A new regulation will allow New Brunswick to move patients waiting for a spot in a nursing home in hospital up the waiting list if the social development minister deems a hospital to be in a “critical state.”
In 2021-2022, 25 per cent of the acute care beds in hospitals run by Horizon were taken up by alternate level of care (ALC) patients, who are patients that have been discharged from the hospital but are awaiting placement at a nursing home.
But a regulation of the Nursing Home Act adopted by cabinet in December would allow the minister to force nursing homes to begin accepting patients from an overburdened hospital on a permanent or temporary basis.
A hospital can be determined to be in a “critical state” by the minister based on a set of three criteria: the amount of people in an emergency room is greater than the capacity of the hospital and there are prolonged ambulance offload delays, the number of people in acute care beds is greater than the hospital’s capacity, or if critical surgeries are being cancelled due to a lack of beds.
If a hospital is deemed to be in a “critical state,” the minister can bump ALC patients to the top of the waiting list of their chosen nursing home or force a nursing home to take on ALC patients on an interim basis from the provincial waiting list.
The minister can force a nursing home to take an ALC patient even if there are people on the facility’s regular waiting list.
Normally, when a person applies for a spot in a nursing home they choose two homes and get added to the waiting list for those homes. The person is also placed on the provincial waiting list, which will offer people an “interim” placement at a different home while waiting for space in their chosen homes. If a person rejects an interim space they are moved to the bottom of the waiting lists.
It’s not the first time the province has looked to clear ALC patients from hospitals. In March of 2020 the province moved 65 ALC patients from hospital to temporary nursing home placements. The province is required to ensure interim placements are within 100 km of where a patient lives and that they go to a facility where they can be served in the language of their choice.
Of the 800 or so people on the waiting list for a spot in a nursing home nearly 500 are currently in hospital.
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