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Showing posts with the label LTC

Ontario hospital and LTC staffing and capacity plans: worse than you thought

By 2027 the PC health care funding plan falls $21.3 billion short, their hospital bed plan falls 500 beds short, their plan to free up hospital capacity by moving hospital patents to long-term care is unlikely to work, and their nurse and PSW staffing plan will fall 33,000 short according to the Financial Accountability Office ( FAO ).  Important and appalling news. But the human problems are actually much worse. The FAO focuses on measuring the gap between the government's stated plans and the government’s stated aspirations.  The bigger -- and much more important -- problem is that the government aspirations fall so very far short of actual human needs. So, on staffing, the FAO makes no claim that government aspirations are adequate to human need. Indeed, their staffing projections do “not reflect an assessment about the quality of services that should be provided by these programs.” As a result, the FAO estimates the government aims to add 1,000 hospital beds between now and

Hospital, long-term care funding cut by the Ford Conservative government

The Financial Accountability Office has released the Ford PC government's funding plans for the various health care sub-sectors .   The news is not good.   The funding plans for 2022/3 in several key line items are down compared to actual funding in 2021/2 :  Funding plans for long-term care services are down $26 million – or down 0.4% compared to last year's actual funding.  Overall funding to the Ministry of Long-Term Care (LTC service funding plus LTC Capital and Development funding) is down $315 million, with the LTC Capital line item down a full $376 million. The LTC Development line item was also completely unspent over the last five quarters. These are mysterious changes when there is a 38,000 person LTC wait list, a desperate shortage of LTC facilities that meet modern design standards, new legislation that forces hospital patients to move into LTC facilities they did not choose, and frequent claims by the government that it is quickly building new, high quality LTC fa

Violence is widespread and growing in Ontario health care

Contrary to popular perception, there are more assaults  in hospitals than in any other industry. Long-term care facilities are also major sites for assaults.  Health care as a whole has  by far  the most assaults that result in lost time injuries – far, far more than any other sector.  Assaults in hospitals and LTC are overwhelmingly on women, and they are increasing over time.   Health care support jobs have seen almost half of all the assaults on health care staff.   Health care support jobs are now the occupation with the most assaults resulting in lost time injuries - - far more than police and firefighters combined. Workplace Safety and Insurance Board (WSIB) data  on approved lost time claims for violent assaults shows that hospital employees have more approved lost time injury claims for assaults than any other industry.  With 2,459 over 2011-2019 that is 10% of the total lost time injuries for assaults and 44% more than the next highest industry group.  As many hospitals a

Ford government promise falls far short of solving hospital hallway medicine problem

Tens of thousands of new Long-Term Care (LTC) beds needed just to offset aging    The new Progressive Conservative government in Ontario has promised 30,000 new long-term care beds over the next ten years, often connecting this to their promise to end hospital hallway medicine.  But how does this promise stack up with growing demand for these facilities? Most people 85 and older live in collective dwellings (LTC facilities, seniors residences, multiple level of care facilities).  The setting with the largest number of elders 85 and older is LTC facilities, with about 35% of the  population  85 to 89  years old and almost 40% of the population 90 to 94 years. Older people are even more likely to be in a LTC facility. Source; Statistics Canada The population  85 and older is the main driver of the need for long-term care beds. An additional thirty thousand LTC beds by 2028 will only partially offset the rapid growth in the 85+ population.  The ministry of finance p

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces.  LTC staffing falls short:   The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces.  Part of this is driven by a low level of provincial funding for LTC. Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation. [1]  The rest of Canada reports 0.665 health care FTEs. [2]  The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario. [3]  No other province reports fewer LTC health care staff per resident (

More spending on new hospitals and new beds? Nope

Hospital funding:  There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities).    For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year.   But, this is just a notional increase from the previous announcement of future hospital capital spending.  Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

Performance Problems: 37 Health Care Issues from the Auditor General

The litany of health care problems identified by the Auditor General  in her 2015 report is frightening. Here's thirty-seven of them dealing with LHINs, LTC, EMS, Rehab Hospitals, Health Infrastructure, Home Care, and Health Human Resources. Local Health Integration Networks (LHINs): A Lot of Problems LHINs have not met performance expectations. "Most LHINs performed below expected levels in the year ending March 31, 2015. In that year, LHINs on average achieved their respective local targets for six of the 15 performance areas".  Also: "Based on the provincial results that include all 14 LHINs, only four of the 11 provincial targets that measure long-term goals for LHINs were met." Performance has not improved. "While province-wide performance in six of the 15 areas measured has improved between the time the LHINs were created and 2015, in the remaining nine areas, performance has either stayed relatively consistent or deteriorated since 2010 or