as:
- help with personal care and activities of daily living, or ADLs
- meals
- laundry
- recreational activities
- social activities
How Long-Term Care Facilities Operate
Long-term care facilities are licensed, regulated , and funded by the province or territory where they operate.
Medicare covers some costs. Residents pay the remaining balance through a monthly fee.
Residents also pay for some personal expenses, including:
- clothing
- toiletries
- hairdresser services
- special nail care services
- other incidentals
Government and charitable organizations operate some facilities on a not-for-profit basis . Private organizations operate other facilities on a for-profit basis.
Each facility hires its own staff.
Nova Scotia CCA Note
In Nova Scotia, long-term care is provided in two types of homes: nursing homes and residential care facilities. The provincial government and the resident share the cost of long-term care. (novascotia.ca)
The province pays health care costs for resident care. Residents pay accommodation charges and personal expenses. A resident who qualifies may receive a reduced accommodation charge after an income-based financial assessment. (novascotia.ca)
Why this matters in Nova Scotia: Sorrentino gives a broad description of long-term care costs. Nova Scotia separates provincially funded health care costs from the accommodation and personal costs paid by residents.
Official source: Paying for Long-Term Care in Nova Scotia
Last checked: August 30, 2026
The Support Worker on the Long-Term Care Team
Long-term care facilities often have structured work environments because they serve many residents with different physical or other disabilities.
Support workers are members of the health care team and report to a nurse.
Nurses plan and coordinate resident care. Support workers provide personal care and help residents with ADLs.
Support workers also contribute important information to care planning. Their observations give the team useful information about residents’ daily needs and possible changes in health.
During family conferences, support workers provide feedback based on their observations of the resident.
Special Units in Long-Term Care
Some long-term care facilities contain special units.
A facility might have:
- a subacute care unit for people recovering after surgery
- a dementia care unit for people living with Alzheimer’s disease or other dementias
- a respite care unit
- a palliative care unit
Support workers may work in these units. Extra training may be required.
Recreation Work
Support workers may also work in a facility’s recreation department.
They may help organize and carry out recreational activities and outings.
In this role, the support worker reports to the recreation supervisor.
Working as Part of a Facility Team
Facility work gives support workers regular contact with skilled health care professionals.
In live-in facilities, support workers usually spend more time with residents than nurses and physicians do. This gives support workers valuable observations about residents’ daily needs and possible changes in health.
Support workers have useful information to contribute during team meetings.
Managing Several Needs at Once
Facility work often involves responding to several residents’ needs and requests.
You may not be able to respond to every demand immediately. Support workers need to prioritize clients’ needs and manage their time.
Facility work also requires:
- flexibility
- diplomacy
- consistency
- organizational skills
- communication skills
Caring for People in Distress
Clients and families in facilities may experience strong emotional or physical distress .
A person may be in pain, afraid, upset, or angry. The person might also resist cooperating with care providers.
Support workers should remain calm and professional regardless of how the client expresses distress. They should also remain sensitive to the person’s feelings and try to understand how the person feels.
During palliative care, support workers need to remain supportive in the presence of intense suffering and emotions.
Completing Many Tasks in Limited Time
Facility work often requires support workers to complete many tasks within a short period.
Support workers must provide thorough, competent, and respectful care even when they have many tasks to complete in a short time.
This work requires self-discipline, dedication, and efficiency.
Respect Your Role and Scope of Practice
Working closely with nurses may expose support workers to many nursing procedures. Familiarity with a procedure does not mean the support worker should perform it.
A support worker might be asked to perform a procedure that falls outside their scope of practice or one that should be delegated.
Never: Attempt a procedure you have not been taught to perform.
Also, never attempt a procedure when you are uncertain about how to perform it safely.
Perform only procedures permitted under the facility’s policies.
Your supervisor must be allowed to train you on the procedure and must provide enough training for you to feel comfortable performing it.
Facilities have written policies to guide workers.
