Ford government will charge $400 a day for long-term-care patients who won’t leave hospital
Posted: September 15, 2022
(September 14, 2022)
By: Rob Ferguson, Toronto Star
Young or old, staying in hospital if you’re cleared for discharge to available care elsewhere could cost you $400 a day as the Ontario government tries to free up beds for the expected fall and winter surge of COVID-19 and flu.
And seniors can be moved to nursing homes not of their choosing as far as 70 kilometres away in southern Ontario — or 150 kilometres in the north — to wait for a bed at their preferred long-term care facility closer to home and loved ones.
Those details came Wednesday as Premier Doug Ford’s government fleshed out a controversial law passed two weeks ago to ease emergency room overcrowding, long waits for beds and surgeries in hospitals by getting more people — mainly seniors — out of them and into nursing homes, home care, community care or rehabilitation centres.
“Acute care hospital beds need to be for acute care patients,” Health Minister Sylvia Jones said after regulations on hospital billing and distances to nursing homes were released for Bill 7, the More Beds, Better Care Act.
The legislation was introduced and passed in 13 days last month without public hearings or study by a legislative committee of MPPs, with Long-Term Care Minister Paul Calandra repeatedly insisting “the status quo is not an option.” Ford did not mention it during the June 2 election campaign.
Critics called the regulations a “cruel scheme” that will coerce hospital patients into going to places they don’t want to go — possibly nursing homes with high death and illness rates in the pandemic — or far from spouses and family members who may have difficulty visiting them because of long distances.
“It’s wrong,” said New Democrat MPP Wayne Gates (Niagara Falls), his party’s long- term care critic. “Those seniors are going to die a lot sooner … than if they were closer to home.”
Caregiver advocate Vivian Stamatopoulos said the long distances are akin to putting the vulnerable elderly in “solitary confinement” away from their families, which proved detrimental during the worst months of COVID when visits were restricted.
“It just shows how little our minister seems to understand what long-term care is about.”
A frail senior, for example, could be moved from a Toronto hospital to a nursing home in Hamilton. In northern Ontario, the move could be from Sudbury to North Bay, a distance of 127 kilometres with the added complication of winter weather approaching.
“Now we’re putting a burden on seniors and their families,” said interim Liberal Leader John Fraser. “For those families it’s going to create hardship.”
The $400 fees begin Nov. 20; the nursing home moves kick off on Sept. 21. Ford had mused last month that hospital fees for uninsured care, such as $1,800 daily at Toronto General, were too high. Jones said Wednesday that the $400 was set to provide “consistency” across the province.
It will also provide an incentive for people to leave hospitals when they no longer need acute care, Jones said.
“We believe it is enough of a concern for people to have those challenging conversations with the placement co-ordinators, to make the effort, as a family, to have the conversations about where do we want our loved ones as they travel through their next journey.”
But a danger in the law is that it gives hospitals new powers to assess patients awaiting long-term care without their consent and share their personal information with nursing homes without their consent, which is “violating” the rights of the elderly, said the Ontario Health Coalition.
Green Leader Mike Schreiner said seniors are paying the price for Ford’s failure to fulfil a 2018 campaign promise to eliminate “hallway health care” in hospitals.
“I’m calling on the government to stop gaslighting seniors into thinking they’re the ones to blame for the government’s own mismanagement of the health-care system and the overcrowding in our hospitals.”
Calandra said moves to nursing homes could be further away than 150 kilometres in the north, where there are fewer nursing homes to choose from.
“If there is no appropriate bed available within the 150 kilometres then they can look at the first available bed outside of that 150 kilometre range,” he told reporters.
“Don’t forget, it’s not just about finding a home that’s available. It’s about finding a home that is an appropriate home for the person that is being discharged from the hospital.”
Calandra and Jones pledged that “couples will be kept together” and moves will “respect religious, ethnic and language preferences.”
Fuelled by the pandemic, the number of patients in hospital who no longer need acute care — and who are called alternate level of care (ALC) patients — has risen by 1,000
in recent months to 6,000, resulting in temporary emergency room closures in some hospitals and crowded conditions across the sector.
Almost 2,000 of the ALC patients are seniors waiting for long-term care beds, for which there are long waiting lists.
The pressure to move patients out of hospitals into nursing homes will make it tougher for seniors living in the community, particularly those experiencing a health crisis, to get beds in nursing homes that are experiencing the same types of staffing shortages that hospitals are facing, the Ontario Long-Term Care Association has warned.