LHIN blames for-profit nursing home industry for lack of available beds

The Central East LHIN is blaming the long term care homes for the current lack of nursing home beds, suggesting at the LHIN’s June 15 board meeting the industry filled the last bed expansion with healthy seniors who didn’t need to be admitted.

The blame comes amid conflict between the LHINs and the for-profit long term care association. The LHIN reports that the association has instructed its membership not to sign accountability agreements with the LHIN pending a fight over disclosure of the nursing homes’ finances.

Remarkably, despite significant public funding, the province has never been able to get audited financial information from the nursing homes. The for-profit industry has maintained that this is proprietary information. Paul Barker, a senior director with the LHIN, said the province has tried to get this information for 20 years.

Further, CE LHIN CEO Deborah Hammons told her board that the province was pressuring them to keep long term care performance requirements to a minimum for now. The LHINs are interested in the rate of referral of residents in the homes to hospital emergency rooms.

Barker said the industry was opposed to the addition of 20,000 new beds built by the McGuinty government. They were worried the new beds would result in their occupancy rates falling, leading to cuts in funding from the province.

Barker says the concern over occupancy rates led homes to fill their beds with healthy individuals who would not normally be admitted. The impact of the new beds was nullified by this action. Given seniors usually divest themselves of their residences prior to entering a nursing home, there is no way to now clear these beds for more acute residents waiting for access.

Now the LHINs are engaged in a game of “chicken” with the nursing homes. Without signed accountability agreements, the LHINs would be within their rights to stop public funding to these homes. However, at a time when nursing homes in the LHIN are at maximum occupancy, the industry maintains the upper hand.

Given the cheques flow from the Ministry, not directly from the LHIN, it is doubtful whether Queen’s Park would be willing to turn off the funding tap if the LHINs did ask.

Meanwhile, new regulations are expected to “rectify” the spousal reunification policy, pushing spouses further down on the waiting list for beds. The previous policy often admitted spouses before more acute patients in need of a bed. The new regulation is expected to come into effect July 1st.

The Central East LHIN reports that the lack of long term care beds is the biggest driver in high numbers of “alternate level of care” (ALC) patients residing in the region’s hospitals. Peterborough’s new hospital is reported to have the highest number of ALC days while Campbellford has the highest percentage of ALC patients taking up beds at the hospital. The Central East LHIN has the second highest percentage of residents over 75 in Ontario.

The Central East LHIN acknowledged lengthening wait lists for long term care, but said these long waits were only for patients waiting at home. There was no wait for patients being transferred directly from hospital, they said. Given the LHIN has a “home first” policy; many of the patients waiting at home would likely have come from the hospitals.

At the beginning of the June 15 board meeting, Peterborough-area board member Stephen Kylie tried to introduce a motion to require the LHIN to do a comprehensive analysis on the long term care situation given the pressures on his local hospital. Board Chair Foster Loucks persuaded Kylie to treat the initiative as a notice of motion to be dealt with at the next meeting.