A Saint John, N.B. man waited 18 months for a nursing home bed. The hospital is now charging him $20,000 for it

Karen Wilson sits with her cousin Malcolm Jones at his new nursing home in Saint John. Jones moved in on March 13 after spending 18 months waiting for the space while in hospital. (CTV News)

SAINT JOHN - An 18-month wait in a Saint John hospital for a nursing home bed has landed a Saint John man a bill for more than $20,000.

Malcolm Jones and his family say the bill came out of nowhere.

The 68-year-old landed in the Saint John Regional Hospital after his health took a turn in the summer of 2024. Diagnosed with paranoid schizophrenia as a child, Jones lives with Parkinson’s disease as well as chronic obstructive pulmonary disease (COPD).

During his stay in hospital, Jones was assessed and deemed to need nursing home level care. But with no immediate nursing home bed available, he stayed in hospital, waiting for one.

That’s when the hospital can begin charging a patient a daily fee, because they no longer require acute care services, but the individual cannot be discharged until they can go to a place with extra services and supports in place – usually a long-term care facility.

Horizon Health Network – N.B.’s English health authority – has set that daily fee at $57 a day.

In January, Jones’ power-of-attorney and cousin, Karen Wilson was sent a bill, for more than $19,000 – which accounts for every day Jones was in hospital, while he was technically medically discharged and waiting for a nursing home bed.

“There was no warning. I didn’t sign anything. He didn’t sign anything saying we would pay fees or we were even charged a fee, so we had no idea,” Wilson said.

She pointed to a document she received last year, outlining the protocol for waiting in hospital for a long-term care placement. In it, it says if an individual refuses a long-term care placement, they “may” be charged a fee.

Wilson said they never refused a placement, and Jones took the first one he was offered. He moved out of the hospital on March 13, after 18 months.

Over 1,000 New Brunswickers are on the waitlist for a nursing home bed, and more than half of them are waiting in hospital.

Right now, around 37 per cent of Horizon Health hospital beds are occupied by patients who are waiting for a long-term care placement or more home care supports.

The health authority pointed CTV News to a “frequently asked questions” portion of their website, where one of the questions is “what are my financial responsibilities if I am medically discharged?”

The answer states that if a patient is medically discharged by a physician, the “continued stay in the hospital is not covered by N.B. Medicare. A daily per diem rate will be charged.”

Wilson said the bill is now over $20,000.

“They want him staying in the hospital for a very basic level of care. Yes, he had a bed. Yes, he had meals every day and his medication given to him. That was it,” she said.

Jones is now two weeks into his new nursing home. Wilson said she can already see a difference in care.

“They encourage him daily to participate and check on him many times throughout the day, so he knows they care,” she said.

Fees charged across the country

New Brunswick’s daily hospital fee isn’t out of the ordinary. Per diems, or “residential rates” are charged in hospitals across the country.

Manitoba’s Northern Health Region has a range of between $43.10 and $104.20 per day.

Ontario passed a bill in 2022, that allows the province to bill a patient $400 per day if the individual refuses to be moved to a long-term care home within 150 kilometres of their preferred choice.

Fraser Health in British Columbia gives patients a 30-day grace period from the start of their wait before being charged a “daily ward rate.”

In Alberta, it’s $69.40 a day.

Others, like in Nova Scotia, state that a fee will be discussed when the patient is officially deemed medically discharged.