Care homes concerned for seniors after instructions from ministry

Some seniors could end up paying more or even being kicked out of their personal care homes after guideline changes from the Ministry of Health.

In January, the ministry sent out letters to personal care homes telling them that if they have a resident who is designated as needing two people to lift them, then the homes have to have two people at the home at all times.

The care homes have always been required to have sufficient staffing levels to take care of all of their residents’ needs. However, it wasn’t until recently that the Ministry of Health defined what that means.

Olive Quesnel is the vice-president of the association of personal care home operators of Saskatchewan. She’s also a personal care home operator herself.

Quesnel explained homes will arrange staff schedules so they can take care of all their residents’ needs, including having two people working during the day and evening and overlapping staff when the work calls for it.

Costs going up?

Having to hire a second person to be at the home at night will add thousands to the homes’ costs every month, according to Quesnel, and that will raise the fees for the residents.

Some homes have said fees could have to go up by as much as $700 a month, and some seniors won’t be able to afford to stay.

“We can do this, it’s not a problem, we can have two staff members on,” Quesnel said. “But really, the bottom line’s going to affect the seniors that come into our care. They can’t afford that.”

The provincial government does offer a personal care home benefit, but it only pays the difference between the senior’s income and $2,000. Quesnel said there are almost no homes which cost only $2,000 a month.

If a resident has to move out and can’t find another private home they can afford, they’ll have to find a bed in one of the province’s long-term care facilities.

Discharging patients

The letter sent out in January let homes know about the clarification and said they were expected to make adjustments by the end of May. If a second person wasn’t hired, the ministry said the homes would have to discharge any patients who required a two-person lift.

For that reason, Quesnel said she recently had to discharge a man who’d been with her for two years.

“That’s really unfair,” Quesnel said. “My heart is really broken for this family. They’re crushed.”

Other care home operators have said they’re not discharging people until they absolutely have to because there’s nowhere to send them.

One operator said this is going to change her business model because she has always told families she will keep residents to the end of their lives, and this will make that difficult if not impossible.

Government response

The provincial government insists this isn’t a policy change, saying the regulations have been in place for several years.

“Sufficient staffing continues to be a requirement because the safety and well-being of residents is a priority,” explained Dawn Skalicky-Souliere, director of licensing for private care homes.

Personal care home operators say that the province had never mandated staffing levels before and that homes had been allowed to make their own plans.

Skalicky-Souliere said most personal care homes are inspected at least once a year, and it was through an inspection that the perceived problem with staffing was found. That’s why the ministry sent out a clarification to homes.

One of the big reasons given to have two people on staff at all times, including at night, is for unplanned situations like a fire.

Quesnel said many homes have panic buttons to emergency services and have plans in place for such instances.

“We approached our neighbours saying, ‘If we have a fire, will you come and help us?’ And they have said yes,” she said.

But Quesnel said the ministry doesn’t think that’s good enough.

Skalicky-Souliere said that, in the case of a fire, the ministry is told there can only be a few minutes to get a person out safely.

“We are being advised that you need to have the capacity right there because when a fire starts, I understand it’s not always the safest thing to go back in the home,” she said.

Quesnel doesn’t think that’s a good argument, because if there are 10 people in the home, it isn’t sensible to require only two staff members when most of the residents would need help getting out.

Another operator said she explains the plans to families before a resident moves in and most of them are OK with it.

Minister wants to work it out

Minister of Health Jim Reiter defended the ministry, saying it’s willing to work with care homes to make sure safety is priority No. 1.

“We’re not trying to put undue strain on anybody, but we do need to ensure that our residents are safe,” said Reiter.

He said that if there’s someone who requires a two-person lift, it’s reasonable to need to have two people available for that.

When asked about the cost that could place on residents, Reiter said cost is always a concern but he repeated that the government has to put safety first.

Reiter also isn’t concerned about an influx of patients into the provincial long-term care system, which only has a vacancy rate of about 2.9 per cent.

He said there are about 4,500 personal care home beds in the province and only a very small number of them require a two-person lift, so they wouldn’t put a large strain on the system if some residents were to have to move to provincial beds.

Quesnel said operators have been trying to talk to the provincial government about this and some families have written letters, but they haven’t got much of a response.

“They just are not listening,” Quesnel said of the government.

But Reiter is still encouraging care home operators to contact the ministry if they’re having problems. He said he’s going to ensure staff are willing to sit down and work through issues and that they’ll be as reasonable as possible. He also offered to meet with operators himself if needed.

EDITOR’S NOTE: This is a corrected version of the story amending a misstatement from one of the people quoted.