Ontario Long-Term Care Minister Paul Calandra kept calm and carried on this week when news broke that the operators of a number of privately operated long-term care homes in his province planned to get out of the business in the next few years.
The story in The Globe and Mail said the operators were opting to sell their buildings into a hot real estate market rather than pay for costly upgrades required by the provincial government. The report said 20 for-profit homes across the province won’t be renewing their operating licences when they expire in 2025 – including six in Toronto that together provide nearly one in 10 of the city’s LTC beds.
Mr. Calandra says his government foresaw this development and worked it into its program to expand LTC availability. Based on his blasé response, the Ford government needs to show a lot more urgency on this matter.
Under its plan – which on paper might appear ambitious – there’s a chance that in five years Ontario will have less long-term care capacity compared with need than it does now. That’s the latest analysis by the Financial Accountability Office of Ontario, released last month.
The FAO estimates that the number of LTC beds in Ontario will increase from 78,200 in 2019 to 105,000 by the end of 2027-28, a jump of 34 per cent.
But it also estimates that the number of Ontarians aged 75 and up – who occupy more than 80 per cent of long-term care beds – will increase by 37 per cent over the same period, leaving fewer beds per person over 75 in 2027-28 than there were at the start of the pandemic three years ago.
That would be disastrous. Lest we forget, a chronic failure to build enough LTC beds in modern facilities, and to staff them properly, was a contributing factor in the COVID-19 deaths of thousands of LTC residents in Canada’s two most populous provinces, Ontario and Quebec, and to a lesser degree in other provinces.
In what has to be the most glaring example of that failure, the FAO says Ontario added a grand total of 87 LTC beds between 2012 and 2019 – a period during which the population of Ontarians aged 75 and up grew by 24 per cent.
Eighteen months into the pandemic, before vaccinations in LTC homes began in earnest, 80 per cent of the Canadians killed by COVID-19 were seniors living in long-term care homes and retirement homes. Understaffed, maxed-out facilities where people were supposed to live out their lives in comfort and safety instead became death traps.
Among the reasons for that were underpaid staff who worked in multiple homes and carried the disease from job to job, older homes with ward-like rooms containing four or more beds, a failure to operate under the assumption that asymptomatic people could transmit the virus, and resulting delays in testing and masking workers.
The outrage caused by the slaughter prompted calls for dramatic but unworkable reforms. They included the nationalization of all LTC homes, the creation of federal standards for LTC homes even though it’s a provincial jurisdiction, and bringing long-term care under the umbrella of medicare.
Those were but sidebars to the real issue: the lack of LTC beds of any kind – for-profit, non-profit or government-run – in a country that is aging rapidly, and also growing rapidly.
The Ford government says it will create 30,000 new LTC beds and upgrade another 30,000 by 2028. It has also begun to raise the wages for LTC workers. Ottawa is chipping in billions to help the provinces raise wages, build new homes and improve existing ones.
But if Ontario is anything to go by, it won’t make enough of a difference. The FAO says more than 39,000 Ontarians were on the wait-list for a long-term care placement last November. Based on the FAO’s analysis, that number could well be higher in five years.
And that means there will be even more seniors occupying much-needed acute-care beds in hospitals while they wait months and months for a placement – the other serious consequence of inadequate long-term care in Ontario and elsewhere.
It is disturbing to see that even after the pandemic’s lessons about the dangers of not meeting the demand for long-term care, the Ford government and Ottawa don’t appear to have grasped what the essential problem is, and just how big it is.
Canada needs many more LTC beds, at the cost of many more billions. What will it take to make our elected leaders understand that?