The one-per cent cut for more than 100 long-term care sites in the last Nova Scotia budget might not seem like much, but some administrators say it's having a big impact.
Anthony Taylor, the administrator at Oakwood Terrace in Dartmouth, said the cut comes following others last year, making it even more difficult.
The 111-bed non-profit nursing home lost $82,000 in funding last year on account of several changes by the health department. This year the funding cut amounts to $86,000.
Biggest cuts ever
"Those two years, back to back, this government has cut more money from this nursing home than any other government has done to this home in the 34 years we have existed," said Taylor.
In an effort to find savings, Oakwood removed a scheduling position, no longer has reception on evenings and weekends and has significantly reduced overtime. For a second year in a row Oakwood finds itself in deficit. Getting out will require fundraising or more cost-cutting, said Taylor.
"You can't really get out of it; it's a vicious cycle."
Looking everywhere for savings
Halifax-based Northwood also finds itself in deficit this year.
Administrator Janet Simm said last year's cut amounted to $360,000 from their long-term care program. They expected a similar cut this year, but it was much bigger: about $600,000.
Simm said they're doing everything they can to save money:
- Evaluated energy costs.
- Tried to increase savings on over-the-counter drugs.
- Worked with a group-purchasing and shared-services program.
- And left administrative vacancies unfilled.
Simm said the biggest challenge right now is with food, as more and more residents have special dietary needs.
"With rising costs of food and the decreasing budget, it's a real challenge to meet the growing demands," she said. "This is where people live and you want to make sure the food is high quality because it is a big piece of quality of life."
NDP Leader Gary Burrill said it's clear from what administrators are saying that a one-per cent reduction has real implications.
"It's very likely to have an impact on the program to do with recreation, it's very likely to have an effect on diet and food and it is particularly likely to have an effect on staffing," he said.
A long-term care site in Port Hawkesbury recently issued layoff notices to eight staff in the cleaning and cooking departments. Burrill said that's to be expected when sites lose two per cent of funding in two years. His party has called for more funding and more long-term care beds.
"It's not like any long-term care facilities have got big piles of money sitting in a safe somewhere that they're saving for a future day."
Patty Saunders doesn't.
'Just another kick in the teeth'
She and her husband operate Saunders Rest Home in Bridgetown, an eight-bed residential care site, meaning it's the lowest level of care. (As Saunders describes it, all of her clients could get out on their own if the site needed to be evacuated).
Saunders said smaller homes were already operating on shoestring budgets before reductions started to happen; she only has one person on staff.
"Basically we operate in overdraft and on credit most of the time anyway. So a one-per cent reduction for us is just another kick in the teeth."
Saunders said there is no more wiggle room: she doesn't control the cost of food and can't reduce staff.
"I'm putting my finger in the dam all the time, just trying to find the biggest hole at any given point to figure out where the money has got to go this month."
Health Minister Leo Glavine said before cuts were made department staff met with administrators, who felt the cuts were doable through partnerships, reviewing contracts and not filling administrative vacancies.
The minister noted there has been no change in front-line care from nurses or continuing care assistants because there are defined requirements for staff related to hours of care.
"I have not heard any ground swell of challenges, because [administrators] know that if they have an infrastructure issue they can, again, go to the department to get that addressed on a year-over-year basis."
Home care a national trend
The province is part of a national trend of placing a greater emphasis on keeping people in their homes longer. The Liberals have put $55 million into home care in the last three years and signalled they will not build any new long-term care beds, although refurbishments to some are coming.
Glavine said this shift reflects that nursing homes are places that should be saved for the people who need the highest levels of care.
"I think we will move away from the concept of the nursing home as a place where people live eight, nine, 10 years."
Failing to see the impact
But Taylor said the province's approach on home care is "pushing us to the brink of not being sustainable at all." He's frustrated because some of the cuts haven't been handled transparently, and troubled that some homes in the province have contracts that protect them from cuts.
Home care is important and should be supported, some of the new government support isn't actually new money, he said.
"They've just shifted money from long-term care to home care, which is fine. That's their decision to do. But they fail to recognize or even comprehend the impact that that's having on long-term care."