{"id":174151,"date":"2021-09-15T10:31:57","date_gmt":"2021-09-15T14:31:57","guid":{"rendered":"https:\/\/irpp-policy-options.local\/issues\/how-can-we-start-to-make-canadas-long-term-care-homes-about-care-not-profit\/"},"modified":"2025-04-14T03:24:36","modified_gmt":"2025-04-14T07:24:36","slug":"how-can-we-start-to-make-canadas-long-term-care-homes-about-care-not-profit","status":"publish","type":"issues","link":"https:\/\/potestlaunch.irpp.org\/fr\/2021\/09\/how-can-we-start-to-make-canadas-long-term-care-homes-about-care-not-profit\/","title":{"rendered":"How can we start to make Canada\u2019s long-term care homes about care, not profit?"},"content":{"rendered":"

In July 2020, 26 people died<\/a> in a single for-profit long-term care home (LTC) in Ontario. These people did not die of COVID-19, but from dehydration and neglect. In fact, the COVID-19 pandemic has been devastating for LTC residents, whether they were sickened from the virus or suffered from the pre-existing conditions it exposed. Of the more than 27,000 people who have died of COVID-19 in Canada, 18,000 (or two-thirds of the total) died in LTC and retirement homes<\/a>. Those who died were elders, from the generation that gave Canada its public health-care system, but many died in homes run for profit.<\/p>\n

Three in five Canadians believe<\/a> for-profit care for our elders should be reduced or phased out entirely. During this federal election, most political parties have raised the urgency of improving eldercare, and rightfully so. But the importance of phasing out profit-driven seniors\u2019 care has not received the attention it deserves.<\/p>\n

Canadians want care to be the sole focus of LTC. But the reality is different. In British Columbia, 37 per cent of LTCs are for-profit, and that share is rising<\/a>. Ontario has the highest percentage<\/a> in the country at 57 per cent.<\/p>\n

There is strong evidence that for-profit homes, on average, provide inferior<\/a> care, not to mention poor working conditions. In Ontario, for-profit LTC homes have higher death rates<\/a> compared with non-profit homes; those owned by corporate chains performed the worst<\/a>. Across the country and in multiple provinces<\/a>, for-profit homes were over-represented<\/a> among homes that had COVID outbreaks and also experienced higher death rates<\/a> from the virus.<\/p>\n

While people were dying, for-profit corporate chains Extendicare, Sienna Senior Living and Chartwell Retirement Residences collectively distributed<\/a> nearly $171 million to their shareholders. Meanwhile, they received $138.5 million in pandemic-related subsidies from the federal government. This form of ownership \u2013 in which long-term care is treated not only as a business, but also as a real estate investment for shareholders \u2013 is unacceptable. How can we permit extracting profits when that contributes to unsafe and inadequate staffing levels, and ultimately the suffering and death of our elders?<\/p>\n

Not all for-profit LTC homes are the same. Corporate chains own and operate multiple facilities. \u201cMom-and-pop\u201d companies operate single facilities, but they are less and less common. Investor-owned chains may be publicly traded on the stock market or privately held by private equity firms or real estate investment trusts. Corporate chains may subcontract operations and front-line care to other firms, creating layers of privatization and undermining care quality<\/a>.<\/p>\n

More specifically, the risky financialized business model<\/a> common to chains, whether publicly traded or not, puts profit extraction first. This high-risk practice came to a head when public health authorities had to take over<\/a> operations of five LTC homes in B.C. and Alberta \u2013 owned by the troubled Beijing-based Anbang Insurance Group investment firm \u2013 as a result of severe staffing shortages and resident safety concerns. While the problems with chains predate COVID-19, the pandemic made them even more dangerous for seniors and health workers. In Manitoba, the Revera-owned Parkview Place had one of the province\u2019s longest and deadliest<\/a> outbreaks, leading to 30 deaths over four months.<\/p>\n

From the perspective of the taxpayer, for-profit corporations get the same funding as non-profits, which devote all their resources to front-line care. B.C.\u2019s Office of the Seniors Advocate found<\/a> that while receiving on average the same funding from government, non-profit operators spend $10,000 or 24 per cent more per year on care for each resident compared to for-profit providers.<\/p>\n

Some argue that for-profits fund the construction of new homes, but in fact taxpayers subsidize that, too. A growing body of evidence<\/a> from provincial auditors general and researchers shows that the public pays more to finance health infrastructure through the for-profit sector. The corporations \u201cend up owning the house after we pay the mortgage,\u201d is how Dr. Pat Armstrong<\/a>, one of the country\u2019s leading LTC researchers, puts it.<\/p>\n

