Horizon sees slight decrease in ‘all-time peak’ of backlogged patients

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Horizon Health Network has seen a slight decrease in the number of patients occupying acute hospital beds while either waiting for placement in a long-term care facility or for community services to return home.

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As of Nov. 22, Horizon reported that 35 per cent – or 613 – of its acute care beds were filled with alternate level of care (ALC) patients across its hospital system. That ALC occupancy rate is down slightly from an “all-time peak” of 39 per cent, or 652, of its acute beds as reported on Oct. 25.

In early November, Horizon officials warned the growing backlog of ALC patients is contributing to longer emergency department waits across the hospital system. It’s also contributing to a now projected $64.7-million deficit for the regional health authority’s 2024-25 fiscal year.

A working group has been set up to share information, as well as develop and implement initiatives, to “further reduce pressure on the system,” according to Kate Wright, spokesperson with the Department of Social Development.

That working group is comprised of senior executive leaders with Social Development, the Department of Health, Vitalité and Horizon health networks, and Extra-Mural.

Over the last year, Horizon has undertaken a concerted effort with the Department of Social Development to steadily reduce the number of ALC patients since that figure hit a once all-time high of 607 in October 2023.

Alternate level of care is a term used for a patient who doesn’t require the intensity of care provided in a hospital setting, but they remain in an acute care bed while waiting for community support. That’s usually placement in a nursing or special care home, but it could include access to home health-care services to be able to return to their residence.

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During a November board meeting, Greg Doiron, Horizon’s vice-president of clinical operations, attributed the recent spike in ALC patients in part due to a lack of new nursing home beds. He noted that a single new bed hasn’t been created in the province since February.

More than 1,100 people were on New Brunswick’s waiting list for a nursing home bed as of Oct. 31, with 540 of those waiting in hospital across the two regional health authorities, according to government data shared by the Coalition for Seniors and Nursing Home Residents’ Rights.

New Brunswick is expected to see at least 240 new nursing home beds come online within the next two years. Hundreds of existing nursing and special-care home beds are currently empty, though, for a variety of reasons, including labour shortages and government policy.

Health Minister John Dornan has previously said the provincial government plans to address the existing vacant beds, as well as add 12 to 16 new nursing homes in the near future to benefit “at least” 1,000 people.

Meanwhile, the New Brunswick government is continuing to work with Horizon to “improve patient flow and to enhance the experience for patients awaiting placement in long-term care,” according to Wright.

“The health authority has also introduced a new assessment process – currently only available in the Fredericton region, but it’s expected to expand to other areas,” she said in an email. “It includes long-term care placement assessments, arrangement of interim home support services and coordinates support services for patients transitioning back to the community, or into long-term care facilities.”

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In its latest community report, Horizon highlighted the success so far of that pilot project in place at Fredericton’s Dr. Everett Chalmers Regional Hospital in partnership with Social Development.

Staff at the Fredericton hospital now manage the assessment process for ALC patients awaiting community placement in the region. As a result of the pilot project, patient wait times have dropped to 24 days from 53, according to the report.

At least 500 new nursing home beds need to be built in New Brunswick by 2026, Doiron laid out in a recent presentation to the Horizon board that detailed eight possible solutions to the ALC crisis.

Among those proposed solutions include turning single-occupancy nursing home rooms into double occupancy to add more beds, contracting home care agencies during “peak seasons” like Christmas to support the discharge of ALC patients, and the creation of community-based transitional care units.

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