‘Extremely unnerving’: Huge financial bill looms if Ontario hospital patients refuse LTC

Under new Ontario legislation health officials can choose which LTC home a hospital patient goes to, if they refuse they could be billed $1,500 a day.

By Cynthia Mulligan and Lucas Casaletto

Questions remain about the Ford government’s plan to move people in hospitals to long-term care homes, not of their choosing.

Last week, the province introduced legislation allowing hospital patients awaiting a bed to be transferred to a “temporary” home while they await space in their preferred home.

While the government insists that individuals won’t be physically forced, advocates fear they will be financially propelled, something that is already happening.

Jane Meadus, a staff lawyer representing Advocacy Centre for the Elderly (ACE), says they receive hundreds of calls on these issues.

She notes that in the last 10 years, sudden hospital discharges and “threats and ultimatums” made by hospitals are the matters her legal clinic deals with most prominently.

According to the provincial government, close to 2,000 people are currently in hospitals waiting for a long-term care bed, and the wait list could last months.

Currently, these patients can be charged the equivalent of a daily rate for a long-term care home until one is made available.

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Under the new legislation, the Ford government is giving health officials the power to choose a long-term care home for these patients — even if it’s out of their community and one they’re not interested in.

Meadus says if a patient turns it down, the hospitals can charge an exorbitant daily fee forcing the patient’s hand.

“They are now going to discharge you on paper. Usually, they can’t send you anywhere because you’re too ill,” Meadus explains.

“They will charge you the uninsured rate, which is around $1,500 daily. It depends on the hospital, but this is a game changer because someone else will be choosing this. I think hospitals will be aggressively using that tactic to ensure that people ‘consent’ — I don’t think it’s consent — but consent to go to these homes even if they haven’t chosen them.”

Last week, Patricia Spindel, the co-founder of the advocacy group Seniors for Social Action Ontario, told The Canadian Press she lives in fear of being sent to a hospital and then off to a home far from her family.

“As somebody who’s 74, I can tell you it is extremely unnerving,” she said. “Anyone over 70 right now must be shaking in their boots to think that this government might force them to be placed in an institution that’s not even in their community.”

On Monday, Paul Calandra, Ontario’s Minister of Long-Term Care, insisted that charging a patient a daily fee was not in the bill. However, Calandra noted that this had been an option for decades.

When asked if he anticipates this will happen more frequently, Calandra responded, “you’re trying to go in a direction that this bill does not put us in.”

paul calandra

Ontario Long-Term Care Minister Paul Calandra. Photo: CityNews video.

Interim Ontario NDP Leader Peter Tabuns strongly criticized Calandra’s stance.

“This is the government saying they’re going to clean out all these hospital patients. Clean them out,” Tabuns said.

“So what are they going to do? Not give them popsicles on Wednesday? They’re going to put tremendous pressure on them to get them out.”

Calandra says the provincial government made the move to ease pressure on Ontario’s beleaguered hospitals, which are facing severe nursing staffing shortages that have forced emergency departments across the province to close for hours or days at a time this summer.

About 24 per cent of patients in Ontario hospital beds require a different form of care — like long-term care, which creates a backlog of patients and contributes to hallway medicine.

RELATED: Nearly 100 Ontario long-term care homes yet to install air conditioning in all rooms

Dr. Amit Arya, a Toronto palliative care physician, says that the government is taking away a patient’s right to choose.

“We can ask people to broaden their choices while waiting in a hospital. I don’t know why the government’s announcement doesn’t call for more investment into palliative care options.”

Dr. Arya says that the average life expectancy of someone admitted to long-term care is 18 months. That means for many; it’s much shorter.

“If we expanded even home-based palliative care options, some people may be willing to take their loved ones home with proper support.”

When asked how many hospitals have charged patients higher fees for not leaving and going to a long-term care home, a government official told CityNews to contact the Ontario Hospital Association (OHA).

The OHA did not get back with the data before publication.

With files from Liam Casey of The Canadian Press

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