The Ontario government says hospital patients who are waiting for space in long-term care homes can be moved to other locations not of their choosing up to 150 kilometers away or be billed $400 per day if they refuse.
Bill 7, also known as the “More Beds, Better Care Act,” allows for the temporary transfer of senior hospital patients waiting for space in a long-term care home to another home not of their choosing. It received royal assent at the end of August.
Advocates have previously indicated concern, saying that seniors would be transferred to long-term care homes far away from family, or that they would be charged exorbitant fees to remain in hospital if they choose to refuse the offer.
As part of the new rules released Wednesday afternoon, the government set firm guidelines as to how far a patient can be moved.
As of Sept. 21, if there is no space at a discharged patient’s home of choice, they can be transferred to a home within a 70-kilometre radius in southern Ontario or a 150-kilometre radio in northern Ontario.
If there is no long-term care home or if there is limited vacancy within this radius, placement coordinators can select the next closest home to the patient’s preferred location.
“This gives us the maximum amount of flexibility so that we can put on the table for patients in hospital who want to transition into better quality care to long-term care more options available to them,” Long-Term Care Minister Paul Calandra said.
If patients refuse the spot, the hospital is allowed to charge a daily fee of $400.
The charges would begin 24 hours after discharge as of Nov. 20 and apply to any discharged patient who refuses to leave hospital, not just those being transferred to long-term care.
Prior to these regulations, the maximum rate for alternative level of care (ALC) patients choosing to stay in hospital rather than move to one of their five homes of choice was $62.18 per day, or close to $1,900 a month.
Health Minister Sylvia Jones told reporters the $400 amount is meant to provide a strong incentive for families to “have those challenging conversations.”
“We chose $400 because we believe it is enough of a concern for people to have those challenging conversations with the placement coordinators to make the effort, as a family, to have the conversations about where do we want our loved ones as they traveled through their next journey,” she said.
“The bottom line is acute care hospital beds need to be for acute care patients.”
The minister said the fees are not meant to be seen as coercion, but rather just an indication that the patient is not in need of hospital care.
“We are making sure that you are most appropriately placed and that appropriate place is not in an acute care facility where you no longer are in need of acute care.”
The government said these restrictions were based on input from the health-care and long-term care sector, although they did not elaborate on who those partners were.
NDP Long-Term Care critic Wayne Gates argues the pressure involved with moving to a long-term care home not of their choosing—potentially further away from families or caregivers—will negatively impact the health and wellbeing of seniors.
“Imagine having to drive two hours to kiss your wife goodnight. Imagine the guilt of knowing you can’t afford to pay $400 a day to keep your dad in the hospital, and having to put him in a for-profit long-term care home with a devastating record and disgusting living conditions,” Gates said.
“Forcing them to move will not ease our health care staffing crisis one bit. What we should be doing is addressing the staffing crisis at the heart of our health care crisis, not playing a cruel game of musical chairs that kicks seniors and people with disabilities out of hospital beds.”
Jones said that this policy could free up 400 acute beds in Ontario hospitals, and that patients transferred would remain on the priority list for a space in their preferred locations.
The province has said there are about 1,800 patients in hospital waiting for a spot in one of their top five long-term care homes.
Factors such as culture, religion and language will all be taken into consideration when finding a placement for senior patients. Couples will be placed together.