PROVINCE CHANGES NURSING HOME BED PRIORITY PROCESS
Telegraph-Journal January 24, 2023
The Oromocto Public Hospital has many patients waiting for a nursing home
A seniors' advocate is raising concerns after the provincial government quietly took steps to clear elderly patients out of overburdened hospitals and put them in nursing homes during critical periods.
Cecile Cassista, the executive director of the Coalition for Seniors and Nursing Home Residents’ Rights, said she knew nothing about the change in regulations made in December until reporters recently drew it to her attention.
“If the government is going to move seniors out of hospital beds, where are they going to put them?” the Riverview advocate said in an interview Tuesday. “We have as many as 277 beds in nursing homes across the province that can’t be used because there’s a severe staff shortage. We don’t have the people available to take care of seniors most in need."
She said the latest statistics from last month showed there were 444 elderly patients in New Brunswick’s hospitals waiting for a nursing home bed. These so-called “alternate level of care” patients are too frail to be sent back home but are not sick enough to be in need of an acute-care bed in hospital.
But with no room available in the province’s 71 nursing homes, they stay in hospital, taking beds needed for acute care or surgical patients.
Alternate level of care patients have long been a concern in New Brunswick, which has a much higher proportion in its hospitals than in other provinces. As many as one in four hospital beds are often taken by people who would be better served in a nursing home.
The regulatory move by the Tory government essentially changes who gets first dibs for a nursing home bed. As it stands, elderly people on the wait list are served in chronological order, regardless if they are still at home or in a hospital.
With the change, the government will be able to prioritize those waiting in hospital over those waiting at home.
“As a way to help with the recent challenges multiple sectors are facing, amendments to the general regulation of the Nursing Home Act were proposed to give the minister of Social Development discretion to prioritize the admission of alternative level of care patients waiting in hospital for nursing home placements during exceptional circumstances,” said the department’s spokesperson, Rebecca Howland, in an email. “This would be for a short period of time. This would be enacted when there is an increased potential risk to human life.”
She said the two regional health authorities would have to prove their case if officials felt the situation was critical at one of their hospitals.
They’d have to show that there’s an overcapacity in the emergency room with prolonged off-loading delays from ambulance bays; acute care units are overcapacity; and there is cancellation of critical surgeries.
Howland said that whether it is under exceptional circumstances or not, no change would be made to the requirements that an elderly patient should be put in a nursing home no farther than 100 kilometres from their permanent address and in the language of their choice, French or English.
Cassista predicted the change wouldn’t help the hospitals much, as there’s already a long wait list for beds, 811 people. Of those, 367 are at home and 444 in hospital, as of December.
“The government needs a better retention and recruitment policy in nursing homes, otherwise the staff shortage will never go away,” Cassista said.
The New Brunswick Association of Nursing Homes confirmed that the province would not be able to remove elderly patients from hospitals and send them to nursing homes if beds in the long-term facilities were unavailable.
“If the homes are full, they don’t have any room to admit and no patients can come in,” said Julie Weir, the association’s executive director. “The change is all about the wait lists and the prioritization of who gets a bed first.”
She said if every home was fully staffed, their beds would remain full, with the only openings available when a client passes away.
“Nursing homes are not like hospitals, which are under more pressure to accept patients and find a place for them,” Weir said. “At a hospital, if the emergency department is full, they try to find space for people, wherever. But in the nursing homes, it’s different. The home can only accept the resident if a bed is available, and that’s in legislation.”
Telegraph-Journal January 24, 2023
The Oromocto Public Hospital has many patients waiting for a nursing home
A seniors' advocate is raising concerns after the provincial government quietly took steps to clear elderly patients out of overburdened hospitals and put them in nursing homes during critical periods.
Cecile Cassista, the executive director of the Coalition for Seniors and Nursing Home Residents’ Rights, said she knew nothing about the change in regulations made in December until reporters recently drew it to her attention.
“If the government is going to move seniors out of hospital beds, where are they going to put them?” the Riverview advocate said in an interview Tuesday. “We have as many as 277 beds in nursing homes across the province that can’t be used because there’s a severe staff shortage. We don’t have the people available to take care of seniors most in need."
She said the latest statistics from last month showed there were 444 elderly patients in New Brunswick’s hospitals waiting for a nursing home bed. These so-called “alternate level of care” patients are too frail to be sent back home but are not sick enough to be in need of an acute-care bed in hospital.
But with no room available in the province’s 71 nursing homes, they stay in hospital, taking beds needed for acute care or surgical patients.
Alternate level of care patients have long been a concern in New Brunswick, which has a much higher proportion in its hospitals than in other provinces. As many as one in four hospital beds are often taken by people who would be better served in a nursing home.
The regulatory move by the Tory government essentially changes who gets first dibs for a nursing home bed. As it stands, elderly people on the wait list are served in chronological order, regardless if they are still at home or in a hospital.
With the change, the government will be able to prioritize those waiting in hospital over those waiting at home.
“As a way to help with the recent challenges multiple sectors are facing, amendments to the general regulation of the Nursing Home Act were proposed to give the minister of Social Development discretion to prioritize the admission of alternative level of care patients waiting in hospital for nursing home placements during exceptional circumstances,” said the department’s spokesperson, Rebecca Howland, in an email. “This would be for a short period of time. This would be enacted when there is an increased potential risk to human life.”
She said the two regional health authorities would have to prove their case if officials felt the situation was critical at one of their hospitals.
They’d have to show that there’s an overcapacity in the emergency room with prolonged off-loading delays from ambulance bays; acute care units are overcapacity; and there is cancellation of critical surgeries.
Howland said that whether it is under exceptional circumstances or not, no change would be made to the requirements that an elderly patient should be put in a nursing home no farther than 100 kilometres from their permanent address and in the language of their choice, French or English.
Cassista predicted the change wouldn’t help the hospitals much, as there’s already a long wait list for beds, 811 people. Of those, 367 are at home and 444 in hospital, as of December.
“The government needs a better retention and recruitment policy in nursing homes, otherwise the staff shortage will never go away,” Cassista said.
The New Brunswick Association of Nursing Homes confirmed that the province would not be able to remove elderly patients from hospitals and send them to nursing homes if beds in the long-term facilities were unavailable.
“If the homes are full, they don’t have any room to admit and no patients can come in,” said Julie Weir, the association’s executive director. “The change is all about the wait lists and the prioritization of who gets a bed first.”
She said if every home was fully staffed, their beds would remain full, with the only openings available when a client passes away.
“Nursing homes are not like hospitals, which are under more pressure to accept patients and find a place for them,” Weir said. “At a hospital, if the emergency department is full, they try to find space for people, wherever. But in the nursing homes, it’s different. The home can only accept the resident if a bed is available, and that’s in legislation.”
