N.S. long-term care home closure a sign of industry staffing woes, experts say

A long-term care home in the Halifax area is planning to close and some experts say the case is emblematic of challenges plaguing the entire sector.

Administrators at Ivy Meadows, a 38-bed facility in Beaver Bank, N.S., have decided not to renew their contract with the province to provide continuing care. Spokesperson Tracey Tulloch said a closure date of Nov. 30, 2023 was chosen to give ample time for residents to be transferred to other facilities.

"It has been a challenge for a very long time to staff the facility," Tulloch said in an interview.

She acknowledged staffing is a long-standing and widespread problem in long-term care, but she chalked up Ivy Meadows' particular challenges to geography. It's about 15 kilometres from Lower Sackville, and used to be on a public transit route, but that line was cut two years ago.

"It's a lovely community, and I think anyone would say that the facility itself is very nice and it's got a good feel to it," said Tulloch. "I believe it's just that little bit further beyond the usual HRM zone that people are comfortable travelling in."

Rosecrest Communities, the parent company of Ivy Meadows, operates two other long-term care homes in Nova Scotia: The Magnolia in Enfield, and Sagewood in Sackville. Tulloch said those locations haven't had as much trouble hiring and keeping staff as Ivy Meadows.

Tulloch said the staffing challenge is primarily with continuing care assistants (CCAs), a part of the long-term care workforce that union leaders have said is chronically short staffed because the workers simply aren't paid enough.

'A canary in the coal mine'

Benjie Nycum, an architect who has designed more than a dozen long-term care homes, said he too considers CCAs underpaid, contributing to a global shortage.

"Being able to get workers to and from their home to a facility where they work is a major issue," he said, referring to Ivy Meadows. "But it's really just a kind of canary in the coal mine of a very big issue that's actually being experienced all around the world — we have more people that need care than we have people that can provide that care."

Janice Keefe, a professor of gerontology and director of the Nova Scotia Centre on Aging at Mount Saint Vincent University in Halifax, said she was initially surprised and disappointed to hear about the closure of Ivy Meadows.

"It was very much a home-like atmosphere … there was a real sense of community and I think that is the type of facility that we want to have as part of our continuum of care in the province.

"The challenge, of course, is that it is remote," Keefe said.

She said rural facilities in particular are trying hard to be innovative in their recruitment efforts by searching internationally, making use of a CCA-specific provincial immigration stream, and making housing accommodations for new staff.

Glen Haven Manor in New Glasgow has taken it a step further by training people in-house to work as CCAs. CEO Lisa Smith told CBC's Information Morning the training program, delivered by a former NSCC instructor, is responsible for 30 per cent of the CCAs working at the facility.

"They are some of our best CCAs," Smith said.

Those workers are unionized just like other CCAs, but they don't receive a formal CCA designation and so their qualifications might not be recognized at other facilities, should they leave Glen Haven Manor.

Smith said the program has been a key factor in her facility's successful operations over the past few years, but she doesn't think it's the answer to the sector-wide staffing challenges. She said CCA wages should rise from $18.95 to $30 an hour, and a professional body or association should be created.

Smith said CCAs are "well worth" the extra money and attention.

"They are caring for what should be the most valued members of our society, our elders."

Meanwhile, the province is planning to create more than 200 new long-term care beds in the coming years in an effort to address a long wait list and to meet new infection control standards that require single rooms for every resident.

Nan McFadgen is the president of CUPE Nova Scotia, which represents about 3,000 CCAs, including some who work at Ivy Meadows. She said its closure is an indication that staffing those beds may be more difficult than building them.

"They're going to be serious challenges without serious change," McFadgen said.

Kristen Lipscombe, a spokesperson for the provincial government, said the Health Department will try to replace the beds at Ivy Meadows through procurement, taking into account any proponents' ability to meet staffing needs.

She highlighted ongoing efforts to grow and support the CCA workforce, including a bursary program for students, and said a recruitment and retention strategy is under development.