Ontario to fully fund nursing homes despite lower occupancies

Theglobeandmail.com
June 24, 2020
Jill Mahoney and Karen Howlett

The Ontario government is paying nursing homes for empty beds while banning new residents from having more than one roommate, leading to concerns that long-term care waiting lists will grow.

As a result of the COVID-19 pandemic, the province is providing long-term care operators with full funding for the 2020 calendar year regardless of their occupancy rates.

Ontario long-term care homes have been hit hard by the coronavirus, with more than 1,800 residents dying from COVID-19. Facilities with active outbreaks are not allowed to admit new residents to prevent the spread of disease.

David Williams, the province’s Chief Medical Officer of Health, issued a directive this month preventing long-term care homes from accepting new residents or re-admitting previous residents to ward rooms, where three or four individuals share one room and bathroom. The order does not affect existing residents who live in ward rooms.

The government is providing long-term care facilities with full funding this year regardless of their occupancy rates “in recognition of the impact of efforts to contain the spread of COVID-19,” Gillian Sloggett, a spokeswoman for Long-Term Care Minister Merrilee Fullerton, said in an e-mail.

The funding will cover beds that are left empty in ward rooms as a result of Dr. Williams’s June 10 order, Ms. Sloggett said. The government provides $180.80 a resident per day, or $65,992 a year, to cover costs including food, nursing and personal care.

“As Minister Fullerton has shared on a number of occasions, ward rooms and congestion have amplified the person-to-person and asymptomatic spread of COVID-19 in our long-term care homes, badly exacerbating this crisis,” she said. “These are long-standing structural and capacity issues that, coupled with a severe staffing shortage that predates the virus, have led to the tragedy we have seen in our homes.”

The Ontario Long-Term Care Association supports the ban on moving residents into ward rooms, said chief executive officer Donna Duncan, adding the homes hardest hit by the coronavirus were those with three and four beds to a room, leaving them with little ability to isolate healthy residents from those sickened with COVID-19.

“We saw a crisis in the making,” she said.

Ms. Duncan stressed that private, for-profit owners of seniors’ homes cannot make money from the government portion of their funding. Rather, she said, their profits come from residents’ co-payments.

“The co-pays have disappeared with the empty rooms,” she said.

The Ontario government should not be giving full funding to for-profit corporations that now have fewer residents to care for, said Innis Ingram, whose mother lives at Camilla Care Community, a 236-bed home in Mississauga that has lost 68 residents to COVID-19.

“It certainly doesn’t seem right,” he said.

However, Jane Meadus, a lawyer at the Advocacy Centre for the Elderly, said long-term care homes need stable government funding to maintain operations and properly care for residents.

“I think that to do anything else would, in most cases, really have detrimental effects on the people in the homes,” she said. “We already know that homes are under-staffed so I think that we need to ensure that the people who are living there now are safe.”

Restricting admissions to single- and double-occupancy rooms will exacerbate a chronic shortage of long-term care beds in Ontario, Ms. Duncan said. When the pandemic began in March, 36,000 people were waiting to move into long-term care.

According to an analysis done by the Ontario Long-Term Care Association, the government’s ban on new admissions to ward rooms will eliminate 4,303 beds, representing 5.5 per cent of the province’s total.

The association, which represents a majority of Ontario’s long-term care homes, is calling on both the federal and provincial governments to provide funding to build new homes and modernize existing older ones. Slightly less than one-third of the 78,372 beds in Ontario are in ward rooms. They are classified as “C” homes, meaning they meet the provincial Ministry of Long-Term Care’s 1972 design standards.

Daniel Pollak, press secretary to federal Seniors Minister Deb Schulte, said Ottawa will continue to work with provinces and territories “to address pressing needs in long-term care facilities.”

In addition, hospital beds in Ontario are quickly filling up again, primarily because of seniors who cannot be transferred to unsafe nursing homes. During the first wave of the pandemic, hospitals freed up beds by postponing non-emergency surgeries and discharging many patients to long-term care homes.

“We are worried about a second wave,” Ms. Duncan said. “Both long-term care and hospitals could see surges.”

Anthony Dale, president of the Ontario Hospital Association, said the number of alternate-level-of-care patients, which is how the health care system describes those who no longer need acute care but have nowhere else to go, reached a historic high of 5,300 as of Monday.

“We really feel that it underscores the need for concrete contingency plans to give hospitals and the system some flexibility for the second wave,” he said.

The sector needs to look at housing patients in hotels and other buildings, Mr. Dale said. In March, the Ontario government gave hospitals the go-ahead to temporarily lease space in other buildings.