So, how can we phase out for-profit LTC?<\/p>\n

New federal seniors\u2019 care funding should be restricted to non-profit provision, including LTC, through federal legislation. The federal government should require provinces to develop plans to phase out for-profit care. While some will say this is provincial jurisdiction, the federal government can set criteria<\/a> that the provinces must meet. For example, the safe long-term care fund<\/a>, a new funding envelope announced by the federal government in 2020, requires provinces to meet specific funding requirements.<\/p>\n

At a minimum, provinces should not grant new licences to for-profit operators. In Ontario, for example, the licences for 185 homes<\/a> containing more than 20,000 beds will expire in 2025. This is an opportunity for the federal government to work with Ontario to transition to non-profit operation.<\/p>\n

You may be surprised to know that Revera, one of Canada\u2019s largest corporate chains, is wholly owned<\/a> by a federal Crown corporation operating the pension funds for public sector employees, who have been leading calls to make Revera public<\/a>. Through federal leadership, Revera could be one of the first of Canada\u2019s corporate chains to shift from for-profit to non-profit and municipal ownership, with the support of provincial and federal governments.<\/p>\n

We also must ensure that governments of all levels work together to provide non-profits and health authorities with access to low-cost capital financing as well as the capital-planning expertise necessary for new construction and renovation. This will enable them to replicate the economies of scale available to for-profit chains, which often run many homes, while still maintaining personalized care and customized programming. A repurposed Canada Infrastructure Bank could help with this rather than embroiling Canada in more costly public-private partnerships<\/a>.<\/p>\n

Furthermore, federally legislated care and quality improvement standards<\/a> for LTC are urgently required. Because it will necessarily put a squeeze on profit margins, it will likely mean many for-profit operators will exit the sector. Realistically, it is not possible to improve conditions for residents, upgrade facilities, increase staffing levels, provide a living wage and increase accountability while still squeezing out a big profit.<\/p>\n

Let\u2019s be frank. Taking profit out of the system alone will not be enough, and is therefore just an initial step. We will all have to contribute a little more to make the lives of elders \u2013 and eventually our own \u2013 a lot better. But this is not all about building more LTC homes.<\/p>\n

Federal and provincial governments need to devote more resources to health promotion through primary care and home care. This will help seniors remain in their homes for as long as possible, and is also more cost-effective. For this to be a reality, a large number of low-income seniors<\/a> need to have secure affordable housing. In fact, a whole suite of publicly funded services such as dental and vision care are required to meet the needs of our aging population. Improving seniors\u2019 care cannot be addressed in isolation from these issues \u2013 and these issues should be at the forefront this election.<\/p>\n

The tragedy of COVID-19 has also been a wake-up call for transforming Canada\u2019s LTC system. As the Canadian population is aging faster than ever before, the demand for eldercare will only increase. So during this election, shouldn\u2019t we hold all political parties accountable to creating an eldercare system that improves well-being through high-quality care, rather than making people rich?<\/p>\n","protected":false},"excerpt":{"rendered":"

In July 2020, 26 people died in a single for-profit long-term care home (LTC) in Ontario. These people did not die of COVID-19, but from dehydration and neglect. In fact, the COVID-19 pandemic has been devastating for LTC residents, whether they were sickened from the virus or suffered from the pre-existing conditions it exposed. Of […]<\/p>\n","protected":false},"featured_media":100114,"template":"","meta":{"_acf_changed":false,"content-type":"","ep_exclude_from_search":false},"categories":[9357,9372,9377],"tags":[8763,8369],"article-status":[],"irpp-category":[4234,4250,4208,4281,4215,4331],"section":[],"irpp-tag":[],"class_list":["post-174151","issues","type-issues","status-publish","has-post-thumbnail","hentry","category-politiques-sociales","category-recent-stories-fr","category-sante","tag-election-44-fr","tag-soins-longue-duree","irpp-category-democracy","irpp-category-democratie","irpp-category-health","irpp-category-long-term-care","irpp-category-social-policy","irpp-category-soins-de-longue-duree"],"acf":[],"yoast_head":"\nHow can we start to make Canada\u2019s long-term care homes about care, not profit?<\/title>\n<meta name=\"description\" content=\"The federal government should restrict new funding to non-profit homes, and require provinces to develop plans to phase out profit-driven care.\" 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