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JIM VIBERT: Nursing home residents homeless in hospital

Doctor shortages at some Shannex nursing homes, including at Cedarstone-Victoria Way in Truro have residents wondering how secure their living conditions are.
Doctor shortages at some Shannex nursing homes, including at Cedarstone-Victoria Way in Truro have residents wondering how secure their living conditions are. - Harry Sullivan

Crisis? What crisis?

Well, it’s a crisis for the elderly residents of a couple of Colchester County, Nova Scotia, nursing homes who need a doctor but don’t have one. They’ll be sent to the hospital and, if they need to be under a physician’s watchful eye on a regular basis, they won’t be going home again.

The two Shannex nursing homes — Debert Court and part of the Cedarstone complex in Truro — recently lost the physicians they’d relied on to treat patients who don’t have a doctor of their own.

And later Tuesday, a third home, Ocean View in Dartmouth also raised the alarm, saying they’ve been struggling for months to find medical coverage for their residents and have had to curtail admissions due to lack of available physician services.

“The Department of Health and Wellness and the (Nova Scotia) Health Authority (NSHA) were notified of this issue in June, but we still have no viable long-term solution to this situation. We have proposed two possible innovative solutions to the Minister of Health and Wellness Randy Delorey and are awaiting his response,” Ocean CEO Dion Mouland said in a news release.

Yet, even later Tuesday, the Health Department was acting like this was all news to them.

“I became aware of the issue yesterday and am deeply concerned for the residents,” Delorey said in a statement, apparently referring only to the most recent news from Shannex. “I asked my department to look into it immediately. We are working with all of our partners to find a solution, to ensure appropriate care is available at the facilities.”

Earlier this week, in a letter to the residents of Debert Court, Shannex wrote: “Any resident who requires physician care and does not have their own physician will be sent to the hospital. Residents who are not under the care of their own physicians and are sent to the hospital will not be readmitted.”

By that Shannex meant that those folks will not be readmitted to the nursing home that’s become their only home. In addition, the two nursing homes can no longer accept residents who do not arrive with a family physician willing to continue caring for them at the nursing home.

"The costs to Nova Scotian taxpayers will increase exponentially and the elderly residents of the nursing homes are, for all intents and purposes, homeless in the hospital. That’s a crisis, and an inhumane one at that."

Catherine MacPherson, senior vice-president of operations with Shannex, said in an interview Tuesday that the statement that residents will not be readmitted to the nursing homes should be qualified.

Residents who are sent to hospital will be assessed on a case-by-case basis to determine whether they can be safely readmitted to the nursing home.

“Our No. 1 priority is the safety of our residents,” MacPherson said, adding that residents without family doctors may be readmitted provided they don’t require ongoing medical treatment. However, if they do, the nursing home cannot take them back.

Presumably, those patients would take up residence in the Colchester Regional Hospital until a solution is found and physician coverage is somehow returned to the nursing homes.

Shannex says it’s been working with the provincial Health Department and the Nova Scotia Health Authority (NSHA) to try to find a solution, but to no avail. This despite the statement from the Health Department suggesting this is news to them. Go figure.

In recent years there have been untold examples of dysfunction in Nova Scotia’s so-called health system, but this seems to go beyond mere dysfunction. It rises to the level of absurdity.

Nova Scotian hospitals are often at or over capacity because a number of beds are occupied by patients waiting for a place in long-term care — a nursing home. Such patients suffer the somewhat insulting label: bed blockers.

The absurdity is that we’ve apparently arrived at the point where, even if there are beds available in nursing homes, the bed blockers will be tossed back into the acute care system if and when they require medical care because physician services are unavailable in the nursing homes.

MacPherson said the problem is more complicated than just a shortage of doctors, although that may be part of it.

She did say that the nursing homes have tried to bring constructive solutions to the table when they met with the NSHA and the Health Department. She diplomatically and skillfully dodged questions about whether the health bureaucracies were also bringing constructive solutions.

Delorey is apparently, or at least reportedly, unaware of those meetings.

Another home administrator, speaking on condition of anonymity, said the health bureaucrats have been told repeatedly that this situation was inevitable, and that the province needed to help nursing homes find physician coverage. To date that help has been either lacking or insufficient, and now the situation the nursing homes warned of has come to pass.

Nursing homes don’t employ doctors. Doctors who treat nursing home residents are compensated the same way they are in their practices.

Elderly Nova Scotians in long-term care will now, effectively, be sent to live in the local hospital, because the system can’t manage to deliver physician care to the nursing homes. The costs to Nova Scotian taxpayers will increase exponentially and the elderly residents of the nursing homes are, for all intents and purposes, homeless in the hospital.

That’s a crisis, and an inhumane one at that.

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