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Are cuts forcing hospitals to push patients out illegally?

With the cuts to Ontario hosptials, high bed occupancy has become commonplace, forcing hospitals to cancel surgeries and introduce hallway medicine.  The Waterloo Record reports that Ontario hospitals have become aggressive about getting seniors out of hospital beds and raises questions about whether the actions of the hospital are even legal.  Some key facts reported by the Record:

  • Many hospitals have developed policies encouraging patients to accept the first long-term care bed that becomes available, with hefty fees threatened for those who don't comply.
  • Experts question whether high-pressure policies are ethical, or even legal.   Health Ministry managers, hospital officials and elder advocates who met in 2008 to examine first-available-bed policies concluded they "have no basis in legislation."
  • Policies "often differ from hospital to hospital and are developed and applied in an inconsistent fashion across the province," the group said in a report of their proceedings, obtained by Metroland. In certain cases, actions that resulted from such policies "may contradict" law, the report said.
  • Jane Meadus, a lawyer for the Advocacy Centre for the Elderly, argues that many hospital policies break the law by "constraining" the patient's right to choose freely - including requirements to choose homes with short wait lists, or by "placing unlawful pressure" on patients to choose a home they don't want.
  • If a nursing home bed becomes available and a patient refuses to leave the hospital, officials can charge a much larger fee, a per diem or "full daily rate." (Toronto Baycrest is an example of a hospital with a formal policy: a fee of $1,745 a day applies to patients who refuse an available nursing-home bed. Baycrest, however, has "yet to encounter a situation" in which the fee was levied, a spokesperson said.)
  • The Ontario Hospital Association says provincial law allows a per-diem to be charged if a patient can be safely discharged from an acute-care bed, but refuses to leave. The Ministry of Health says per diems are not regulated. The Public Hospitals Act gives hospitals the authority to levy fees, but does not specify how much can be charged.
  • Toronto-based Advocacy Centre for the Elderly surveyed Ontario hospitals in 2007 on their discharge policies, and 38 responded. "The threat of a per diem is made in the discharge policies of 89.5 per cent of the hospitals who responded to the survey," the centre said, noting that fees ranged from $277 to $827 a day.

     The full story can be found at:

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