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Barbara Coutts, right, with daughter Caroline on Feb. 13, was given notice that her subsidized assisted-living unit at Terraces on 7th would not be available any longer.

In announcing plans to turn some of its subsidized assisted-living units into more expensive private suites, Retirement Concepts has highlighted concerns about privatization in seniors' care, with critics suggesting the trend could put seniors at risk of having to move or pay more than they can afford.

"The extent to which health authorities have relinquished control of seniors' care to for-profit companies is deeply troubling," Jennifer Whiteside, secretary-business manager, Hospital Employees' Union, said on Monday.

"It puts subsidized assisted-living spaces and care home beds are at risk whenever these companies believe they can increase profits by marketing these services privately – or cash in on rising real estate prices."

Last week, Terraces on 7th, a Vancouver retirement home, told about 20 people that their subsidized assisted-living units would not be available as of September 30.

Terraces on 7th is owned by Retirement Concepts, a Vancouver-based company that was recently majority-acquired by a subsidiary of Anbang Insurance, a Chinese insurance conglomerate. Terraces on 7th was not included in that acquisition.

In a letter to residents, Terraces on 7th and Vancouver Coastal Health - which holds the contract for 21 assisted-living units at the site - said the move was "based on a business decision" and that residents affected would be given priority at one of VCH's other assisted-living sites if they chose to remain in that type of accommodation.

For tenants, some of who are in their 90s, the move is disruptive.

The HEU and others are also concerned that there is an insufficient, and shrinking, number of subsidized units.

In subsidized assisted-living units, residents pay 70 per cent of their income.

While the number of subsidized assisted living units has stayed relatively flast over the past years, the number of private assisted living units has increased in four of five regional health authorities, says a 2016 report from the B.C. Senior's Advocate,

In the Vancouver Island Health Authority, the number of private, registered assisted-living units went from 361 in 2012 to 621 in 2016, an increase of 72 per cent.

As of March, 2016, there were 918 people on a wait list for subsidized, registered assisted living, the same report said.

Caroline Coutts, whose mother Barbara Coutts lives in Terraces on 7th, says her mother's health has been affected by the worry and stress of potentially having to move.

Caroline Coutts is also worried that what's happening at Terrace could happen elsewhere, as contract operators decide it makes better sense to operate private-pay units rather than rely on contracts with health authorities.

"This feels like a tipping point," she said. "I'm worried if this goes through, other operators will be emboldened and do the same thing."

So far, however, that doesn't seem to be happening.

Vancouver Coastal Health spokesman Gavin Wilson said Monday that it has not received any other contract notices and that none are anticipated.

Fraser, Vancouver Island and Interior health authorities also said they had not received notices from contract providers.

The business decision by Terraces on 7th to eliminate subsidized assisted-living units in favour of more lucrative private pay units underscores potential pitfalls of relying on contractors, said Dr. Margaret McGregor, a clinical associate professor at the UBC Department of Family Practice.

"It speaks to this challenge of how public funds, taxpayer money goes into care [by companies] whose institutional goal is to make a profit," Dr. McGregor said, adding that pressures to generate a strong, consistent return can increase as an organization grows.

"It's putting very vulnerable people in the hands of a dynamic that is very hard to control, poorly accountable and hard to get out of once you [health authorities] have engaged in that type of agreement, " she said.

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