Staff shortages prompt growing number of N.S. nursing homes to halt admissions

More than one in every 10 nursing homes in Nova Scotia have closed their doors to new admissions because of staffing shortages.

The province provided the latest figures to CBC News upon request following an announcement this week that it plans to invest $1.7 million into recruitment and retention efforts for the continuing care sector.

As of Nov. 1, 16 long-term care homes had paused admissions due to staffing levels. According to a provincial directory, there are 134 licensed long-term care facilities provincewide with a total of about 8,000 beds.

A spokesperson for the Department of Seniors and Long-Term Care said the province is working with the affected facilities to assess their needs and provide support.

Michele Lowe, executive director of the Nursing Homes of Nova Scotia Association, which represents about half the homes in the province, said the decision to refuse new residents is not taken lightly.

"There isn't an administrator in the province who wants to pause admissions," said Lowe. "We all know that elders who are assessed to be in long-term care, need to be in long-term care. It's specialty care and that's where they need to be."

CBC reported in September that some homes had started to refuse new residents because they were short-staffed. At that time, four homes were affected.

Many homes in Nova Scotia kept some beds vacant early in the COVID-19 pandemic to prevent viral spread, but the previous Liberal government eventually told them to return to full capacity or lose funding.

Barbara Adams, minister of seniors and long-term care in the new PC government, said funding has not changed for homes with vacancies, under the current circumstances.

"We are hopeful that if we can ensure that there's sufficient staffing that those beds will be able to be reopened as soon as possible," she told CBC News Tuesday.

Lowe said long-term care administrators began to worry this spring they might eventually need to stop admitting new residents, and were looking for guidance on making such a decision.

The association looked across the country for guiding documents on the topic and found none, so it developed its own, which Lowe calls "a framework to avoid bed closures."

She said the framework was shared with administrators in September, so they're now all able to follow the same list of criteria to determine whether they've reached a critical enough state to justify closing beds.

The framework lays out factors that indicate whether a home is in the "yellow zone," meaning it's very close to being at the point of having to close admissions, or the "red zone," meaning the home has reached the critical point where no new residents can be accepted.

As an example, Lowe said a home that's regularly pulling staff from other departments (including managers and administrators) to help feed residents during mealtimes is in the yellow zone. A home that has maxed out its ability to pull staff from other departments to help with key aspects of care is in the red zone.

Shortfall of at least 589 continuing care assistants

On Monday, the province announced a recruitment and retention strategy for long-term care and home care staff — in particular continuing care assistants (CCAs). Six recruiters are being hired to attract new workers, locally and abroad.

In Nova Scotia, like many other jurisdictions, there are too few CCAs.

Long-term care homes and home-care agencies recently reported 589 CCA vacancies in a survey conducted by the province. That figure is likely an underestimate, as not all facilities and agencies responded. 

Lowe called the new recruitment and retention strategy a "fantastic initiative," and one that the industry has been asking for for several years. But she doesn't think the plan goes quite far enough. She said wages for CCAs have to go up to make any recruitment efforts successful.

The call for better wages and benefits has been a common refrain from industry groups and union leaders in Nova Scotia. The Nova Scotia Government and General Employees Union reiterated that call Monday in response to the recruitment and retention strategy. It also called for the province to legislate a minimum of 4.1 hours of daily care per resident.

The Progressive Conservatives have promised to turn that staffing ratio into law, but Adams said it likely will not happen until next spring to give recruiters time to make up some of the current staffing shortfall.