The operators of eight long-term-care homes in Toronto with nearly 1,300 residents have told the province they intend to shut down and move their operations elsewhere, CBC News has learned.
Six other nursing homes, with more than 500 residents, are considered "at risk" of leaving the city, according to an assessment by the Toronto Central Local Health Integration Network (LHIN), a regional administration agency under the province's Health Ministry.
The agency is refusing to reveal which homes are under threat of relocating.
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"The information you have requested is not publicly available as the long-term care homes have not consented its release," said Megan Primeau, communications director for Toronto Central LHIN, in an email to CBC News.
The umbrella groups representing nursing homes in Ontario are also declining to name the facilities.
The potential for 14 homes to leave Toronto, disrupting the lives of some 1,800 residents and their families, comes amid a chronic shortage of long-term care beds across the province. About 28,000 people are currently on the waiting list for the 79,000 spaces in Ontario nursing homes.
Industry officials say the long-term care operators are considering leaving Toronto because the provincial government is not giving nursing homes in the city an adequate subsidy to rebuild to meet the Health Ministry's new design requirements, such as eliminating four-bed wards.
More than 300 long-term care homes across Ontario are slated for redevelopment over the coming decade to meet the new standards, including 20 in Toronto Central LHIN.
Toronto Mayor John Tory said Tuesday morning he intends to contact counterparts in the provincial government to discuss how the situation can be resolved. He added this is simply one more instance in which provincial regulations fail to account for the fact that providing long-term care on a consistent basis in Toronto "is going to be different and more expensive than it's going to be in Sudbury or Guelph.
"I would just hope that the province would take a second look at this," Tory told reporters.
Construction subsidy 'doesn't work' for Toronto
"The problem with Toronto is the cost of land is astronomical, the development fees are quite high," said Candace Chartier, CEO of the Ontario Long-Term Care Association, representing 437 homes, the majority run by for-profit companies.
"If you can find land it's millions of dollars, and with the current construction funding subsidy itself, the land would not work because of that," said Chartier in an interview with CBC Toronto.
It's a similar message from the association that represents non-profit long-term care providers, AdvantAge Ontario. Its CEO, Robert Morton, said long-term care facilities in central Toronto can't meet the government's requirements for more space on their existing properties, and buying more land is too expensive.
"It becomes unaffordable for a not-for-profit or municipal home to find a site," said Morton.
Subsidy adequate, health minister says
Health Minister Eric Hoskins rejects the notion the provincial subsidy is inadequate for Toronto and says that some homes in the city are rebuilding.
"I do appreciate the cost of land in Toronto is higher than in other parts of the province, but there is new construction of long-term care happening in Toronto … so I'm confident that it can be done," said Hoskins in an interview.
Provincial subsidies will fund 60 to 80 per cent of the cost of rebuilding long-term care homes, he said.
Are you affected by these homes potentially leaving Toronto? Click here to email CBC Toronto and tell us your story.
The news that long-term care homes could shut down and leave Toronto is revealed in the latest annual report by the CEO of Toronto Central LHIN, which covers an area from Islington Avenue to Warden Avenue, generally south of Eglinton Avenue. The document says the agency contacted the operators of the 20 long-term care homes in this area that need to be redeveloped to meet the new design standards.
"Based on the discussions with [long-term care] home operators, three groups have emerged," says the report:
- Committed to stay in Toronto Central LHIN — six homes (1,011 beds).
- At risk of leaving — six homes (519 beds).
- Intending to leave — eight homes (1,270 beds).
Those 20 homes are listed below.
'Holding the government hostage'
Advocates for people living in long-term care question the operators' motives.
"They're holding the government hostage," said Kathy Pearsall, spokesperson for Concerned Friends of Ontario Citizens in Care Facilities. "I don't know why they would threaten that way unless they think they can boost their stocks by closing these homes down and maybe reinvesting somewhere else."
For-profit companies run 57 per cent of long-term care homes in Ontario, charities run 24 per cent and municipalities 17 per cent, according to figures from the Ontario Long Term Care Association.
"It is always a concern that homes may have to move outside the city, because it involves moving a vulnerable population from their home and creates stress for the family caregivers," said Lorraine Purdon, executive director of Family Councils of Ontario, representing the loved ones of people living in long-term care.
"On the other hand, many homes do need to be rebuilt," said Purdon in an email to CBC Toronto. "It really is a very challenging project."
The Liberal government promised in 2007 to redevelop 35,000 long-term care beds over the decade to come. It did not hit that target. By 2014, the number of beds to be redeveloped stood at 30,000. The government revised the program, offering a higher construction funding subsidy to reflect inflation.
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Chartier said the current construction funding subsidy "does not work at all" for long-term care facilities in Toronto.
"The ones that are intending to leave have done all their due diligence, they've worked with their architects, their financial lenders, the availability of land, and it's not working," said Chartier. "So what they're probably doing is looking at transferring those beds outside of the Toronto Central LHIN to where they can find land at a price that works for them."
Chartier rejects describing the homes' message as a threat.
"Nobody wants to uproot residents and move them out of the city and out of the area that they've lived in, but what they do want to do is to sit around a table and strategize of what we can do better," she said.
Chartier would not say how much more the government should contribute, but said the association will make public its budget proposal later this month. "We've given [the government] some options of how the construction funding subsidy could be increased at low or no cost to them," she said.
The lengthy wait-lists to get into nursing homes contribute to hospital overcrowding in Ontario, as many acute care beds are occupied by patients who don't need to be in hospital but are waiting for a long-term care bed to become available.
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Listed below are the 20 long-term-care homes in Toronto Central LHIN that are designated to be rebuilt to meet the province's new space guidelines. Of these, six are committed to staying in the city, six others are "at risk" of leaving, and eight are "intending to leave," according to the LHIN, but officials are refusing to say which ones fall into each category.
- Castleview Wychwood Towers.
- Cedarvale Community Lodge.
- Chartwell White Eagle Long Term Care Residence.
- Elm Grove Living Centre.
- Fairview Nursing Home.
- Fudger House.
- Garden Court Nursing Home.
- Ivan Franko Long Term Care Home.
- Lakeshore Lodge.
- Main Street Terrace.
- Maynard Nursing Home.
- Nisbet Lodge.
- Norwood Nursing Home.
- St. Clair OConnor Community.
- St. George Care Community.
- Suomi-koti Toronto Nursing Home.
- The Heritage Nursing Home.
- The O'Neill Centre.
- The Rekai Centre at Sherbourne Place.
- Vermont Square.