Hundreds stuck in N.S. hospitals due to staff shortages in long-term care homes

There's growing frustration among hospital staff and administrators in Nova Scotia that more isn't being done to free up beds currently occupied by people waiting for space in long-term care facilities.

As of January 11, 355 hospital inpatients were eligible for discharge if a long-term care facility was willing to take them. One hundred of those people are at the province's largest hospital, the QEII Health Science Centre in Halifax.

Amidst the Omicron wave, the QEII is under pressure, where only the most serious cases get a room in the emergency department and everyone else is treated in hallways.

Transfer from ambulance to emergency room staff has also slowed to a crawl. Wait times range from hours to half a day.

"Getting patients into long-term care is a real challenge right now and it's made that much worse because long-term care is facing the same challenges that we are," said emergency room physician Dr. Kirk Magee, who also oversees emergency departments in the Halifax area.

"Anything that can be done to expedite our ability to get patients out of hospital into long-term care would certainly be welcome news."

But COVID-19 has also hit long-term care homes, causing staff shortages across the province.

The Nova Scotia government is currently unable to provide a figure on how many seniors home beds are closed as a result, said spokeswoman Kristen Lipscombe.

"The number of long-term care beds unoccupied due to COVID-19 is also a very fluid number that changes rapidly based on staffing pressures and current outbreaks so we can't provide a truly accurate picture at this time," Lipscombe told CBC News.

As of Tuesday, 50 nursing homes and two residential care facilities were dealing with COVID-related absences or infections, she said. 

"Of these 52 facilities, 18 are classified as having an outbreak," Lipscombe said.

"The public health definition of an outbreak is two or more laboratory confirmed cases in residents and/or staff in a 14-day period, and there is an epidemiological link between the cases and at least one case could have acquired the infection in the facility," said Lipscombe. 

"The number of nursing homes currently impacted accounts for 70 per cent of the beds in the province."

Appearing Tuesday before the legislature's Standing Committee on Health, Paul LaFleche, deputy minister of long-term care, said hospital transfers were a priority and that the province was aware of the problem.

In fact, long-term care homes have been accepting transfers from hospitals as a priority since March 16, 2020.

"We've got staffing issues in everything we do," he said. "We've got to do something about that, particularly we've got to do it quickly in long-term care."

"The pandemic has really strained a system, a long-term care that was already under strain."

The pandemic has lengthened and made wait times so difficult to predict the province simply stopped posting anticipated placement wait times on its webpage.

"Given the waves of COVID, the wait list doesn't become that meaningful," said LaFleche in his closing statement to the committee. "I'm told we're just somewhere over 200 days now for (admissions from the community) and about 45 days for those in the hospital."

"But again that's totally dependent on COVID and the directives we get from public health … so those numbers shouldn't be taken to heart."

In fact, Nova Scotia Health told CBC News on Wednesday the average stay is now 91 days for admission to long-term care from hospital. 

In an interview with CBC following his committee appearance, the deputy minister dismissed a suggestion the province could do what it did during the first wave of infections — send patients no longer needing hospital care to a hotel as an interim measure to free up hospital beds.

"It is an option, it may not be a quick option," said LaFleche. "And we're looking for quick options."

Setting up transition units outside hospitals in places like hotels would not work this time because of the current shortage of care staff because of the highly contagious Omicron variant, said Katelyn Randall, director of long-term care for the province.

"The issue there is you do still require staff," she said. "Our facilities that are closing to admissions don't have staff."

"We're looking at where is the best use for those staff. You could have beds but you need staff to support them."

She said the 25 facilities currently not admitting or severely restricting the number of new residents have staff vacancy rates in the 25 to 30 percent range.

She said the province needs up to 1,400 continuing care assistants (CCAs) and 600 nurses to meet demand. 

Where the province can find that many people willing to work in the sector remains unclear, especially when it comes to CCAs.

There are about 800 seats a year for CCA training available at community colleges province-wide, according to LaFleche.

He said only 300 people enrolled in the program this year. The union that represents thousands of continuing care workers, CUPE Nova Scotia, says the reason people are no longer interested in the training is the job is seen as low- paying and back-breaking.

Last month, the province announced it would provide free training for up to 2,000 people who wanted a career as a CCA and that they could learn on the job in an accelerated, 10-month program rather than the current one-year program offered at community colleges.