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January 14, 2014

Three Toronto-area rehabilitation clinics have been found guilty of submitting false insurance claims in a multimillion-dollar collision scam. The charges, laid by the Financial Services Commission of Ontario under the Insurance Act, stem from investigations into a staged collision ring dubbed Project Whiplash by Toronto Police in 2012. The ring allegedly orchestrated or fabricated accidents, then filed fraudulent insurance claims for vehicle damage and bodily harm.

Toronto Star Sun May 17 2015

At last, Ontario Health Minister Eric Hoskins seems to get it. After nearly a year of insisting Ontario's much-criticized home-care system is performing just fine, Hoskins is now admitting the system is an utter mess and in desperate need of fixing. Hoskins made the concession last week in unveiling a 10-point "road map" to improve home- and community-care delivery across Ontario. The program is a small, first step in the right direction, but lacks real details and falls far short of what is required to reform a system in such disarray.

Encouragingly, Hoskins unveiled several new measures last week that potentially could help patients receive better and more cost-efficient care. One pilot program would give patients money to hire their own home-care services and health professionals to provide care in their homes. For example, hospitals might be able to work with discharged patients in regards to co-ordinating community supports. Ultimately that could spell the demise of CCACs, which now co-ordinate community care, usually through private companies and non-profit organizations. As good as such steps are, Hoskins could have done so much more to truly improve home care.

A patients’ advocacy group that says Ontario hospitals are being forced to close beds, shut clinics and cut services that cannot be replaced by community-based agencies

The Ontario Health Coalition said a zero per cent budget increase has forced hospitals to cut services, with out-patient clinics for everything from physiotherapy and pain management to cardiac rehab and audiology being closed across the province.

“The services being cut in hospitals aren’t even provided by home care

tens of thousands of Ontario patients are going without the treatments or services they need to function as best they can at home or in their communities.

Matthews, who has been health minister since 2009, has watched over her ministry as it quietly allowed vital services and funding in rehabilitation services — physiotherapy, occupational therapy, speech-language therapy, dietitians and social work — to be slashed across the province.

In recent years, hospitals from Ottawa to Toronto and Windsor have closed or drastically reduced their in-patient and outpatient therapy departments

May 16 is Personal Support Worker Day. PSWs are increasingly providing the majority of direct care services to elderly or ill patients who live in long-term care institutions or who receive home care.

Richards noted that “they [PSWs] are constantly on the go … they have very little time to actually sit down and provide comfort to residents and build that important relationship between themselves as caregivers with the residents and their family members”.

There is a great deal of variation in what PSWs do, where they work, and how they are supervised. This has made many argue that there must be more standardized training and regulation of PSWs. Others point out that it is at least as important to ensure that their working conditions allow PSWs to provide the compassionate and high quality care that their clients deserve.

"Convalescent care" beds are a form of "short-stay" beds in long-term care (LTC) facilities.  Convalescent beds receive an extra $70.94 more per day than standard long-term care beds.  That's 45.7% more funding than the $155.18 for a standard bed.   Started in 2005, the LTC "convalescent care" program is now a “Home First Program” that is designed, in part, to reduce hospital Alternate Level of Care (ALC) days.

The for-profit section of the long-term care industry sees convalescent care as a growth part of the LTC industry.

the average length of stay as the length of stay for the short-stay long term care beds varies from 25 to 65 days, while the ‘long term’ LTC beds have an average stay of 3.1 years

Canadian seniors account for 85 per cent of patients in hospital beds who could be receiving care elsewhere

Thursday's report by the Canadian Institute for Health Information called Health Care in Canada, 2011: A Focus on Seniors and Aging, examines how seniors use the health system and where there’s room for improvement.

47 per cent of seniors have completed their hospital treatment but remain in an acute-care hospital because they're waiting to be moved to a long-term care facility such as a nursing home or to rehab or home with support (so-called "alternate level of care" patients.)

Association claims seniors are being “pushed out of hospital, abandoned at home” after serious incidents such as strokes, without rehab services to take up the slack.

