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Exterior photos of the Nanaimo Seniors Village in Nanaimo, B.C., on Dec. 3, 2019. The report says care homes in the not-for-profit sector spent 10 per cent more of their revenues on direct care compared with care homes in the for-profit sector.CHAD HIPOLITO/The Globe and Mail

The operators of for-profit senior care homes spend less on their residents than non-profit homes and fail to deliver on the services they are being paid to offer, B.C.’s seniors advocate has found.

Isobel Mackenzie’s latest report, released Tuesday and entitled “A Billion Reasons to Care,” provides the first in-depth look at how the province’s $1.4-billion contracted long-term care sector is spending the public money it receives. The report finds significant differences in expenditures between for-profit care homes and their not-for-profit counterparts.

The report says care homes in the not-for-profit sector spent 10 per cent more of their revenues on direct care compared with care homes in the for-profit sector. The report finds that with the same level of public funding, the for-profit operators failed to deliver 207,000 hours of funded care while the not-for-profit sector delivered 80,000 more care hours than they were funded to deliver.

The report reviewed industry contracts, annual audited financial statements and reporting on revenue and expenditures for the years 2016-17 and 2017-18.

The report points out that the for-profit sector generated 12 times the amount of profit generated by the not-for-profit sector, and spent more than twice as much on building expenses.

“It translates into $10,000-a-year-per-resident difference between what is being spent on care in for-profit care homes and what is being spent on care in not-for-profit care homes,” said Ms. Mackenzie, adding for-profit care homes spent $37,000 a year on care for their residents compared with $46,000 spent by their non-profit counterparts.

“As a senior advocate, this is one of the more troubling findings from this review is this disproportionate spending on direct care by care homes who are receiving the same amount of public funding.”

The review also highlights wages paid to care aide staff in the for-profit sector can be as much as 28 per cent or $6.35 less per hour than the industry standard.

Last year, B.C. health authorities imposed outside management at three Retirement Concepts care homes on Vancouver Island. The unusual intervention followed investigations into neglect of residents that has been attributed to acute staffing shortages. The investigations uncovered a litany of infractions involving patient health and safety.

The Retirement Concepts chain, the largest private provider of resident long-term care beds in the province, was sold to China’s Anbang Insurance Group in a deal approved by Ottawa in 2017 despite widespread concerns about how foreign ownership might affect the quality of care.

The company that operates the Retirement Concepts facilities said in December the industry was having a “staffing crisis," but also acknowledged that its lower wages were causing a problem.

Ms. Mackenzie’s report notes that in 2017/18, the industry-standard base wage rate for a care aide was $23.48 an hour, but the lowest confirmed wage rate of $16.85 an hour was found in a for-profit care home.

“It’s very concerning to me to think about what messages we’re saying to the people who might want to work in care when we see this kind of differences in wages paid within our publicly funded system that is all supposed to be delivering the same level of care,” Ms. Mackenzie said.

Meanwhile, the report states that the funding and monitoring system in the sector lacks accountability, openness and transparency.

Ms. Mackenzie listed five recommendations in the report, including calling for publicly funded care homes to make their revenues and expenditures public, and to ensure that funding for direct care to be spent on the service.

In B.C., more than 27,000 seniors live in 300 publicly funded longer-term care homes. There are an estimated additional 3,000 seniors living in private-run care homes, which were not included in this review, and do not receive government funding.

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