Good discharge laws badly practiced for long term care

The laws governing hospital discharge and admission into long term care (LTC) homes are good but they are badly practiced by hospitals, says Judith Wahl, the Executive Director and Senior Lawyer at the Advocacy Centre for the Elderly (ACE).

Speaking in Toronto June 20th at the High-Level Briefing and Summit on Retirement Homes and Alternate Level of Care (ALC), Wahl was critical of practices that violated existing legislation, calling them unethical.

Some hospital discharge policies include statements that if a person refuses to pick from their short list of nursing homes they must take the first available bed that becomes available or face punitive fees.

An elderly patient was threatened with $1,800-a-day fees from a Toronto area hospital, and a Windsor hospital threatened to charge $600 a day if a patient refused to take the first open bed in a nursing home.

Wahl says it is her opinion that this is illegal.

Hospitals are permitted to charge $53 a day. That rate is also subject to a rate reduction under the Health Insurance Act.

The Long Term Act, passed into legislation in 2010, now makes Community Care Access Centers directly responsible for placement of individuals into long term care, not the hospital.

The CCAC must determine eligibility, assist with the application, and confirms requirements for choice of LTC homes for that person.

The legislation also states that patients can choose up to five homes and is not required to go into a nursing home unless he or she consents. Consent must be informed and voluntary, with fair representation.

Wahl says the Public Hospitals Act (PHA) and Health Insurance Act (HIA) further ensure that on discharge, patients cannot be abandoned even if they have completed their acute care treatment.

For patients and their families that need long term care they must to be aware of their rights on discharge from hospitals.

The Long Term Care Homes Act ensures that patients have the right to choose his or her own care.

3 responses to “Good discharge laws badly practiced for long term care

  1. Jill McIllwraith

    This is a very informative article. I work in a hospital and did not realize my patients had these rights. There must be a better way to get this information to people. Clearly our government does not want people to know this even though they should be making everyone aware of the legislation.

  2. The minister has already commented (in the media) that the punitive practice of charging a big per diem is prohibited in hospitals. Here in Windsor, the LHIN responded quickly and eliminated any shadow of the ‘first bed’ policy from our discussions with patients and their families.

  3. Fiona McMurran

    Many thanks for this excellent synopsis of Judith Wahl’s presentation. I certainly was an eye-opener!. I have concerns about the power that this legislation has given CCACs within the hospital setting. My experience, in two hospitals in two different cities, is that CCAC personnel in hospitals are making decisions about the treatment of patients that should be the jurisdiction of trained medical personnel only.

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