Ontario hospital patients waiting for long-term care can be moved to unwilling nursing homes up to 150 kilometers away, at a cost of $400 a day if they decline, the province announced Wednesday.
As of next Wednesday, patients in southern Ontario will be able to move up to 70 kilometers, while those in northern Ontario will be moved up to 150 kilometers, Health Minister Sylvia Jones and Long-term Care Minister Paul Calandra said.
Beginning Nov. 20, hospitals must charge a daily fee of $400 to patients who have been discharged by their doctors and refuse to be moved to a home that is not of their choice.
Jones said discharge planners will have to have “very challenging” conversations with patients about entering a home they don’t want to go.
“Those conversations include ‘Yes, we will have to charge you if you refuse to take the long-term care bed we found for you,'” Jones told reporters.
“That part is, frankly, to make sure people understand that a hospital bed is for an acute patient, not for long-term care patients.”
Ministers said the policy only affects patients awaiting discharge from hospital whose preferred long-term care facilities have no available places.
The changes will be reflected in regulations for the new law, which have not yet been made public. Until Wednesday, few details had been provided about how the law would work.
The county passed legislation last month to allow hospitals to send so-called alternative care patients to an unelected long-term care facility on a temporary basis.
The county has said about 1,800 of those patients are currently hospitalized awaiting a place in one of their five preferred choices in a long-term care facility.
Legislation has sparked outrage
The bill, which has been pushed through the legislature without public hearings, has sparked outrage among seniors and lawyers.
The regulations announced on Wednesday are part of an effort to free up hospital beds as the healthcare system grapples with temporary emergency room closures and a massive surgical backlog.
Emergency departments at hospitals across the province have been closed for hours or days at a time in recent months, largely due to a shortage of nurses.
Calandra said the distances will be calculated based on the location of a patient’s preferred home.
“This gives us the maximum amount of flexibility so that we can provide more options for patients in the hospital who want to transition from better quality care to long-term care,” he said.
In northern Ontario, if no nursing homes are available within 150 miles, legislation allows hospitals to look at the nearest home outside the border with empty beds.
Patients who are moved to homes they don’t want to go to remain on the priority list for their preferred long-term care home care center, Jones said.
Couples stay together and the government is working on a guideline to respect religious, ethnic and language preferences.
First Nations homes will also be exempt, Calandra said.
New law designed to free up beds, says minister
According to Ontario Health data, the average length of stay across the province in emergency departments before being admitted to hospital is 20.7 hours. Only 24 percent of patients are admitted from the emergency room within the target time of eight hours.
Jones said the new law will free up hospital beds, but wouldn’t say how much or how it would affect emergency room wait times.
“If we can handle a percentage of the alternative level of care of patients in the province of Ontario, it’s going to give us some flexibility and quite frankly the ability to let people in earlier when those beds are available,” she said.
Changes will put pressure on seniors, says NDP
NDP long-term care critic Wayne Gates said the changes will put pressure on seniors and their caregivers.
“I think it’s absolutely heartbreaking that they expect our seniors and their families to travel 70 miles,” he said, referring to the distance for patients in southern Ontario.
“Don’t force seniors to go 70 kilometers from their families. They need their families, they need their husbands.”
Calandra said they want to keep residents “as close as possible” to their preferred long-term care home.
Placement coordinators would select long-term care facilities within a 70-kilometer radius from the patient’s preferred location, except in the north, where the radius would be 150 kilometers.
Province punishes the elderly, says Green Party leader
Ontario Green Party leader Mike Schreiner said in a statement Wednesday that the elderly should not be punished for the province’s failure to invest in health care.
“It is wrong to force the elderly to pay $12,000 a month if they refuse to move into an LTC home that is not of their choice and far from family,” Schreiner said.
“It is embarrassing to push seniors into believing that the crisis in our hospitals is their fault. And taking them away from their loved ones and caregivers will actually exacerbate the staffing crisis by putting additional pressure on our yet already overworked PSWs and LTC staff. Without a doubt, this puts the elderly at risk.”
Schreiner said the provincial government should do the following to treat people in long-term care with dignity:
- Invest in home care so that people can receive care at home and grow older.
- Address the workforce crisis, with the repeal of Bill 124 as the first step.
- Invest in nonprofit long-term care facilities across the county.
As for Ontario liberals, interim leader John Fraser said the regulations will trample seniors’ rights.
“The greater the distance between families, the greater the hardship.”