Staff shortages forcing some long-term care homes to close admissions
While N.S. has announced funding to renovate and add beds, homes don't have people to staff them
Long-term care homes in Nova Scotia are facing such a severe staffing shortage that some have already announced they must temporarily close to new admissions.
Those who work in the industry say it is the worst staffing shortage they have ever seen, and they fear it is affecting the ability of homes to serve existing clients as the province prepares to spend millions of dollars on creating new beds.
"This is probably the worst I have seen in my 37 years for staff recruitment. It used to be that you'd post a job and you'd get 20 applicants. Now you post a job and you may get no applicants at all," said Joyce D'Entremont, CEO of Mountains and Meadows Care Group in Bridgetown, about two hours outside Halifax.
D'Entremont is also the vice-chair of Health Association Nova Scotia's Continuing Care Council and sits on the Canadian Association for Long-Term Care.
While she said her own facility has not yet had to look at reducing admissions, it's already happening in some others.
"The last thing any of us would ever want to do is have to, by attrition, close beds as beds become empty," she said.
D'Entremont said the only reason her facility is in a good staffing position is because of Linda Bailey, a nurse who came out of retirement and spends two days a week recruiting workers.
"If you don't keep on to them and, you know, keep talking and calling, they will go other places because they know right now it's a hot market," Bailey said.
She has had some success recruiting staff from India and Africa, as well as nurses who wanted to move from Ontario.
A difficult decision
Ocean View Continuing Care Centre in Eastern Passage serves more than 500 clients between two sites and multiple programs.
On Aug. 25, CEO and president Dion Mouland posted a message notifying the community that the home is temporarily closed to admissions due to "unprecedented staffing shortages." Another home named the Birches, which has the same CEO and some shared services, is also closed to admissions.
"We have not made this decision lightly," Mouland wrote. "Despite our ongoing recruitment efforts, I can say that in my 30-year career, I have not experienced such a shortage of staff at all levels."
Ocean View is offering signing bonuses of between $3,500 and $7,500 per position in an effort to attract staff, but Mouland wrote the existing staff cannot offer appropriate care if new admissions continue.
In July, the company that runs Ivy Meadows in Beaver Bank, outside Halifax, decided not to renew its contract to run the 38-bed facility beyond November 2023. The company made the decision in part because it was having trouble getting staff who are willing to travel to the community by bus.
"For staff who were, perhaps, trying to piece together some part-time positions, they can't go out to Beaver Bank and then also work in the city. It just makes it logistically too challenging," said Tracey Tulloch, the director of communications with Rosecrest Communities.
Tulloch said since Ivy Meadows is a smaller facility, many of the positions are part time. It is no longer accepting admissions for new residents.
'An awful situation'
Before the COVID-19 pandemic began, there were 1,300 people on the wait-list for long-term care in Nova Scotia. That number grew during the first wave.
In an effort to cut down on the wait, the province made major spending commitments this year, including an announcement in January to add 236 beds in the central zone, and an announcement in July of $96.5 million to add more beds and renovate or replace 17 facilities.
Michele Lowe, the executive director of the Nursing Homes of Nova Scotia Association, welcomed those investments but said if staff are not available to work in the new facilities, the province will be in an "awful situation."
"People are tired and fatigued and burned out. And so the second and third wave [of COVID-19] have certainly seen a number of people who have taken time off for their own mental and physical wellness," she said.
Administrators want to let their staff recharge, she added, but are having trouble maintaining coverage.
"It became incredibly apparent that, you know, it just meant that their staffing levels would be far below what they are now. And so how do you negotiate those kinds of breaks?" said Lowe.
"We've seen some of our staff completely leave the sector."
Even the largest operator in the province, Shannex, said its homes have "never experienced the staffing pressure to the degree we are seeing today."
Lowe said her association believes one part of the solution is an increased wage for long-term care employees.
The Department of Health and Wellness covers the cost of salaries for most long-term care workers at a rate outlined in a contract between the department and the workers' union.
"As operators, you are dictated as to what you pay based on what you're funded for," said Lowe.
No one from the department was immediately available for comment.
While some homes are using signing bonuses, the set base salary in some cases, such as continuing care assistants, can be around $17 per hour.
In the details of its election platform on long-term care, the Progressive Conservatives estimated approximately 2,000 more long-term care staff are needed.
Their calculations put the cost of salaries for 1,400 additional continuing care assistants and 600 additional RNs and LPNs at $78.6 million per year.