Walker misses point on why for-profit nursing homes cherry-pick residents

Dr. David Walker is accusing long-term care homes of cherry-picking patients who are easy to care for, leaving more complex ones to hospitals.

As the province’s point person on the alternate level of care issue, did he just discover this?

When Ontario decided to put the more than half of its nursing home beds in the hands of profit-seeking companies, what did they expect?

About one in six long-term care beds in Ontario are municipally run, although the province has recently opened the door for them to reduce their participation to a single home each. The City of Toronto, by contrast, operates 10 homes for the aged.

During times of austerity, it has frequently been the municipalities that have topped up funding for these homes to maintain standards of care.

In Sudbury there is currently debate over whether Pioneer Manor, one of the largest municipal nursing homes in the province, should be sold off. The home includes a new 64-bed wing that specializes in care for seniors with dementia.

It is no secret that the municipal homes have been doing much of the heavy lifting, taking on more complex care residents that the for-profit sector doesn’t want.

Earlier this year Dr. Walker called for more specialized long-term care homes, yet the decision to move municipalities away from operation and ownership of these facilities seems contrary to this objective.

Walker told the Toronto Star “the incentive at the moment is that you fill up your nursing homes with the healthiest people and our health system ends up burdened with all sorts of people with high needs.”

There’s even a word for this: cream skimming.

That’s what happens when decisions are made based on profit and not on meeting community need.

Instead of addressing Ontario’s extraordinary imbalance of for-profit to not-for-profit and municipal homes, Walker talks about “creating enough incentives” for long-term care homes to take on these high-needs residents.

Wasn’t that how funding was supposed to work? Wasn’t it supposed to be based on the relative acuity of those in the homes?

To be fair Walker’s summer report does recommend enhanced staffing and training at these homes.

Walker’s comments came in response to news that the hospitals were once again bullying seniors to take the first available long-term care beds by threatening to charge exorbitant daily fees – something the Health Minister had previously promised she would stop.

Didn’t the McGuinty government pledge to uphold the principles of the Canada Health Act?

While Toronto East General apologized for threatening a senior with $1,300 a day in charges if she refused to vacate her bed, Jane Meadus, a lawyer with the Advocacy Centre for the Elderly told the newspaper that she didn’t think this was an oversight by an overambitious junior manager.

“I think hospitals think they can get away with this,” she told the Star. “In many cases they are dealing with people who don’t know any better.”

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