New rules could lengthen wait for nursing home beds

The long wait-list for a bed at an Ontario nursing home could grow even longer, thanks in part to new provincial restrictions on older facilities with four-bed rooms.

The long wait-list for a bed at an Ontario nursing home could grow even longer, thanks in part to new provincial restrictions on older facilities with four-bed rooms.

According to new directives outlined recently by Dr. David Williams, the province's chief medical officer of health, incoming residents can be “placed in a room with no more than one other resident. That is, there shall be no further placement of residents in 3 or 4 bed ward rooms.”

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That poses a serious problem for many of the province's older nursing homes, and for the 37,000 people currently waiting for a bed.

We anticipate that that could add another four to five thousand people on the wait list just overnight by reducing occupancy.– Donna Duncan, Ontario Long Term Care Association

“If we are reducing occupancy in long-term care homes so that we don't have four people in a room and are taking two beds out of those rooms, we anticipate that that could add another four to five thousand people on the wait list just overnight by reducing occupancy,” said Donna Duncan, CEO of the Ontario Long Term Care Association, which represents hundreds of facilities in the province.

For those facilities that now must limit new admissions to two residents per room until December, the government “will continue to fund operational beds at full capacity,” according to the Ministry of Long-Term Care. 

The directive applies to new admissions only, and does not force homes to move current residents out of four-bed wards — a potential concern in the event of a second wave of COVID-19 hitting the long-term care sector. 

Majority of deaths in homes with 4-bed rooms

“I think a big part of the problem is the infrastructure itself. If homes have four-bed wards, or in some cases entire wings of a floor limited to one bathroom, how do you effectively quarantine in those types of situations?” asked Marissa Lennox, chief policy officer for the Canadian Association of Retired Persons (CARP). 

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A CBC Marketplace investigation earlier this month found a majority of deadly COVID outbreaks occurred in older homes with four-bed wards.

In eastern Ontario, four homes that suffered significant COVID-19 outbreaks this spring have four-bed wards:

• Almonte Country Haven — 29 deaths.
• Carlingview Manor — 61 deaths.
• Extendicare Laurier Manor — 25 deaths.
• Stoneridge Manor in Carleton Place — six deaths.

Some new or recently renovated facilities in the province, including Madonna Care Community in Orléans, also saw a large number of cases and deaths, while some older homes with four-bed wards have remained free of COVID-19 throughout the pandemic. 

“We've certainly learned a lot through this phase of the pandemic,” Duncan said. “But what I would say is 80 per cent of long-term care homes in Ontario had absolutely no outbreaks, so we know that there are measures that were put in place that were effective and that worked.” 

Donna Duncan, CEO of the Ontario Long Term Care Association, says reducing occupancy rates in the province’s long-term care homes would add thousands to a wait list that is already 37,000 people strong. 0:43

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Wait times 

In Ottawa and the surrounding area covered by the Champlain Local Integrated Health Network, there are approximately 11,000 names the wait-lists for a long-term care bed, though some names may appear on more than one list. 

While the wait for a bed in a newer care with private rooms can be three to five years, the wait for a spot in many older homes, including those with four-bed rooms, tends to be shorter.

A commission into COVID-19 outbreaks at Ontario long-term care homes now plans to start work in July. The province has also sent teams to conduct “comprehensive, detailed inspections at high-risk long term care homes” this month. 

In Ontario, 64 per cent of all deaths from COVID-19 have occurred in long-term care homes, according to provincial data. In eastern Ontario alone, 269 nursing home patients have died of the respiratory illness.

“We just weren't built for this. Our legislation and our care model and our staff models in our homes didn't contemplate a virus like COVID-19. It's been devastating,” Duncan said.

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