8/1/17

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 

LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 

Part of this is driven by a low level of provincial funding for LTC.





Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2]  The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 



No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy rates are slightly higher in Ontario than in the rest of Canada (97.4% in Ontario versus approximately 96.8% in the rest of Canada).  As a result, there are
0.590 health care FTEs per resident in Ontario and 0.687 in the rest of Canada.
Ontario:  (0.575*100/97.4) = 0.590
Rest of Canada:  (0.665*100/96.8) = 0.687

This is equal to 3.15 paid hours per day in Ontario and 3.67 hours in the rest of Canada.
Ontario: (0.590*1950 hours) / 365 days = 3.15 hours per day
Rest of Canada: (0.687*1950 hours) / 365 days = 3.67 hours per day



This means the rest of Canada has 16.4% more health care full-time equivalent staff per LTC resident than Ontario.  That is over half an hour of extra paid care for every resident on every day.

Other LTC Staff:  This gap is not made up by more of other sorts of staff.  In Ontario, there are 0.220 FTEs per bed in non ‘health care’ occupations (i.e. “administration and support”: dietary, housekeeping/laundry, administration, maintenance, plant, security, and other general services).  But in the rest of Canada there are 0.276 FTEs per bed.  In other words, there are 25.5% more administration and support employees per bed in the rest of Canada than in Ontario.

In total, there are 0.931 FTE staff per bed staffed and in operation in the rest of Canada but only 0.794 in Ontario.  Per resident the ratio is 0.962 staff in the rest of Canada compared to 0.815 in Ontario.

Another way of putting this is that there are 18% more paid staffing hours per resident in the rest of Canada than in Ontario.  That is 47 more minutes of paid care and service for each resident every day than in Ontario. 



Conclusion:  Care in long-term care facilities across the country falls short of what is required.  However, care in Ontario facilities is lower than anywhere else across Canada.  Stronger staffing levels are required.  Residents in long-term care facilities are becoming sicker and so low levels of staffing is becoming a bigger problem.  

The low level of provincial funding and staffing of LTC facilities is consistent with the low level of funding and staffing of Ontario hospitals demonstrated in reports from the Ontario Council of Hospital Unions / CUPE, the Ontario Health Coalition, and others.


The latest CIHI data on LTC staffing is available by clicking here.  The CIHI data on LTC occupancy rates is available by clicking here.


[1] Notably, this is lower than reported for 2012 – which showed 0.598 FTEs per staffed and operational bed.
[2] CIHI defines a FTE as total paid hours per year divided by 1,950 hours.  For the CIHI numbers, see the links above.  
[3] Quebec is not included in the CIHI data.   The CIHI “health care staff” category includes somewhat more staff than included in the proposal for 4 hours worked care put forward by CUPE and others.   While the bulk of staffing hours fall within the CUPE proposal (RN, RPN, and PSW) the CIHI health care category also includes a few other staff - -physiotherapists, occupational therapists, recreation staff, etc.  The CIHI figures also report ‘paid hours’ rather than “worked hours”.   CUPE however focuses on the latter as it more directly measures the actual amount of care provided to residents. We estimate that worked hours equal roughly 88% of paid hours. Also note: the most recent year reported by CIHI is for the 2013 fiscal year. 
[4] BC is however close – with 0.596 health care FTEs per resident.

1 comment:

  1. M. Thurlow ( recently retired registered nurse...LTC Ontario)August 1, 2017 at 6:35 PM

    So surprised! (NOT)

    ReplyDelete