Tag Archives: Advocacy Centre for the Elderly

Briefs: TSH looking for $6.8 million in savings, Arnprior petition and more

The Rouge Valley Health System and The Scarborough Hospital officially filed notification to the Local Health Integration Network of their intent to merge, but it doesn’t mean hard times are over. Robert Biron, CEO of The Scarborough Hospital, sent a memo to staff Tuesday that reminded everyone that the health service provider still has a budget to balance. Biron estimates cost pressures of $8.4 million for 2014-15. The hospital has projected revenue increases of $1.6 million, but it still leaves them $6.8 million short. That shortfall represents about two per cent of TSH’s annual budget. Biron says it is the intention of the hospital to “minimize the impact” to services and staff positions where possible, however the memo gives notice that voluntary exit and early retirement packages will be offered soon. No specific cuts were identified in the memo. The TSH board will receive the budget plan on March 4th. Despite the formal notification to the LHIN, the hospitals will not make a final decision to merge for another 60 to 90 days.

In December we reported on a local fight-back campaign by the unionized staff (CUPE, OPSEU and ONA) at the Arnprior and District Memorial Hospital. The professional and support staff at the hospital are upset by the loss of six acute care beds at a time when the region’s population is rapidly expanding. Now our colleagues at CUPE have posted an on-line Avaaz petition for community members to sign that calls on the hospital to reopen the beds and staff them properly. If you’d like to add your name to the Avaaz petition, click here.

The Ontario College of Physicians and Surgeons has raised an interesting point around the province’s plan to shift endoscopies from hospitals to private Independent Health Facilities (IHFs). The College notes that IHFs are presently exempt from the Out of Hospital Premises Inspection Program (OHPIP) it conducts. Up until now endoscopy clinics have been considered community speciality clinics, not IHFs. In the most recent issue of the College’s Dialogue Newsletter, they state “the OHPIP model functions more efficiently and quickly to protect patients than the IHF model.” Despite the shift in status, the College is proposing to continue doing OHPIP inspections at these facilities. In 2011 the College warned that a private Ottawa endoscopy clinic failed to properly sterilize equipment and placed patients at risk of HIV, hepatitis B, and hepatitis C. The College also found that the clinic’s nurse was preoccupied with advancing the scope and not recording vital signs, that potential exposure to toxic fumes took place, single-use items were being re-used, and that cramped and cluttered premises posed a hazard by making it difficult to transfer a patient in the event of an emergency. Endoscopies and cataract surgery are at the top of the province’s list for divestment from community hospitals.

The more Ontarians understand the threat by PC leader Tim Hudak to end the Rand Formula, the less they like the Tories. While Forum Research president Dr. Lorne Bozinoff told the Toronto Star the anti-union policies are not seen as a massive wedge issue, “there’s some uneasiness that they’ve (PCs) just gone too far to the right.” The Forum Research Poll shows the Tories dropping in public opinion in tandem with declining disapproval of the Rand Formula. Those opposed to the Rand Formula dropped from 45 per cent to 38 per cent from November to January. Likely Ontarians are coming to understand that by undermining the province’s trade unions all labour rights are threatened – both union and non-union. The Forum Research polls still places the Tories in the lead at 36 per cent followed closely by the Liberals at 33 per cent and the NDP at 26 per cent. NDP Leader Andrea Horwath and Liberal Premier Kathleen Wynne share 40 per cent personal approval ratings while Hudak continues to lag behind with 21 per cent. In a press release issued yesterday, Bozinoff said “it appears Tim Hudak’s signature idea, ending compulsory union dues, is not a winner in Ontario, even among supporters of his own party.” The random sampling of public opinion was conducted among 1222 Ontarians 18 years of age and older between January 24-25.

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Zero tolerance for abuse and neglect? Hardly.

Health Minister Deb Matthews talks about zero tolerance of neglect and abuse in Ontario’s nursing homes. Her actions would suggest the opposite.

Yesterday Matthews said that inspection of long-term care homes will be based on complaints and critical incidents only. If the home doesn’t get complaints or critical incidents go unreported, it doesn’t get inspected.

This is despite a requirement in the Long Term Care Homes Act that requires an annual inspection of each home.

Jane Meadus of the Advocacy Centre for the Elderly says the intent of the Act was that each home would receive an annual resident quality inspection (RQI) – a detailed inspection conducted by a team of specialists, including an RN, a dietitian and an environmental inspector. An RQI can take as long as 17 days to conduct.

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Retirement homes in conflict of interest over abuse line — ACE

Have a complaint about abuse at a retirement home? The telephone line you are required to call is operated by the trade association run by the retirement homes – a conflict of interest according to the Advocacy Centre for the Elderly (ACE).

This spring the Ontario government introduced a new Retirement Homes Act, promising to immediately enact provisions to protect seniors living in these homes from abuse.

While the Retirement Homes Regulatory Authority (RHRA) is being set up as part of that Act, the public is being advised to call the Complaints Response and Information Service line (CRIS).

The CRIS line is operated by the Ontario Retirement Community Association (ORCA), the private sector trade association for retirement home operators. That means if you have a complaint about a retirement home, you have to take it back to the advocates for that home. 

ACE is concerned that CRIS will continue to operate the line after this initial set up period, triaging complaints and deciding what gets forwarded on to the independent authority responsible for licensing and inspecting retirement homes.

“ACE has raised this concern with the Office of the Minister Responsible for Seniors given that what is considered abuse and neglect may be different from the perspective of the operators of the CRIS line, the tenants (residents) of the homes, the home operators, and the Authority,” writes Judith Wahl, executive director of ACE in the centre latest newsletter.

ACE is also asking questions about whether complaints to the CRIS line operators will be required to be kept confidential from ORCA – the operator’s employer.

ACE is calling for an independent call line to be maintained directly by the regulator authority, and not by the trade association.

Retirement homes have become more populated with seniors with higher levels of acuity in the absence of available spaces in Ontario’s regulated nursing home sector.

Retirement homes are also being used by hospitals to off-load “alternate level of care” patients who are unable to go home on a short-term basis. The government says they are protecting these patients by applying the Long Term Care Act to these specific beds.

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.