More than 100 patients at Windsor Regional Hospital waiting for long-term care beds elsewhere equate to a 30-year hospital stay, officials say.
Two of the patients have each been at the hospital for more than 500 days rather than at a long-term care facility, where medical professionals say they belong. In total, approximately 100 patients account for 11,000 patient days, which should be used for other acute care normally provided at the hospital.
In November, the hospital cancelled four surgeries because of the lack of beds. None of the cancelled procedures were emergency surgeries.
"But these are patients who have planned their lives and schedules around these surgeries," said Karen McCullough, the hospital’s vice president of acute care. "We do it rarely, but when we do, it’s telling about how tight the flow is in acute care."
A year ago, there were approximately 150 patients between Windsor Regional and Hôtel-Dieu Grace waiting for long-term care. There were 35 spaces available in area nursing homes.
It’s worse today.
There are now approximately 185 patients in the two hospitals and on Jan. 17, there were six available beds.
McCullough has held her position for six years. She said nothing has changed in that time.
Numbers have 'tripled'
On Dec. 12, 2012, Ontario's auditor general released a money-for-value audit.
He found that 85 per cent of the 25,000 people placed in a long-term care home in 2011-2012 were 75 or older.
Since 2005, the number of Ontarians aged 75 or more grew by 20 per cent.
The median average wait for placement in a long-term care home tripled, since 2005, from 36 to 98 days.
Between 2012 and 2021, the 75-and-up age group in Ontario is expected to grow by another 30 per cent.
On the same day the report was released, Windsor Regional Hospital 92 patients waiting for long-term care while in a hospital bed.
It’s worse at Hôtel-Dieu Grace.
"Over the last year, these numbers are almost triple," said Janice Dawson, the hospital’s director of patient flow services.
McCullough said the long-term care patients, defined by the hospital as needing an alternate level of care, strain the emergency room and EMS system.
On average, Windsor Regional Hospital has 15 acutely ill patients every day in its emergency room waiting for a bed.
"They are very acutely ill, they’ve been admitted and we don’t have a bed to put them in," McCullough said. "Some patients wait for six hours, sometimes up to 48 hours, for a bed. If we didn’t have 30 patients waiting for long-term care facilities we’d have flow through our emergency department."
Windsor-Essex has 19 long term-care homes. Few have space for new residents.
Patients are asked to list three preferred long-term care facilities to be transferred to. Sometimes, patients refuse their choices, including their first. However, often, none of the choices become immediately available.
"Certainly, everyone has the right to their first choice. But it’s not as through patients waiting for long-term car are being challenging. It’s very rare to have a vacant bed," McCullough said.
The map below shows all the long-term facilities in Windsor-Essex and the number of beds at each.
View Windsor-Essex Long-term Care Facilities in a larger map
'I just have to be patient'
Rena McAdam fell in November. She was eventually brought to Windsor Regional’s Tayfour Campus and hasn’t been able to leave.
"It’s sort of boring," she said. "There is physiotherapy, and as long as I’m kept busy, I’m all right. But if I’m just lying here in bed, it’s pretty boring. I was used to being very active.
"There’s a long waiting list. I just have to be patient."
She has no immediate family. The two nephews she does have don't live close by.
Windsor Regional Hospital CEO David Musyj said a hospital is no place for a person who needs to be in long-term care.
"In a long-term care facility, they would have an opportunity to interact with other residents, other caregivers and be able to socialize," Musyj said. "A hospital is not built for that. A hospital is not where they should be."
A year ago, Musyj suggested that hospitals be allowed to pay patients to leave hospitals.
Musyj said his suggestion was passed up the line, through the local health integration network and to the ministry of health but was rejected.
However, hospitals can now charged patients for the real cost of care they receive while in hospital if patients have no valid reason to reject their first-choice long-term care bed. That means a patient could be charged as much as $1000 per day.
Musyj said that hasn’t happened at his hospital. However, staff has, on occasion discussed with some patients their family about doing so.
Schlegel Villages is scheduled to open a 256-bed long-term care facility on the campus of St. Clair College in 2014. It will do little to fix the problem, hospital officials said.
"Even before the doors open at the new facility, it’s full," McCullough said.
Besides the nearly 200 people waiting in hospital, there are another 400 in the community McCullough and Musyj said.
"We need to look at existing long-term care facilities and see if they have the ability to expand and talk to them about increasing their licenses so they can provide more beds for the residents that want to go there," Musyj said.