Building an Incontinence Supply Program: Product Mix and Budget Planning

Walk into the supply room of a 120-bed long-term care home in Ontario and you will find the same math problem on every manager's desk: roughly 70 percent of residents need continence management, and each one goes through four to eight absorbent products a day. At six changes per resident, that is 15,000 product changes a month before underpads and cleaning supplies enter the picture. The real question is not whether to stock these products — it is which mix, at what volume, and at what cost per change.

Start with categories, not the catalogue

Every continence program rests on four pillars: tab-style adult briefs for residents who are bed-bound, pull-up pants for residents who can stand and transfer, underpads for beds and chairs, and skin-care products such as wipes, cleansers and barrier creams. Homes that standardize on two brief sizes and one underpad size negotiate better unit pricing than buildings carrying eight SKUs from three distributors.

Underpads get used in volumes nobody budgets for. One episode in bed can consume two or three pads, and aides grab whatever is within reach. That is why we recommend pairing a heavy-absorbency disposable underpad with a written change protocol rather than simply ordering more.

A working cost model for a 120-bed home

Here is a monthly model for an Ontario home where 84 of 120 residents are on a continence program, using typical Canadian distributor pricing. Adjust the ratios for your own case-mix, but the proportions hold up across homes.

The largest lever is cost per change, not cost per pack. A $0.10 difference on a brief multiplied by 15,000 monthly changes is $18,000 a year. When you compare quotes from Medline, McKesson or Kimberly-Clark distribution channels, ask for delivered cost per change and per episode — that is the number your board will care about.

Size the program to the building

Small homes and clinics (under 60 beds)

Keep the mix tight. One brief size range, one pull-up size and one underpad SKU will cover nearly every resident, and a single distributor order per month keeps freight sane.

• Stock a four-week buffer; reorder at 25 percent.
• Use the CliniEco urology care kit as a starter bundle to test absorbency levels before committing to case volume.
• Budget roughly $45–$60 per continence resident per month.

Mid-size homes (60–150 beds)

This is where standardization pays. Split briefs and pull-ups at roughly 60/40, add a second underpad size for bariatric or high-output residents, and put wipes on the same purchase order as absorbents so you avoid separate small-order freight charges.

• Negotiate quarterly pricing against a written volume commitment.
• Trial the 60x90cm 5-layer medical underpad with SAP for 90 days and track changes per episode before switching wards.
• Budget roughly $65–$80 per resident per month including skin care.

Large LTC operators (150+ beds)

At this scale you are buying for several buildings, and the mix shifts toward pull-ups because more residents are mobile. Standardize one brief, one pull-up and one underpad across the portfolio, and let each home carry only the sizes its case-mix requires.

• Move to a four-to-six-week rolling forecast with your distributor instead of fixed monthly orders.
• Ask for consignment or vendor-managed inventory on high-volume absorbents.
• Budget roughly $70–$90 per resident per month; per-change cost drops as volume commitments firm up.

Build to the standards inspectors check

Ontario's Fixing Long-Term Care Act, 2021 and O. Reg. 246/22 set explicit expectations around continence care and skin integrity, and the CSA Group's health facility standards (CSA Z8000) shape storage and supply decisions in new construction. The medical devices in this category are regulated in Canada (CliniEco holds MDEL #35334), and ISO 9001-certified manufacturing is the baseline we hold suppliers to. Toronto General and other large teaching hospitals apply the same filter in their own tenders. Keep SDS sheets and device documentation where care aides can actually find them — a missing binder has cost more than one home a deficiency citation.

Ordering cadence that survives flu season

Consumption spikes in winter. Respiratory outbreaks mean more residents confined to bed, which pushes underpad usage up 20 to 30 percent. Build a seasonal buffer into your November order and review it again in February.

Track two numbers every month: cost per change and stockout rate. If either drifts, adjust the mix before you adjust the budget. Start with one ward, measure for a month, then scale the pattern across the building. That is how the numbers stay boring — which is exactly what a supply program should be.

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Related reading: explore our long-term care and home care resources.

start with our underpad buying guide for absorbency, sizing and cost.

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• Building an Incontinence Supply Program: Product Mix & Budget Planning

Frequently Asked Questions

How many absorbent products does an LTC resident go through each day?

Plan on four to eight absorbent products a day for a resident on a continence program, which most homes translate into six changes per resident per day. In a 120-bed home where roughly 70 percent of residents need continence management, that reaches about 15,000 product changes a month before underpads, wipes or barrier creams are counted. Size the budget on that change count rather than on the number of packs ordered.

Which absorbency tiers should a care home keep in stock?

Two brief sizes and one underpad size cover most buildings, with briefs and pull-ups split at roughly 60/40 in a mid-size home. A 3,000 mL brief handles scheduled daytime changes, a 5,000 mL overnight brief holds a single change until morning, and a 50-pack of vacuum-compressed underpads covers bed protection. Buildings carrying eight SKUs across three distributors rarely negotiate unit pricing as well as buildings that standardise on one formulary.

Why do underpads overrun a continence budget?

Because a single episode in bed can consume two or three pads, and care aides grab whatever is within reach. Pair a heavy-absorbency disposable underpad with a written change protocol instead of simply ordering more, then measure changes per episode for a month. Consumption also climbs 20 to 30 percent in winter, when respiratory outbreaks keep more residents in bed, so build that buffer into the November order and review it again in February.

Should the whole building standardise on one brief?

No. One tier for every resident means the night shift double-changes at 2 a.m. while daytime residents wear a product with more capacity than they use. Keep the formulary to two brief sizes and one underpad size, tier the order by shift and resident group, and review the mix quarterly against resident acuity instead of last year's order history.

What does Ontario require for continence care in long-term care?

Ontario's Fixing Long-Term Care Act, 2021 and its general regulation O. Reg. 246/22 set expectations for continence care and skin integrity, and CSA Z8000 shapes storage and supply-room decisions in new construction. Keep safety data sheets and device documentation where care aides can find them, because a missing binder has cost homes a deficiency citation. CliniEco Medical supplies 60 x 90 cm five-layer underpads in facility volumes with documentation that can be attached to the purchase order.

CliniEco Medical is a licensed medical device establishment (MDEL #35334).

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