Nova Scotia hospitals bill patients $4.8M due to lack of long-term care beds

Nova Scotians were chargednearly $5million last year to livein hospitals, with the highest bills tallied in the Sydney area, New Glasgow and Halifax, a CBC Nova Scotia investigation has found.

The patients whopayare receiving an alternate level of care,a bureaucratic description for people in hospitalwho are no longer acutely ill. The category captures seniors waiting for long-term beds in what are called transitional-care units.

More than 30hospitals in Nova Scotia hadsuch patients last year, according to a databaseof invoices obtained by CBC Nova Scotia through freedom of information legislation.

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The situation Sandra Dunn of Sydney faced reveals the pressureon patients and the system.

In late 2012, Dunn's mother, Katherine Hendersonthen 97and suffering from dementia was admitted to Cape Breton Regional Hospital with an infection.

Henderson recovered,but spent the next sixmonths in hospital because Dunn,herself a senior, suffered acompression fractureand could not look after her motherat home.

"They do the best they can, but they don't have enough," Dunn said.

'Avery valuable bed'

Cape Breton Regional is one of three Sydney area hospitals with a ward that is a licensed but not provincially fundednursing home.

During Henderson's stay, there was no room for her in transitional-care Unit3B,so she was put in acute-care wards.She wascharged $1,100 a month, whichDunncalled"reasonable."

At the same time, she notes her mother took up a "very valuable bed." Dunnsaid she set up a cot in her mother's room where she would spend nights.

"It's a place they have to stay, but I don't think it is ideal," Dunn said.

AfterDunnrecovered, shecared for her mother at home until shewas eventually placed in a nursing home. Hendersondied in March 2015 at age 100.

Breakdown of billings

Last year about 70 patients a month were billed a total of $1.1 million for alternate level care at three Sydney-area hospitals:Cape Breton Regional, NorthsideGeneral and Glace Bay.

The hospital with the single highest total billings, however, was the Aberdeen in New Glasgow. It billed about $640,000, and had anaverage of 30 patientsper month.It is followed by theQEII Health Sciences Centreat approximately $613,000.

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The 34-odd patients a month who paid to stayat the transitional-care unitin Halifax'sVictoria Generalbuilding could not drink the tap water because of legionnaires' disease in the pipes. In fact, some had to be movedwhen the building flooded last fall.

Seniors group wants billing stopped

Seniors are being billed for nursing home services they are not receiving, saidBill VanGorderof the Canadian Association of Retired Persons. He said the practiceshould be stopped.

"In a long-term care facility, you have access to recreation, to people who come and visit to keep you happy," VanGorder said. "There is socialization where it's medically appropriate. None of these things are available in a hospital nor should they be."

Some seniors cannot understand why they are billed to stay at a hospital that was free when they were ill, he said.

"Don't charge people who are still in hospital just because you can't find a room for them somewhere else."

How much Nova Scotia hospitals charged patients between October 2014 and September 2015

Province says patients must contribute

The average payment is $30 to $40 per day, according toLindsay Peach, Nova Scotia Health Authority's vice president of integrated health services, community support and management.

Alternate level of care patients pay a standard accommodation fee based on income, which is set annually by the provincial government.The maximum for those waiting for a nursing home bed is $110 per day. The maximum for a residential care bed is $65.

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There are right nowabout130 people in the provincewaiting for a long-term care beds who areliving in Nova Scotia hospitals, Peach said.

She said she does not accept VanGorder's argument andargues thecharge is reasonable.

"What we are really doing is asking individuals to contribute towards that care in the same way as they would if they were going in a nursing bed," Peach said. "It is unfortunate that we're not able to offer them a nursing home bed right away."

The billings do not cover the expense of alternate level care, since the cost of a hospital bed ranges from $600 to $1,400 per day, depending on whether it is acute or transitional care.

Peach saidthe situation is improving, with the wait list for long-term care dropping by 30 per centsince the province changed how it manageswait lists in March 2015. To cut down on place holders, people are taken off the list if they do not accept a bed when offered.

Since 2003, the wait has dropped by half, Peach said.

"We have seen that shift where individuals are choosing to make the decision to wait in the community," she said.