Nova Scotia CCA Note
Nova Scotia separates a CCA’s scope of practice from their scope of employment. Scope of practice describes the roles, responsibilities, functions, competencies, and limits that come from CCA education. Scope of employment describes the job-specific work an employer defines through job descriptions and policies. (novascotia.ca)
Nova Scotia’s CCA framework describes three levels of function: independent care, client-specific assignment, and delegation. Routine ADLs and IADLs may fall under independent practice when they fit the CCA’s education, competence, scope of practice, scope of employment, and established care plan. Client-specific assignments involve non-routine care within the CCA’s scope and require direction and supervision from a regulated health care professional. Delegation applies when an intervention is outside the CCA’s educational preparation and scope of practice but has been approved by the employer, and the CCA has received the required additional education and has been deemed competent. (novascotia.ca)
A CCA must not work outside their scope of practice, scope of employment, or the employer’s policies and procedures. A CCA performing a client-specific assignment or delegated function works under the direction or supervision of a regulated health care professional. A delegated intervention is specific to the client or situation and is not transferable. (novascotia.ca)
Why this matters in Nova Scotia: Sorrentino gives a general warning about training, supervision, and facility policy. Nova Scotia adds specific rules for scope of employment, client-specific assignments, and delegation.
Official source: CCA Scope of Practice and Competency Framework
Last checked: August 30, 2026
Shift Work
Most facilities operate throughout the entire day.
Support workers may work evening or night shifts. Depending on the agency, shifts may last from 8 to 12 hours.
Some workers enjoy the variety of changing shifts. Other workers have difficulty adjusting their sleep and lifestyle habits.
Some workers with families may value schedules that give them time to take part in their children’s activities.
A Live-In Facility Is the Resident’s Home
A live-in facility serves as the resident’s home.
Staff should treat the setting with the same respect they would give a person’s home. Support workers should take care with residents’ personal belongings.
Every staff member must help create a positive, homelike environment.
Protect Privacy and Dignity
Support workers must respect privacy and dignity in every work setting.
During personal care:
- knock on the door
- announce your presence before entering
- screen the area carefully
- keep the resident covered
Lack of privacy may lead to loss of self-esteem, especially during personal care.
Privacy also includes keeping conversations about the resident confidential and professional.
Support workers should respect residents’ property and recognize each resident’s right to express personal preferences.
Maintain Professional Boundaries
Support workers sometimes provide care to residents who have few close personal relationships.
Spending a great deal of time together may lead to strong attachments.
Support workers should remain caring and supportive without becoming too personally involved with residents or their families.
The main responsibility remains providing care while maintaining a professional attitude.
Exam Clue Words
- Never: Do not attempt a procedure you have not been taught to perform or one you are uncertain about performing safely.
- Only: Perform procedures permitted by the facility’s policy.
- Usually: Support workers usually do not provide care to hospital clients whose conditions are unstable.
- May: A support worker may assist a nurse with moving, turning, or bathing an unstable client in areas such as the CCU or ED.
- Must: Support workers must respect clients’ privacy and dignity.
Common Mix-Ups
| Wrong Idea | Better Idea |
|---|---|
| An inpatient and outpatient both stay overnight. | An inpatient stays overnight or longer. An outpatient does not. |
| Long-term care provides the same type of care as a hospital. | Long-term care supports people who cannot care for themselves at home but do not need hospital care. |
| Support workers plan and coordinate resident care in long-term care. | Nurses plan and coordinate care. Support workers provide personal care, help with ADLs, and contribute observations. |
| Knowing how a nursing procedure looks means a support worker should perform it. | Perform only procedures you were taught to perform and that facility policy permits. |
| Caring about a resident means becoming personally involved with the resident or family. | Remain caring and supportive while maintaining professional boundaries. |
Fast Review
Facility-based work changes depending on the type of facility, the people receiving care, and the worker’s role. Focus on the differences between settings and the rules that guide support worker practice.
- A hospital usually provides short-term care for people with acute illnesses or injuries.
- An acute illness begins suddenly and usually lasts less than 3 months.
- An inpatient stays overnight or longer. An outpatient does not stay overnight.
- Hospitals may provide acute, subacute, complex continuing, respite, rehabilitation, palliative, and mental health services.
- A long-term care facility provides accommodations, 24-hour nursing care, and support for people who cannot care for themselves at home but do not need hospital care.
- Long-term care aims to maintain residents’ health and independence as much as possible while meeting several areas of need.
- In long-term care, nurses plan and coordinate resident care. Support workers provide personal care, assist with ADLs, and contribute observations.
- Support workers may work in specialized units, and extra training may be required.
- Never perform a procedure you have not been taught or one you are unsure how to perform safely.
- Perform only procedures allowed under facility policy and after sufficient permitted training.
- Protect privacy by knocking, announcing your presence, screening the care area, covering the resident, and keeping discussions confidential and professional.
- Remain caring and supportive while maintaining professional boundaries with residents and families.
Final Pep Talk
There are several settings, services, and role limits to separate here, so give yourself time to sort them into groups. Focus first on hospital versus long-term care, inpatient versus outpatient, and what a support worker is permitted to do.