THUNDER BAY — The CEO of Thunder Bay's regional hospital is welcoming new provincial legislation that allows hospitals to transfer elderly patients to long-term care homes once they are ready to be discharged.
Bill 7, which takes effect Sept. 21, also requires hospitals to charge a daily fee of $400 to patients who refuse to be moved to a nursing home that's not of their choosing.
The fee can be levied as of Nov. 20.
In an interview Friday, Thunder Bay Regional Health Sciences Centre president and CEO Rhonda Crocker-Ellacott acknowledged the measures may cause stress for some patients and their families, but said there's an urgent need to free up beds for new patients requiring acute care.
The hospital is seeing an escalation in emergency department volumes, along with increasing numbers of patients continuing to occupy hospital beds while waiting for alternate care or services in other facilities, she said.
As of Friday, TBRHSC had 107 of these Alternate Level of Care patients, including 33 ready for placement in a long-term care home.
The hospital is currently operating with 423 beds, plus 32 in its off-site Transitional Care Unit.
Last week, there were more than 30 patients waiting in corridors in the Emergency Department because no beds were available.
"If we can free up some flow for patients who need acute care urgently, it's a really good thing. It also means, for those patients waiting for long-term care, they're getting more appropriate care. Our hospital doesn't have the services that would be available in a long-term care facility," Crocker-Ellacott said.
Those services include items such as recreational therapy and social, dining and other supports.
She said some TBRHSC patients have been waiting to be moved to other facilities for many months, and in some cases even years.
According to Crocker-Ellacott, there are currently seven or eight beds available in various nursing homes in Thunder Bay.
"If we can match eight patients of the 33 [currently in hospital] to available community beds, that's a good thing for any acute-care hospital. It means those patients waiting in the Emergency Department will get access to acute care more readily."
The government of Premier Doug Ford has come under sharp criticism for Bill 7 from the opposition parties and other critics, with the NDP calling it "horrifying" and the Liberals accusing the government of trampling on patients' rights.
The legislation enables patients in Northern Ontario to be transferred up to 150 kilometres away if necessary, while in Southern Ontario it can be up to 70 kilometres away.
Long-Term Care Minister Paul Calandra has indicated some patients in Northern Ontario could end up going to nursing homes even farther away than 150 kilometres, if there is no vacancy within that radius.
Patients should still be accommodated in the Thunder Bay area
But Crocker-Ellacott said that's extremely unlikely to happen in Thunder Bay and the district, because "we don't have that number of available beds in the Northwest."
That means people transferred out of the hospital to facilities they wouldn't otherwise choose will still remain in Thunder Bay, she said.
Moving eight individuals out of TBRHSC beds will make only a modest difference to start with.
"We're hoping that, over time, it will help to improve system flow, and really help [facilitate] a better conversation with respect to where's a better place to wait and how do we ensure people get to their first choice as quickly as possible."
She added that she recognizes how emotionally distressing transfers may be to people.
"I can understand how challenging it is when you have a loved one not wanting to go somewhere to wait. The balancing against that is that we have a trauma patient with a heart attack waiting on a stretcher in the Emergency Department, and an overwhelmed ED... It's a push-pull, it's a very difficult piece, but it's really [about] that balance."
Other hospitals in the province, such as the Trillium Health Network, which represents three hospitals, and the Scarborough Health Network, have also welcomed Bill 7.
Scarborough Health Network interim CEO David Graham told CTV News, “We know that the longer it takes to be admitted to hospital or receive required surgeries, the worse the outcome is for the patient."
Conversely, the Ontario Health Coalition has charged that Bill 7 is "rife with discrimination against the elderly."
The coalition is a network of seniors’ groups; patients’ organizations; unions; nurses and health professionals’ organizations; physicians and physician organizations that support the public health system; non-profit community agencies; student groups; ethnic and cultural organizations; residents’ and family councils; retirees; poverty and equality-seeking groups; women’s organizations, and others.
It says the legislation will push elderly patients and people with chronic care needs out of hospitals, overriding their right to consent, and notes that it requires hospitals to charge patients waiting not only for long-term care, but also for home and community care.
In 2019, the Ontario Hospital Association calculated that at that time, it was costing approximately $500 per day to provide care for a patient in hospital, $150 in long-term care and less for home and community care.
