Quebec’s long-term residential care system, known as CHSLDs, faces serious challenges due to aging infrastructure, rising demand, and systemic inefficiencies. The system includes public CHSLDs with 29,668 beds, private funded CHSLDs with 6,800 beds across 63 facilities, and private unfunded CHSLDs for semi-autonomous seniors who pay out-of-pocket. Placement is determined by the ISO-SMAF profile, which ranks autonomy and prioritizes those with severe impairments (profiles 10 to 14). Despite this, waitlists remain long, with 649 people in Montreal awaiting placement. In 2019, the Quebec government launched a $2.8 billion plan to renovate 2,500 CHSLD spaces and add 3,468 new ones by 2026 through Maison des Aînés, Maison Alternative, and combined MDAA facilities that provide private rooms and culturally inclusive care. Despite representing over half the province’s population, Montreal is set to receive only 144 new beds before 2025. Insufficient capacity forces patients to occupy hospital beds unnecessarily. A hospital bed costs $1,127 per night, while a CHSLD bed costs $64. Annually, 2.4 million hospital days are attributed to these patients, suggesting a potential savings of $2.55 billion if they were transitioned into long-term care.

This project proposes rehabilitating a vacant Class C office building at 575–577 Henri Bourassa Blvd, Montreal, through Deep Energy Retrofit to expand CHSLD capacity in dense urban areas. This strategy offers a sustainable, cost-efficient alternative to new construction, transforming underused, low-performance buildings into energy-efficient, high-comfort care environments. Upgrading envelopes, systems, and insulation improves energy performance and supports provincial climate goals. Simultaneously, it revamps outdated building stock across Quebec. Adapting deep office floor plates allows for modern care layouts with private rooms, communal spaces, and full accessibility. In cities like Montreal, where land is limited, this model accelerates care infrastructure delivery and reduces emissions.