For-profit operators of long-term care facilities in British Columbia failed to provide half a million hours of direct care last year that they were paid by taxpayers to deliver to residents, a new study says.
The report released Monday by Isobel Mackenzie, B.C.’s independent Seniors Advocate, takes aim at the for-profit operators that provide more than half of the long-term care beds in the province, saying the funding system allows them to boost their profits by delivering less care to residents than the non-profit operators.
“We are rewarding them for not spending on the care,” she said in a news conference, adding that the province has not pursued those operators that have provided less care than they were paid for.
The province transfers $2-billion each year to the private sector to provide for a majority of the 28,000 long-term-care beds that are publicly subsidized, Ms. Mackenzie notes in the report. Despite cost pressures from inflation and the COVID-19 pandemic, profits have climbed by 113 per cent over the past five years.
In a side-by-side comparison of two unnamed long-term-care facilities, both the same in size, Monday’s report highlights how the non-profit operator spent an average of $229 per resident on care each day, while the for-profit operator spent $151 daily per resident. Labour costs are the largest expense in long-term care, and direct care is a key indicator of patient care.
Overall, the review found not-for-profit facilities provided 93,000 more care hours than they were funded to deliver in the fiscal year 2021-22, while for-profit facilities provided 500,000 fewer hours of care than they were paid for.
Ms. Mackenzie was silent for several seconds when a reporter asked her how the province could recoup the money it paid for services that were not provided.
“Ask for it back,” she finally said.
The BC Care Providers Association, which represents the majority of B.C.’s contracted not-for-profit and for-profit long-term care operators, welcomed the call for a new funding formula for long-term care.
But the association’s chief executive officer, Terry Lake, questioned some of Ms. Mackenzie’s findings, saying it is too early to draw conclusions based on COVID-related spending because the dust hasn’t settled on the financial accounting.
“To say this time was chaotic is an understatement,” he said in a statement.
The report concludes that the provincial government has made significant investments over the past five years to improve the quality of life for residents in long-term care, but progress is limited in a system that is rife with inequities.
She calls on the provincial government to enact changes to ensure that seniors are provided with minimum hours of direct care, no matter who owns the long-term-care facility where they live.
The federal government, meanwhile, is working on legislation to implement national standards for long-term care that have been introduced but not mandated. The new standards are designed to boost quality of life and prevent the spread of infection after the pandemic exposed disturbing shortfalls in care.
Ms. Mackenzie said those federal standards could improve the minimum standards for care, but the province still needs to create regulatory powers to ensure they are met, similar to the enforcement regime that is in place for child-care facilities.
In an interview, B.C. Health Minister Adrian Dix brushed aside a question about the failure by some operators to fully deliver the care they were contracted to provide.
“The issue is not just funding the care, it’s about ensuring we have the workers,” he said. He cited the “extraordinary collective achievement” of recruiting of thousands of workers to the sector since the start of the pandemic.
“And, we are putting in place new reporting tools – enhanced accountability and oversight of funding – something we’ll be presenting soon.”