Nursing home wait list hits record high — and is now holding up 500 hospital beds

The number of New Brunswick seniors waiting to get into a nursing home has reached a record high, and nearly 500 of the people on that list are waiting in hospital beds that could be used for acute care, according to a seniors' advocate.

Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, said 833 people are on the waitlist as of November. Of those, approximately 483 are in hospital

That's up from 782 and 455 in October, according to data from the Department of Social Development.

Cassista described the numbers as "astounding" and "very upsetting."

They're the highest they've been since she started tracking them in 2006-07, she said.

"I'm really… frustrated because the government is not taking the responsible role to make sure that our most vulnerable seniors are protected. And it's just like they've been forgotten."

The latest statistics come as the triple threat of respiratory illnesses — the flu, respiratory syncytial virus, known as RSV, and COVID-19 — increases the strain on the hospital system.

Created emergency care beds during COVID surge

In January, during a surge of COVID-19 Omicron hospitalizations, the Department of Social Development announced it would work with long-term care home operators to create emergency care beds for people waiting in hospital for placements in a bid to reduce pressure on the health-care system.

The beds, primarily in special care homes, would provide short-term alternate placements for patients until a bed in their preferred location became available, the department said in a news release at the time.

CBC asked both the Department of Social Development and the Department of Health whether they plan to relocate any of the hundreds of seniors waiting in hospital and free up hospital beds for patients with respiratory viruses and other illnesses, but did not receive any response.

At the beginning of the pandemic, the province also introduced an "urgent nursing home placement process" to free up hospital beds occupied by the so-called alternate level of care (ALC) patients. About 65 seniors were transferred to nursing home beds to make way for an anticipated influx of COVID-19 patients.

Space in special care homes

There are 71 licensed nursing homes across New Brunswick that provide 4,953 beds.

But as of Nov. 13, the latest figures available, 276 beds sat vacant due to staff shortages, among various other reasons. 

According to Cassista, there are beds available in special care homes — but they're expensive. The beds cost between $5,000 and $6,000 a month, compared to about $3,450 a month.

Cassista said that would cost less than keeping seniors in a hospital bed, which she said costs around $800 to $1,000 a day.

It would also be better for the seniors, whose health can deteriorate while they wait in hospital, she said, which could extend the time they have to remain in hospital.

"Hospital's no place for anyone to languish. It's there for sick people," she said.

The New Brunswick Special Care Home Association did not respond Thursday to a request for an interview about the availability or cost of beds. In January, president Jan Seely told CBC about 800 of the province's 7,000 special care beds were vacant.

Failed to address increased demand

Last year, then-auditor general Kim Adair-MacPherson said the government had failed to address the increased demand for nursing homes. In her report, she cited July 2020 statistics. At that time, 773 seniors were waiting for a nursing home placement. Of those, 365 were waiting in hospital.

The number of seniors over the age of 75 will double by 2036, warned Adair-MacPherson.

"The province is not ready for the increase in seniors requiring placement in a residential facility," she said.

Three weeks ago, the province announced plans to build four 60-bed nursing homes in Bathurst, Bouctouche, Moncton and Oromocto. It will be a couple of years before they open, said Social Development Minister Dorothy Shephard.

The four homes are part of the government's 2018-2023 Nursing Home Plan to build 10 homes, adding about 600 beds.

Cassista called the plan to build new homes "ludicrous."

"I don't know who's going to staff them."

There were nearly 400 job vacancies in the sector, as of August.

Focus on recruitment

Instead, she thinks the government should focus on a better recruitment strategy and said this could include loosening accreditation requirements for trained and qualified immigrants.

"Get them working alongside other workers. I mean, these are smart people that [are] coming here. They're well-educated. … We should put them in the profession that they've actually studied for," she said.

The Department of Social Development is working with partners, such as the New Brunswick Association of Nursing Homes, the regional health authorities, and Department of Health to "explore several solutions to the challenges the long-term care sector has encountered," spokesperson Rebecca Howland said in an emailed statement.

Among the initiatives, the department is working to ensure "active representation" at multiple job fairs online and in person, at national and international levels, she said.

Cassista would also like to see the assessment process streamlined. As it stands, it can take months, she said.

She maintains seniors would be better served under the Department of Health, as they were prior to 2000, and as they are in other provinces. The Department of Social Development is "so huge and so complex" she said, that seniors are "getting lost in the system."

She also called for more resources for home care.

Howland said Social Development added staff to discharge teams within hospitals earlier this year to assist with the process of moving seniors waiting in hospitals to nursing homes.

"As all of our efforts continue, the department will work closely with facility operators to ensure New Brunswickers receive the best care and support possible," she said.

"Although the Department of Social Development is focused on responding to the growing aging population in the coming years, we also want to ensure the needs of New Brunswick's most vulnerable are met now."