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Patients waiting for a nursing home bed at the Moncton Hospital are now required to accept the first available space — even if it’s not their first choice.
Until now, these patients have been able to decline a nursing home bed and remain in a hospital bed until space opens up in a nursing home they prefer.
Known as alternate level of care, or ALC, patients, these patients were, as of Tuesday, occupying 36 per cent of Horizon Health Network’s bed space provincewide.
CEO Margaret Melanson said on Thursday Horizon started requiring patients to move out of the hospital when a bed is free within a certain distance at the start of January.
“They would be required to accept this nursing home bed offer to them while waiting for transfer to their home of choice,” Melanson said.
Horizon Health Network is now requiring patients at the Moncton Hospital who need long-term care to accept the first available nursing home bed while waiting for their preferred home.
Melanson didn’t specify exactly how far a patient might be sent from a hospital, but she said it could be between 50 to 100 kilometres.
Horizon said six patients in the Moncton area have been have been moved to a first available nursing home bed this month.
Melanson said relocated patients will remain on the waitlist for a bed at their preferred location.
The change is only in effect now at the Moncton Hospital, but Horizon is asking the province to change its policy so the approach can be used in other locations.
“[We’re] really having those conversations with patients, families to help them to understand that an available nursing home bed, even if it’s not their first choice, if it’s in a reasonable geographic range, is a better quality of care for them than staying in our hospital,” Melanson said.
“We cannot continue to have large numbers of patients refusing nursing home offers.”
ALC patients were using 27 per cent of beds at the Moncton Hospital on Tuesday.
But that hospital has also been over capacity for nearly all of January, sitting at 112 per cent as of the network’s last update.
Susan Harley, chair of Horizon’s board of directors, said the situation has meant holding patients in spaces not designed for clinical care, including storage rooms.
“Fragmented accountability and insufficient coordination across government departments is leading too many older adults in the hospital beyond their acute care needs,” Harley said in a board meeting Thursday.
“The consequences are visible and serious … The situation is unsustainable. Change is not optional if we are to continue delivering high quality and safe patient care.”
Harley and Melanson both said Horizon is asking the province to update its policy to allow a no-refusal approach at its other hospitals.
Asked why Horizon is moving patients out of the Moncton Hospital before that policy change, clinical operations vice-president Greg Doiron said the health authority is acting within the rules.
“Horizon has always had the ability within the existing policy to place medically discharged patients awaiting long-term care in the first available suitable nursing home bed on an interim basis,” Doiron said by email.
“This is less about requiring formal approval and more about ensuring collaboration and alignment with the Department of Social Development before implementing a significant change in approach.”
Lyne Chantal Boudreau, the minister responsible for seniors, said the province supports the move but did not say if Social Development will update its policy as Horizon has requested.
“We respect New Brunswickers’ right to choose where they wish to live,” Boudreau said in a statement. “But we also recognize that the situation in our hospitals has reached a critical state.”
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