For the next month, hospital patients waiting for a long-term care bed in New Brunswick will move to the top of the waitlist as Horizon Health Network tries to ease overcrowding at four of its regional hospitals. On Wednesday. New Brunswick’s Minister of Social Development Cindy Miles approved a request Horizon Health Network made the day before to temporarily grant Horizon “critical state admission prioritization status” at its hospitals in Fredericton, Saint John, Miramichi and Hartland. The protocol allows the health network to prioritize patients who no longer need acute care but are still in hospital — known as Alternative Level of Care (ALC) patients — and place them into long-term care once a bed is freed up. “We do have beds available across the province,” Miles told reporters. “The folks that are in hospital now are going to be prioritized for those beds.” Miles says the next step is making sure they don’t end up in that same position. “We want to give everyone the opportunity to be able to stay home as long as they can and not be waiting in hospital.” Horizon’s hospitals in Fredericton, Saint John, Miramichi and Hartland have been operating above capacity and hospitals have been treating a record level of ALC patients at 40 per cent of its acute care beds. Horizon Health Network President and CEO Margaret Melanson said as of Wednesday, the number of ALC patients had dropped to 658 patients — down slightly from the record 667 from last week, but was still extremely high. That this is happening in July, and not when numbers typically peak, is also problematic, as hospitals need to have adequate beds in place for the upcoming flu season. “Of these 658 patients, 368 could be discharged today if a long-term care bed were available,” said Melanson. “This was not a decision we made lightly. However, it became clear that urgent action was required.” While the target is to see patients admitted to emergency departments moved to a bed within eight hours, Melanson says that currently, it’s happening after an average of close to 20 hours. She says other patient units are overcapacity with patients in hallways, dining areas and other nontraditional spaces, calling it “absolutely inadequate.” “Some do not have a washroom facility,” she said. “The patient would need to be taken to another location, and it is simply not the type of care or quality of care that is, I would say, ideal for any patient and have.” The provincial government approved a similar request from Horizon in January 2024. Back then, Melanson says Horizon was able to discharge 23 patients in Saint John and 52 in Fredericton. At the time, a new long-term care home had just opened in Fredericton, allowing the placement of more patients. Melanson says while it’s difficult to say how many patients may be placed in long-term care this time, she is hopeful the numbers seen last time in Saint John — 23 patients — could be mirrored, with fewer patients in the Miramichi and Upper River Valley area. According to the province, nursing home admissions are normally done chronologically. However, during critical circumstances, the minister can, when requested by a regional health authority, prioritize admission of ALC patients waiting in hospital. When asked what the government’s measure of success is in 30 days time, Miles said the measurement is going to be acute care. “Our hospitals able to deliver the acute care that they need to be able to deliver,” Miles said. “That’s going to take some very, very collaborative ongoing conversations.” Families who understand the long wait In May 2023, Shelley Poirier’s father, now 100-years-old, had a heart attack. He waited 17 months in a hospital until he was placed in a long-term care home. She said at first, her dad was okay being in hospital, but eventually it became difficult. “We watched his mental health decline, too, right? He started to get … quite depressed,” she said. “After such a long wait, he started to believe it was never going to happen.” According to the province, there are currently 1,093 people on the wait list for a long-term care bed in New Brunswick, with 483 people waiting in hospital. Poirier believes it’s scary that the situation isn’t getting any better, saying the focus shouldn’t just be on hospitals and nursing homes, but the whole system. She estimates it took her father between five to six months to be assessed, noting how a neighbour is currently in hospital and finds himself in the same situation: waiting to be assessed. “It’s not just about the nursing homes and the hospitals — it’s about the whole system,” she said. “If we get more beds, where are the staff coming from?” Kelly Lamrock, New Brunswick’s child, youth and seniors’ advocate, says the problem has been foreseeable for a while and likened the problem to a financial deficit that governments have left for the next one. “A growing number of patients are in acute care when they really need long-term care, and it’s hurting those patients,” Lamrock said. “It’s destabilizing the urgent care system and putting everybody at risk. It is going to require some drastic action.” In March 2024, Lamrock released a report investigating senior care in New Brunswick. It outlined why an overhaul is needed to ensure the safety and viability of the province’s long-term care system, warning if urgent action isn’t taken, the cost to people’s health and the bottom line would continue to spiral. Lamrock says there are things government can do. If they’re trying to find placements, they need to make short-term investments to make patients’ lives better. “Making sure families have the financial capacity to visit often, making sure that you are providing short-term help for special care homes and others who might be able to take on different levels of care, if they were properly funded,” he said. Lamrock said there’s also a need to empower frontline social workers treating people in home care. “Even if the formula says this person makes too much money or this is too expensive, ask yourself: if we don’t make the home a place a person can stay, what does that cost, versus somebody showing up at the acute care or urgent care hospital?” With Files from CTV’s Laura Brown
