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3 Fredericton-region hospitals denied 'critical state' status

Social Development Minister Jill Green has regulatory authority to prioritize the admission of alternate level of care patients waiting in hospital for nursing home placements, when requested by a regional health authority. (Jacques Poitras/CBC - image credit)
Social Development Minister Jill Green has regulatory authority to prioritize the admission of alternate level of care patients waiting in hospital for nursing home placements, when requested by a regional health authority. (Jacques Poitras/CBC - image credit)

Social Development has denied a request from Horizon Health Network to grant "critical state" status to three more Fredericton-region hospitals, which would have temporarily prioritized their patients on the nursing home waitlist.

The department informed Horizon it did not provide the "necessary data" for the Oromocto Public Hospital, the Upper River Valley Hospital in Waterville, and Hotel-Dieu of St. Joseph in Perth-Andover, to meet the criteria for approval, said Greg Doiron, vice-president of clinical operations.

But it advised Horizon that it "may submit a request for those specific hospitals with supporting data," he said.

Doiron did not say whether Horizon intends to reapply to fast-track alternate level of care patients waiting at those three hospitals for a nursing home bed.

Under the Nursing Homes Act, the Social Development minister may grant "critical state admission prioritization" to a hospital for up to 30 days at a time when:

  • The hospital's emergency room is over capacity and there are prolonged off-loading delays from ambulance bays.

  • Acute care units are over capacity.

  • There is cancellation of critical surgeries due to a lack of available hospital beds.

Greg Doiron, vice-president of clinical operations for Horizon, said health-care workers are 'under an intense amount of pressure and media scrutiny' right now, but continue to provide excellent care in the face of increased, more complex patients and consistent staffing shortages.
Greg Doiron, vice-president of clinical operations for Horizon, said health-care workers are 'under an intense amount of pressure and media scrutiny' right now, but continue to provide excellent care in the face of increased, more complex patients and consistent staffing shortages.

Greg Doiron, vice-president of clinical operations for Horizon, noted Social Development did approve critical state admission prioritization for the Saint John Regional Hospital and Dr. Everett Chalmers Regional Hospital, which both remain active. 'We sincerely appreciate their attention to this matter,' he said. (Government of New Brunswick/Zoom)

Horizon has started using the new regulation to request temporary prioritization for alternate level of care patients — people who have been medically discharged but are waiting in hospital for placement in a nursing home or other long-term care setting, as a number of its hospitals struggle with high occupancy rates, staffing shortages and long wait times.

Normally, nursing home admissions are done chronologically.

Chalmers approved on Jan. 23

On Jan. 8, Horizon applied for this change in status for all four of its Fredericton-region hospitals, including the Dr. Everett Chalmers Regional Hospital in Fredericton.

Social Development Minister Jill Green approved the Chalmers request on Jan. 23.

"This government understands that there is an exceptional need in some of our urban centres, and evidence provided from Horizon Health Network suggested that implementing this prioritization would assist with that need," Green said in a statement earlier this week.

"This is not something we do lightly," she said. "This reprioritization will decrease the number of patients waiting in the hospital, and instead provide them with the appropriate care in a long-term care residence."

Assessed on 'hospital-by-hospital basis'

Up until Friday, neither Social Development nor Horizon responded to requests for an update on the status of the other three Fredericton-region hospitals.

"If a regional health authority (RHA) believes a hospital meets the critical state criteria, the RHA must provide data that supports that," said department spokesperson Rebecca Howland.

"This includes data that shows the emergency rooms and/or acute care units are over-capacity, lack of available hospital beds, cancelled surgeries, and delays in off-loading in the ambulance bays," she said in an emailed statement.

The criteria are assessed on a "hospital-by-hospital basis."

"Once [nursing home] operators receive notice of a hospital being in critical state, any nursing homes with available beds must give priority to those waiting in the affected hospital," Howland said.

About 35 patients discharged under 'critical state'

As of Jan. 31, eight alternate level of care (ALC) patients have been discharged from the Chalmers to their preferred nursing home, according to Howland. "Approximately half of that number were placed as a result of the critical state admission prioritization," she said.

A New Brunswick hospital worker wipes down a hospital bed railing.
A New Brunswick hospital worker wipes down a hospital bed railing.

The measure is designed to free up beds at overcapacity hospitals in 'urgent need,' and is 'in the best interest of those who require care in a hospital setting,' Health Minister Bruce Fitch has said. (CBC)

An additional 31 people who were waiting at the Saint John Regional Hospital or St. Joseph's Hospital in Saint John have gained access to a nursing home placement as a result of the critical state implemented there earlier in January, Howland said. She did not specify how many were placed in their preferred home.

Social Development has also created temporary beds in a special care home for three people, she said. "These individuals will remain on the [nursing home] waitlist for their preferred home."

901 people awaiting nursing home bed

As of Jan. 29, Horizon had 563 patients who no longer require acute care services occupying hospital beds. That represents more than a third of Horizon's total inpatient beds.

Of those, 304 were awaiting placement in a nursing home.

A total of 901 New Brunswickers are waiting for a nursing home bed, as of Jan. 31, down from 935 on Jan. 1, according to Social Development data obtained by the Coalition for Seniors and Nursing Home Residents' Rights.

Of those, 421 people are waiting in hospitals across the province, while the rest are waiting in the community, either at home or in special care homes.

The regional breakdown includes:

Service areaNumber in hospitalTotal on waitlistFredericton79177Woodstock1035Miramichi2473Edmundston521Restigouche2971Bathurst5162Acadian Peninsula2745Moncton103233Saint John73139St. Stephen713Sussex1332 421901

"The numbers remain alarming," said Cecile Cassista, executive director of the coalition.

"There appears to not be any progress … to address the quality of life for seniors who remain in a hospital setting with no stimulation," she said in an emailed statement.

"The government needs to move quickly to assist seniors to move them to an environment of choice and assist more in covering the cost, especially in the special care homes."

Social Development is scheduled to reassess the critical state status of the Saint John Regional Hospital after Feb. 3 and of the Dr. Everett Chalmers Regional Hospital after Feb. 22.