Had I been told a year ago that a new long-term care home would be opening in Richmond, I would have thought, great. We need more of those. A shortage of long-term care beds has created a bottleneck in our health care system, contributing to overcrowded hospitals.
Today, my response is similar — but not quite the same. I very much welcome news that Hamilton Village Care Centre will be opening this fall. (See page 8) But before I get too excited, I want to know a little more. What we’ve learned from the astonishing number of COVID-related deaths in long-term care (LTC) facilities is that they’re not all created equal.
Like anyone who pays attention to the news, I was aware there are some bad care homes out there. I’ve seen the “special investigation” reports with hidden cameras and outraged family members. But the focus is usually on one or more bad workers who abuse a helpless resident. Hence, the installation of nanny cameras, calls for accountability, etc.
What this pandemic has shown is a different kind of abuse — abuse in the name of profit.
Situations where staff are refused full-time hours and not given paid sick leave, where safety regulations are flaunted and residents are denied the minimum hours of nursing care — these are all forms of abuse.
Perhaps what we really need is a nanny cam in some board rooms where financial statements are being discussed. Failing that, we can look to a report Isobel Mackenzie, B.C.’s Seniors Advocate, came out with just before the COVID-19 pandemic hit.
When the report was released in early February, I took note of its general conclusion that, on average, not-for-profit facilities provide better care than for-profit ones. What I didn’t look at closely was how funding and accountability works. Regardless whether a facility is for-profit or not-for-profit, it is publicly funded to the same level. (I should clarify that we’re not talking about independent and other types of seniors residences here.)
On average, a LTC bed costs about $80,000 a year in the Vancouver Coastal Health region. To cover the cost, residents are expected to pay 80 percent of their after-tax income. For some, that’s less than $20,000 a year. The rest is picked up by Vancouver Coastal Health, or another provincial health authority, to the tune of $1.3 billion.
In other words, these homes have a fixed revenue. The only way for them to make a profit is to spend less, and it appears that’s exactly what they’re doing.
According to Mackenzie’s report, on average, private care homes spent $10,000 — 24 per cent — less per year on care per resident than not-for-profit homes. For-profit care homes also “failed” to deliver 207,000 care hours, while not-for-profits delivered 80,000 hours more than they were funded for.
Meanwhile, for-profit care homes ended up with $34.4 million in profit compared to $2.8 million for not-for-profits.
The kicker is for-profit facilities are not required to make their financial statements public, while not-for-profits are.
Something’s wrong with this picture, and you don’t have to be a loony leftist to see it. In a recent release, Richmond MLA Linda Reid along with BC Liberal leader Andrew Wilkinson called on the NDP government to provide more support for LTC and assisted living. They don’t say anything about for-profit versus not-for-profit facilities, but that may come. Even Doug Ford, the decidedly right-wing deregulationist premier in Ontario, has concluded LTC homes in his province should not be for-profit.
It’s often said, the profit motive helps create efficiencies. And in many cases it does. But is having our loved one’s diaper changed less often the kind of “efficiency” we’re willing to stomach? Because that’s what it comes down to.
