Industry braces for looming clash over long-term care reform

By Alan S. Hale May 6, 2021

The PCs and opposition parties agree reforms are needed for the business model of long-term care after the government’s independent commission found a lack of direct profit incentives led care to be neglected by private nursing homes, but the parties remain far apart when it comes to those details.

While opposition parties are calling for profit to be removed from the system entirely, the PCs are considering more minor tweaks.

Sources close to the industry say private nursing home operators recognize the need to rehabilitate their public image and are eager to begin the work of fixing the system, but are bracing for a nasty political debate in which they will be cast as villains.

The commission report chided the LTC system’s reliance on real estate investment trusts, which build long-term care homes as investment vehicles but also hold the licenses for facilities, thus putting them in charge of providing care to residents.

Long-Term Care Minister Merrilee Fullerton said it may be prudent to put an end to that arrangement.

“A little over a year ago, we started looking at how we could create a system whereby you have one partner that does the construction, and the other partner comes in and operates,” she explained.

Fullerton acknowledged it would be a difficult task to separate different aspects of private long-term care from each other, adding that not all private homes that had an outbreak are “bad actors.”

“It’s a sticky ball of wax. Because when you have operations combined with the construction, and the licences are attached to that, it’s hard to disentangle it,” she told reporters Wednesday.

“The value of some of the for-profit groups is quite varied. Some of them give the operations to credible companies to operate while they maintain the building and the property.”

The key, said Fullerton, will be to find a best practice model that satisfies residents, their families and staff. But she doesn’t believe such a model can be found by placing all long-term care homes under public control.

But for the New Democrats, the horror stories contained in the commission report demonstrated a system that failed on a fundamental level when it mattered most and can’t be fixed by tinkering around the edges.

NDP Leader Andrea Horwath slammed the PCs for “protecting the private profits of long-term care teams.”

“That’s not what people expect; that’s not what the commission recommends,” she said.

Speaking on background, a source close to many private home operators said the sector takes comfort in the fact the commission stopped short of calling for profits to be removed from the system entirely and is willing to work with Opposition parties on areas where common ground exists, such as new standards of care.