September 18, 2022
You have seen the news on TV and in the papers that our hospitals are short of beds. Patients are in the hallways waiting for an empty bed. Hospital administrators express the shortage of beds statistically: the hospital is 110 percent occupied.
The government is aware of this, but hospitals are expensive to build and take years to construct. So, the shortage is not likely to be alleviated soon.
Part of the problem is patients who need an “alternative level of care” or ALC and not acute care provided in a hospital. These patients are ready to leave the hospital but need a level of care that may not be available in their homes or have family willing and able to care for them. They need to move on to long-term care facilities but may be choosy and not willing to take the next available vacancy wherever they may be.
To satisfy the need for beds, hospitals rent entire floors of hotels to place the ALC patients today at an enormous cost to the public but not to the ALC patients, who get a pleasant room and food at modern hotels. No wonder they do not want to leave.
In trying to solve this problem, the government decided to act: next week ALC patients will move to any available long-term care home vacancy within 70 kilometers or pay $400 a day if decide to stay in the hospital or hotel. A drastic but possibly necessary measure to ease the problem of overcapacity hospital use
I got thinking about who will select the ALC patients to move; who will make the arrangements for the move and what kind of negotiations will take place between the patient and the hospital administrators.
The doctors already have signed the patient into the ALC category. There may be dozens of these patients in the hotels and some still in the hospital occupying beds needed for acute patients. The hospital administration will have to establish a group of people tasked with moving these patients into long-term care homes.
I can see a hospital administrator assigned to a patient searching for vacancies in long-term care homes, not more than seventy kilometers from …is it from the hospital or the address of the patient? Then, he will have to negotiate with the patient over the available choices.
The clock is ticking for the patient at $400 a day. A decision would have to be made soon to avoid an expensive hospital stay. And what if the patient refuses to leave? And may not have the resources to pay for an additional stay at the hospital. Surely these patients will not land on the streets as homeless people?
The family of the ALC patient may get involved; they would like to visit their loved one and would prefer a long-term care home near them. Not only that, but some of these homes have acquired a terrible reputation in the past years because their staff and the ALC patient may refuse to move there.
I see a messy process and a difficult one: how to move ALC patients out of hotels and hospitals peacefully. Arguments with family and the patient may erupt and lawsuits started. And I see a huge amount of additional work for hospitals. Only time will tell how successful the program will be.
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