MORE CARE with more beds.

There is a growing demand for service throughout Ontario’s long-term care sector. The waitlist for care has grown by 8,000 since 2015, reaching 32,000 individuals as of June, and continues to grow at a rate of 15% per year.

Most, if not all, of these seniors are being cared for at home or in hospital (in an ALC bed) while waiting for placement. These are not suitable places for seniors who require the specialized care and support that long-term care homes offer. If there are no new beds added to the system, the waitlist could grow to over 84,000 seniors in the next 10 years (by way of comparison, this group would be larger than the entire population of Peterborough).

We need to provide homes with the necessary resources to redevelop.

This demand and capacity issue is resulting in increased wait times for long-term care and over- capacity hospitals throughout Ontario’s health care system. It’s a poor use of valuable tax dollars (it costs over $750 per day to care for a senior in hospital versus $175 per day in a long-term care home) and increases strain and emotional stress on family caregivers.

Potentially impacting this challenge further is
an issue related to deteriorating infrastructure. Approximately 40% of Ontario’s long-term care homes (300+ homes, 30,000+ beds) must be either rebuilt or renovated by 2025 – that is when the licenses for these homes and their associated beds expire. But progress is less than slow.

The current renewal program, which was released in 2014, has only shepherded a handful of projects, despite a significant number of applications to the Ministry.

Under the current program operators must build to design standards that call for homes to be built with 32-bed resident home areas. In many cases, operators do not have the necessary number of beds to build to multiples of 32. Most are also looking to build homes at 128 beds or more, so as to improve economies of scale associated with their projects.

Under the current scenario, an operator must either acquire licenses by purchasing from another operator, or amalgamate their homes to achieve adequate economies of scale and meet the design requirements. That’s why additional licenses are important, not only because they directly address the sector’s capacity needs, but because new beds would also support the viability of many capital renewal projects.

Redeveloping a home in a rural community can be particularly challenging and these make up the bulk of the homes in need of upgrading. There are more than 300 Ontario homes that require redevelopment and 188 are small (with less than 96 beds). Many are situated in small and rural communities. For many operators, amalgamating a number of small homes is one solution they are reluctantly forced to consider. The reluctance stems from the need to choose one community over another when both would benefit from renewed long-term care homes. In many cases it is the additional licenses that could make a difference. Operators could move forward with certain projects if there was a pool of licenses they could draw from to support their projects.

ENHANCING THE CONSTRUCTION FUNDING SUBSIDY

One of the biggest issues keeping long-term care operators from moving ahead with redevelopment has to do with subsidies. The province gives older homes a per-resident-per-day subsidy for redevelopment. This is known as the Construction Funding Subsidy (CFS). The long-term care sector has been very vocal about the need to enhance funding in this area.

Based on some general analysis conducted by our operators, we believe that growing the CFS by $4 per-resident-per-day would mean more than 80% of our older long-term care homes could be renewed (with the exception of homes in the GTA where the cost and availability of land
is significantly more than anywhere else).

WHAT DO WE NEED TO GET MORE BEDS?

  • The government should commit to the addition of up to 10,000 new long-term care beds over the next five years, solely dedicated to helping improve the viability of existing capital renewal projects throughout the province.
  • Ensure homes can continue to equitably participate in the Enhanced Long-Term Care Home Renewal Strategy program by growing the CFS at the rate
 of inflation (as per Ontario Construction CPI) until the end of the program.
  • The CFS could be increased by adjusting the way long-term care homes are taxed, by considering them residential instead of commercial and then having the Ministry use those savings to grow the CFS.
  • The government should create a small and rural community long-term care home sustainability strategy (128 beds and less) inclusive of enhanced construction funding and operational subsidies by adding $4 per-resident-per-day to their Other Accommodation funding.

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