The Department of Social Development now has an expanded ability to fast-track certain patients from hospital beds into nursing homes.
New Brunswick hospitals have been struggling with a shortage of beds, which the two health authorities have largely blamed on the high number of their patients who no longer need medical care but can’t get into nursing homes.
Use of hospital beds by so-called “alternate level of care patients” has put pressure on other hospital areas, including surgery and emergency departments.
This summer, at the request of the Horizon and Vitalité health networks, Social Development tried a 30-day period known as a “critical state,” which allowed alternate level of care patients to jump the lineup for nursing home placements.
Horizon said this approach resulted in 59 patients being discharged and placed in nursing homes, but those briefly empty hospital beds were quickly filled by patients in the same position.
Now, under the change announced on Friday, Social Development Minister Cindy Miles is authorized, under certain circumstances, to ignore the normal wait list for nursing homes for 120 days at a time.
Those circumstances are that hospital-bed occupancy has to exceed 95 per cent for a week, and more than 25 per cent of beds have to be taken up by patients waiting to be placed in nursing homes
A news release said the minister, whose department oversees nursing homes, can also prioritize people waiting in the community who are at “exceptional health risk.”
In an interview, Miles said the change was needed because the critical-state period the department started using in July wasn’t flexible or sustainable.
“It was really tight parameters on how we could respond and react,” she said. “What this does now is that it allows for much more intentional and collaborative conversations … to be more person-centred.”
When asked to clarify how patients would be selected, Miles directed questions to the health authorities and the Health Department.
Horizon said 39 per cent of its hospital beds are occupied by patients who are waiting for transfers to nursing homes. (Shutterstock)
The news release billed the change as a change to the Nursing Homes Act, but the legislature adjourned June 6 and hasn’t been in a position to amend legislation over the summer.
Miles said the move was made by cabinet.
The act already allows the minister to implement an “alternate admission process” to nursing homes under “exceptional circumstances.”
Miles said it was done in collaboration with the Health Department because patients waiting in hospitals for surgery “were not getting the care and support that they needed. So we knew we had to take bold action right away. This isn’t something that could wait.”
CBC News requested interviews with Horizon and Vitalité health networks.
A Horizon spokesperson said no one was available but provided an email statement from CEO Margaret Melanson, who welcomed the change.
“As of today, nearly all our hospitals are operating over-capacity,” Melanson wrote, adding that Horizon’s overall occupancy rate is currently 105 per cent.
She also said that 690 acute care beds, or 39 per cent of those across Horizon hospitals, are occupied by alternate level of care patients.
“This situation has been many years in the making, shaped by New Brunswick’s changing demographics, aging population, and limited long-term care capacity,” Melanson wrote.
Vitalité did not reply to the interview request.
When asked how often her fast-tracking powers would be used, Miles said she hoped it wouldn’t be often, and went on to say that a long-term care plan would be released this fall. She declined to give specifics.
Miles said there are currently 180 new long-term care beds being constructed in the province, “but even with this, we’re not meeting the needs right now for New Brunswickers.”
Miles said her department is working with the health authorities, the nursing home association and the special care home association.
CBC News recently reported how successive New Brunswick governments, both Liberal and Progressive Conservative, have been ware of the nursing home wait list crisis since the early 1990s.
Asked how this plan would be different from others in recent decades, Miles said she couldn’t speak to the past, but that the province needs “bold action.”