Financial accountability in long-term care sector

Jun 23, 2020 | 41-5, Blog, Governance, Question Period, Video | 1 comment

Today I asked the Minister of Health why privately operated care homes are not obliged to make their audited financial statements available to the public, and when British Columbians can expect the government to implement a more transparent system.



A. Olsen: As we noted yesterday, the government spends $1.3 billion contracting long-term care to for-profits companies and not-for-profit societies. Ninety-three percent of the sector’s revenues are funded through B.C. taxpayers.

Given the magnitude of the public expenditure and the vulnerability of the populations served, it’s reasonable to ask whether sufficient financial oversight is in place to ensure that B.C. seniors are receiving the best possible care for the money that we’ve invested. Unfortunately, the answer seems to be no.

Contracted care homes are required to provide their health authority with annual audited financial statements. These statements are available to the public if the care home is operated by a not-for-profit society. But for-profit operators are not obliged to make their audited financial statements available to the public.

Considering that for-profit companies are already not delivering hundreds of thousands of hours of care that they are publicly funded to provide, my question is to the Minister of Health. Why are we not requiring significantly more disclosure from for-profit care home operators, especially considering significant public resources are going into these facilities?

Hon. A. Dix: The member will know that, historically, in the past, the health care system, the long-term care system, was a more direct system. There were independent long-term care contractors, but everyone operated under the same collective agreement, and there weren’t any subcontractors.
Over the past couple of decades, that changed. We mostly have a contracted system that includes a very significant for-profit private sector, non-profit private sector and, importantly, subcontractors.

This was the situation in 2017-18, reflected in the report that he refers to from Isobel Mackenzie, the seniors advocate in B.C.

So what have we done? We’ve increased the standard of care for everybody in the system by increasing the care hours for all residents. This is important — and put behind that auditing measures that support it. Those are very significant changes because they improved the quality of care.

Currently, the accountability the member talks to comes in through data spreadsheets. That old-fashioned methodology makes the accountability he wishes more difficult. I agree. That’s why we’re moving to a web-based tool that allows broader information, so we can find the very information required to ensure that the money taxpayers spend goes to the care that residents deserve. That’s what we’re doing. In addition, in the coming year, we’ll be reviewing contracting and the contracting system with our partners in the sector, with the goal of making things better for residents.

There needs to be more accountability, I agree, and there will be. The seniors advocate report reflects the situation in 2017-18, and we are working together with all of the partners in long-term care to improve accountability for residents, to improve the accountability of care, but also increase care standards. That’s what we’ve done, and that has served us well in British Columbia, as compared to other jurisdictions in North America in the last few weeks.

Mr. Speaker: Leader of the Third Party on a supplemental.

A. Olsen: I’d like to thank the Minister of Health for the detailed and straightforward answer.

We’ve seen, as he noted, B.C. seniors advocate, Isobel Mackenzie, has a detailed report. In that report, it highlights how the accountability mechanisms and transparency mechanisms are different by contract, by operator, by health authority. It seems like there is — I think as the minister acknowledged — a wide variety of different mechanisms in place, making it very, very difficult to be able to get a really good understanding of how $1.3 billion of taxpayers money is being spent. I appreciate the minister acknowledging that there will be greater accountability measures being put in place.

Can the minister please let British Columbians know and let us know here when British Columbians can expect those accountability measures to be in place?

Hon. A. Dix: I think you see it now. You see it in the application of the 3.6 moneys which have been supported by all parties in the Legislature. You see it in the restoration of the rights of workers in Bill 47. You see it in the change in accountability models. You see it in the money that’s being provided to ensure that workers’ wages are levelled up during this period when people are under provincial health orders. It’s called the single-site order to ensure that workers get the money that’s being provided to ensure that their wages are levelled up.

All of these other changes are important, and you see it in the daily hard work of medical health officers, who do the work at long-term care homes everywhere in B.C., working for health authorities and working with care providers to ensure the quality of care is high. And when it’s not –– as was the case at Comox seniors home, as in the case of Nanaimo Seniors Village, as is the case at Selkirk here in Victoria, as in the case in Summerland –– with the support of member of all sides of the House, medical health officers and health authority boards and myself intervened to ensure the quality of care was protected.

It is important to all of us. It is what we owe to people, to residents in long-term care, and it’s what we’re continuing to work to improve, working with all of the partners in long-term care in the coming weeks and months.

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1 Comment

  1. Chris Cowland

    Adam, I liked your question about financial accountability for care homes, but I think it would be more important for them to report on care-related matters, not just dollars and cents. I’m not an expert in this area, but I used to be the auditor for Rest Haven Lodge, and my daughter Stephanie is an RN who has worked in this field for many years. The problems they continually face appear to be lack of staff, and ridiculous demands to work overtime. There should be a certain staff / patient ratio, and sometimes this can suffer. There are internal “incident reports” which can be hidden from reporting, for example when a resident escapes from the home, has a fall, or assaults staff. Isobel would be a great resource in this area.

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