Assessment bottleneck keeping some P.E.I. long-term care beds empty, says CEO

Long-term care is facing its share of challenges on P.E.I., but staffing is not always one of them, says the CEO of P.E.I. Seniors Homes.

In fact, Jason Lee said there are 14 rooms available between Garden Home and Whisperwood Villa in Charlottetown and he has staff "ready and waiting" for people to be admitted.

Part of the issue, he said, is the delay in getting people assessed to see if their condition is suitable for long-term care. Recently, P.E.I. updated its method of assessing people living at home or seeking admission after being hospitalized, but fewer employees are now qualified to do them.

"That's, I think, one bottleneck in the system, is that we're not able to get the assessments done as quickly — and once the assessment is done, there's a considerable amount of paperwork," Lee said in an interview with Island Morning host Mitch Cormier.

"Generally from that assessment process to when you get on a list that I would see, [showing] somebody waiting to come into our home, is two weeks. So that's two more weeks of someone waiting in hospital or waiting at home."

Lee was responding to a recent report from the Canadian Institute for Health Information that suggests Prince Edward Island has the second-longest wait times for patients who need to move from the hospital to long-term care, community care, home care or other supportive housing.

160 unoccupied beds

Islanders waited an average of 43 days for a bed in a facility, almost twice as long as the national average of 24 days, the study said.

There are about 160 unoccupied licensed long-term care beds in public and private facilities in P.E.I., Lee told CBC News. Many couldn't be filled during various waves of the COVID-19 pandemic, as several facilities froze admissions during outbreaks. 

"Now we have to start filling up those rooms," Lee said.

At least one of Lee's nursing homes may not be able to take part in that process, however. 

Whisperwood Villa is operating under a provisional licence after inspections found 27 areas of partial compliance with regulations, and five areas of non-compliance. The licensing board is expected to make a decision next week about whether the facility will be allowed to keep accepting new residents after Sept. 1. 

The Garden Home also has a provisional licence. 

Lee told CBC News on Thursday that the "pandemic had definitely put the system under strain" and they are committed to making the improvements the province wants to see.

"There was considerable staff turnover and when we were inspected in June… we were just coming out of those very difficult months. But as recently as yesterday, I was meeting with the inspectors and the Licensing Board and we work very closely with them. We have a great relationship."

Reasons for empty beds

In a recent interview, chief operating officer of Health P.E.I. Corinne Rowswell said the beds remain empty largely due to a shortage of staff — particularly registered nurses — to care for patients who would occupy those beds.

But Lee said there are other issues at play, including the new assessment model.

In May, the province switched to a system called interRAI, which it said is more reliable and widely used in Canada and around the world and "informs and guides comprehensive care and service planning."

The interRAI assessment tool is a reliable, evidence based, person-centered assessment that informs and guides comprehensive care and service planning in the Home Care sector, and is widely used in Canada and around the world.- Health P.E.I.

According to Health P.E.I., there are 13.7 full-time equivalent assessors in the provincial home care program, assessing people living in their own homes to see if they should move to long-term care. 

Under the previous program, there were about 40 Health P.E.I. team members qualified to do assessments, as well as other officials who work in community and long-term care facilities.

The wait for long-term care on P.E.I.

2 years ago

Duration 8:32

Jason Lee on why he believes beds remain unfilled.

"It is a step forward, but we're going through some growing pains right now," Lee said of the new assessments. "This will correct itself. Eventually more people will be trained, but today it's a factor."

It's not just about staffing — because in our case, in our two homes, we have the staff.— Jason Lee

The province says private care homes like Lee's can still use the old assessment tool to come up with a service plan for clients residing there. But having the interRAI assessment done is among the steps required for people to be placed in a facility from their own homes or hospitals in the first place.  

Potential residents must also have a tax assessment in order to qualify for government-subsidized care, which can also cause delays, Lee said.

And he said many on the waiting list want to choose the location of their long-term care home, which may not have availability.

Few turn down beds: Health P.E.I.

However, Health P.E.I. said fewer than one per cent of people turned down LTC beds last year because the available bed was not in their preferred community.

Beds in a home not specified by the client are generally are not offered unless the person is deemed to be in "crisis in community," Health P.E.I. said in an email response to CBC News.

"In the rare occurrence that an individual is offered a bed (in a facility of their choice) and refuse[s], they are moved to the bottom of the wait list. If an individual refuses (a bed of their choice) a second time, their name is removed from the wait list."

Lee recommends that people who want their relatives to move to a long-term home should start lobbying the provincial home care program to get their interRAI assessment done quicker.

"I really want people to know that we're doing everything we can to speed up the process and provide the nursing care that they're looking for for their loved ones. And, you know, it's not just about staffing — because in our case, in our two homes, we have the staff."