Some of Nova Scotia's nursing home administrators felt blindsided last week when the province told them to reduce the number of beds they're keeping vacant — in case of COVID — to just one.
Before the Health Department's edict, many nursing homes had been holding up to three per cent of their beds vacant so they'd have some room to isolate residents who test positive for COVID-19, when and if needed.
The three-per-cent solution was an agreement between the homes and the province. The decision to reduce the number of vacant beds to one per home was made unilaterally by the province.
Last month, the government announced that it was setting up six regional care units (RCU) across the province — all but one are in hospitals — where nursing home residents who test positive for COVID-19 will be transferred, quarantined and cared for.
Now that those units have been established, the Health Department says keeping three per cent of nursing home beds vacant is no longer necessary, and that those empty beds are needed.
The department says that its RCU plan supports the safety of long-term-care residents, while ensuring that those Nova Scotians waiting for a bed in a nursing home don't wait too long.
Homes are being asked to keep just one room vacant so there's a place to isolate a resident who tests positive for COVID-19, until that individual can be transferred to the regional care unit.
But the nursing homes worry that what little flexibility they had in trying to contain a COVID outbreak is gone, along with their vacant beds.
One home administrator, who spoke on condition of anonymity because the government doesn't like its “partners” to step out of line, said the loss of the three-per-cent cushion will make isolating residents more difficult, and in some cases impossible.
That's partly because the nursing homes need to isolate residents both when they're coming and going.
As a precaution, any new resident admitted to a nursing home needs to complete 14 days of isolation before he or she can interact with other residents and move freely about the facility.
So, nursing homes are concerned that their allotted single vacant bed won't be vacant much at all, but instead occupied by an incoming resident when it's needed to isolate a current resident who tests positive for COVID-19.
Nova Scotia, like most jurisdictions across Canada, has a chronic shortage of nursing home beds. Acute care beds in hospitals are often occupied by Nova Scotians who are awaiting placement in longterm care, where demand for beds exceeds supply at the best of times, and these are most decidedly not the best of times.
While a handful of the province's larger homes and long-term-care providers have established in-house units to isolate and care for residents should they develop COVID, the majority of homes will look to the province's regional care units to take in any of their residents who test positive.
The designated RCU in the central region, where the vast majority of Nova Scotia's 88 current COVID-19 cases are located, is Ocean View Continuing Care Centre in Eastern Passage, but staffing up its unit has been a problem.
On its website, Ocean View continues to run a recruitment ad under the heading, “We have an IMMEDIATE NEED FOR COVID-19 WORKERS for our REGIONAL CARE UNIT.”
Ocean View, the Health Department and Nova Scotia Health are all working to resolve the staffing problem.
In the meantime, if staffing at Ocean View prevents it from taking in residents of other nursing homes, the health authority says those residents will be cared for in place, in their current nursing homes.
The province's plan to move, isolate and care for nursing home residents who get COVID isn't perfect, but it's a far sight better than the response during the province's first fatal brush with the virus in the spring.
Back then, once the virus gained a foothold in a crowded nursing home, it could spread like wildfire through the facility, as it did in Northwood's Halifax nursing home where 53 of Nova Scotia's 65 deaths from COVID-19 occurred.
To date, 12 per cent of Canada's COVID-19 cases have been in long-term-care facilities, but more than 75 per cent of the nation's COVID deaths have occurred there.
Journalist and writer Jim Vibert has worked as a communications adviser to five Nova Scotia governments.