‘I’m not paying it’: Family furious over $400/day hospital fine for not moving to LTC

A few weeks ago, Michele Campeau faced what seemed like an impossible decision: move her mom from a hospital bed to a long-term care home the family hated or pay $400 a day to remain at the health-care facility.

Campeau chose neither – the family has been racking up a monster bill since March 11 that remains unpaid while her mother has stayed on at a Windsor, Ont., hospital. 

Campeau’s mother is among those caught up in a law that allows hospitals to place discharged patients into long-term care homes not of their choosing in order to free up beds. Should patients refuse the move, they face a $400 per day charge to remain at the hospital.

“I’m not too worried about it because I’m not paying it,” Campeau told The Canadian Press.

The law, known as Bill 7, was passed by the Doug Ford government in the fall of 2022 in an effort to open up much-needed hospital space. It is aimed at so-called alternate level of care patients who are discharged from hospital but need a long-term care bed and don’t have one yet.

Hospitals can send patients to nursing homes not of their choosing up to 70 kilometres away, or up to 150 kilometres away in northern Ontario, if spaces open up there first.

For Campeau and her 83-year-old mother Ruth Poupard, the last few months had already been overwhelmingly stressful, even before the Bill 7 drama began. 

Poupard lived through cancer, a heart valve transplant and the onset of dementia over the past few years. She moved in with Campeau who took care of her and has power of attorney for her mother. 

Over the last year, Poupard’s dementia deepened, her daughter said. 

Two days after Christmas, Poupard hallucinated during the night, fell and broke her hip. Campeau rushed her to hospital where she ended up having surgery. Poupard was later moved to the Hôtel-Dieu Grace Healthcare hospital in Windsor for rehabilitation.

On Feb. 21, Poupard’s attending physician discharged her, determining she no longer needed the hospital’s specialized care. By then, Campeau and her brother decided their mother needed more care than they could provide.

“We decided that it’s time for long term care,” she said.

The hospital helped with the paperwork and Poupard put five nursing homes – the maximum allowed – on her list. But those homes were full. 

“Then the co-ordinator called me and said, ‘OK, according to Bill 7, I have to add another home to the list,'” Campeau said.

The co-ordinator continued to add homes to Poupard’s list until there was one with an available bed.

“They called me up and said they had a home for her and gave me 24 hours to go look at it and get back to them,” Campeau said.

There was no answer when she called, so Campeau showed up at the downtown nursing home in Windsor last month. With the code for the front door’s keypad taped nearby, she walked right in. 

“I’m sorry, but it was disgusting,” she said.

The halls were cluttered, the rooms dirty and it took her 15 minutes to find a staffer, she said.

It was unlike the long-term care home she helped her father-in-law get into a few years prior, a “beautiful” place where he spent his final days.

“So I went back to the co-ordinator and said, ‘No, I’m sorry, I would not put my dog in there,'” Campeau said.

That’s when the hospital said they would charge her $400 per day if her mother refused to leave. Then it gave a letter explaining the law and the charges to her mother.

“She read it and was really scared and confused,” Campeau said.

The letter laid out the hospital’s position.

“Given that you no longer need the specialized care at this hospital, and have been offered a safe and supported discharge plan and destination, your attending health care provider will be discharging you from the hospital on March 9, 2024,” the hospital wrote.

“Starting on March 11, 2024, you will be charged $400 for every day that you remain in hospital.”

Campeau said she gave the hospital a piece of her mind.

“I just said, ‘try it,'” she said.

A month later, the co-ordinator has not reached out to discuss the issue, or to add more homes to her mother’s list, or to communicate at all, Campeau said. 

She’s also frustrated by the fact that she has no recourse, with no appeal process built into the legislation.

While Campeau hasn’t received a bill so far, she believes a big one is coming. 

Hôtel-Dieu Grace Healthcare said it cannot comment on specific cases to protect the confidentiality of its patients.

A spokesman for Long-Term Care Minister Stan Cho said the ultimate goal is “getting everyone the care they need when they need it.”

“Placement in a non-preferred home is a temporary measure until a spot in a preferred home becomes available,” Daniel Strauss said.

“Overall, of the over 17,000 discharged ALC patients only 1.69 per cent were admitted to a LTC home selected by a care co-ordinator and only 0.04 per cent of discharged patients have had a fee levied by a hospital.”

The province has said 293 people have been placed into homes not of their choosing under the law, while seven people have been charged by hospitals for refusing to go to a nursing home they did not select.

The new law has also affected cultural nursing homes. 

The alternative-level-of-care patients are now prioritized for any home, including those geared toward people who prefer to live among certain cultures. That has resulted in non-Italian speakers placed in homes where all programming is offered in Italian, for example. 

For Campeau, the entire ordeal has caused pain, frustration and anger.

“This law is elder abuse,” she said, “plain and simple.”

This report by The Canadian Press was first published April 10, 2024.

Liam Casey, The Canadian Press