BC Senior Advocate Calls for Long-Term Care Funding Reform


Renewed calls for a sweeping reform in the funding structure for contracted long-term care providers have been brought forward by British Columbia’s advocate for seniors, Isobel Mackenzie. This follows a detailed study revealing that for-profit facilities have consistently fallen behind in the provision of services despite the substantial funding they have received.

Scrutiny of financial data from 2021 and 2022 overtly reflected this discrepancy. For-profit long-term care establishments rendered 500,000 fewer care-hours than they were financially equipped for by the province. Contrarily, non-profit run facilities surpassed their commitments, delivering an extra 93,000 hours of care despite being apportioned equivalent funding.

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This condition derives from the current funding formula which, in Mackenzie’s words, seems to perpetuate and reward the misalignment of profit-oriented motives over quality care delivery. Notably, the province disburses approximately $2 billion annually to contracted operators for long-term care beds, a sizable portion of the provincial budget.

Long-term care provision in B.C. unfolds largely through contracting out to private entities. Of the total 28,000 subsidized long-term care beds, 65% are bestowed to private operators, either for-profit organizations or non-profit societies.

The situation is further brought under scrutiny as the latest report uncovers a 35% surge in the cost of a publicly subsidized long-term care bed facilitated by a private operator in the past five years. Mackenzie underscores the need to tightly controvert the taxpayers’ money from drifting towards expenses other than care provision.

In the course of the comprehensive review, it was uncovered that profit in 2022 saw a staggering 113% increase over a span of five years. In the same period, expenditures such as supply costs and staffing compensation rose 61 and 33 per cent respectively.

This sobering reality accentuates the necessity for transparent dialogue with care providers, and Mackenzie insists on the government’s role as the premier regulator and financier, not merely a partner in the care process. The primary onus, she believes, rests on ensuring optimal care for the residents and justified utilization of public funds.

Undoubtedly, efforts have been made to ameliorate long-term care, yet penetrating issues have obstructed the province’s investment from effecting the required modification. Mackenzie’s review pinpointed that not-for-profit facilities expensed approximately 25 per cent more per resident on direct care as compared to for-profit care homes. An abnormally higher expenditure, 42% more per bed than their non-profit counterparts on capital building costs, was also reported by for-profit facilities.

Additional suggestions beckon a more homogenized definition of “profit” and more precise tracking of care hours, advocating for meticulous expenditure auditing and precluding any diversion towards peripheral operational costs.

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