Wed Apr 23 2014

The province is rationing health care to seniors, pushing them out of hospital when they are still acutely ill, charges the Ontario Association of Speech-Language Pathologists and Audiologists. Health reforms that involve drastically downsizing hospitals discriminate against seniors, said Mary Cook, executive director of the association, whose members help stroke patients learn to swallow and speak again. As the province continues to cut beds and eliminate speech-language pathologist positions from hospitals, seniors are being discharged too quickly with promises they will still get the care they need in their homes through home care and community supports, Cook told a news conference at Queen’s Park on Wednesday.

The Leader-Post (Regina) Fri Aug 21 2015

Solomon Elimimian is now staring at a long rehab that makes the B.C. Lions linebacker no different than the thousands of weekend warriors who have ruptured an Achilles tendon in pickup basketball games, racquetball matches or rock-climbing adventures gone awry. The difference is, while an increasing number of ordinary people are choosing the non-surgical option, Elimimian elected surgery to repair his Achilles, or calcaneal tendon. In doctor-speak, it mainly connects the calf muscles - gastrocnemius and soleus - to the calcaneus, or heel bone. It is the strongest and thickest tendon in the human body, enabling a person not only to play football, but to perform everyday activities such as climbing stairs or jumping rope. Elimimian's surgery was done Thursday morning at a private clinic in New Westminster, hours before the Lions faced the Montreal Alouettes at BC Place Stadium, and just four days after the CFL's reigning most outstanding player suffered a complete tear, or rupture, against the Hamilton Tiger-Cats. Unlike Lions receivers coach Khari Jones, who suffered the same injury just two weeks earlier while skipping rope at the team's training facility in Surrey, Elimimian researched his options, sought out opinions and decided to put his faith in a surgeon's skill. Studies show that lower re-rupture rates and better functional outcomes result from surgical repair rather than non-surgical management. But the difference is marginal.

The Leader-Post (Regina) Wed Jun 24 2015

Nurses are raising concerns about staffing in Saskatchewan health-care facilities, in spite of an increased number of nurses working in the province. "We're really concerned around short-staffing," said Saskatchewan Union of Nurses (SUN) president Tracy Zambory. "There isn't enough registered nurses on the floor to provide safe care."

Further, she said the right staff mix is an issue. A Canadian Institute for Health Information (CIHI) report released Tuesday says there were 10,341 registered nurses (RNs) working in Saskatchewan last year. The number has increased every year since 2006, when 8,480 RNs were working in the province.

The Whitehorse Daily Star Fri May 16 2014

A re-elected Liberal government would expand the powers of nurses and nurse practitioners to do more tasks currently done only by doctors, Premier Kathleen Wynne pledged today. Registered nurses would see the breadth of their abilities widened to include prescribing a wide range of medications, such as those for skin conditions, while nurse practitioners would be allowed to order tests such as CT scans and X-rays, she said. "We want to make sure that we keep the health care system strong, and a large part of that is making sure that we have the right supports in place for the nurses who do that foundational work," Wynne said at a Toronto rehab hospital. "It's about letting nurses work to the full scope of their practice - that their capacity and their education is used fully in the system." Prescriptions for narcotic drugs would still be handled only by physicians, she said. Some 100,000 registered nurses work in the province, compared to about 2,000 nurse practitioners, according The College of Nurses of Ontario.

Toronto Star Sat May 17 2014

Tim Hudak owes voters a full explanation of what services his promised 100,000 public service job cuts will hit, Liberal Leader Kathleen Wynne said Friday at West Park rehab hospital. "It is something he needs to be pushed on," she told reporters after announcing the Liberals, if re-elected June 12, would grant powers to nurses to prescribe medications for common ailments. With 50 per cent of provincial spending going to health care, Wynne was skeptical of Hudak's claim that front-line health workers would remain untouched. "That that could be done without affecting health care is questionable at best," she added.

The Chronicle-Herald Thu Jun 5 2014

"Our health care system is primarily built for immediate, acute medical care and some rehab," Snow said. "This is a chronic condition, and the number of people who get it, neither system can handle. So we're maxed-out at residential programs, community program, support programs and day programs. And the impact isn't felt just in hospitals and treatment facilities. Snow said that out of five families that are experiencing life with dementia, four them will fall apart.

Posted on June 3, 2014

Ontarians are paying a premium of $164.9 million to replace Kingston’s mental health and rehab hospitals with a public private partnership. That’s nearly 38 per cent more than the public alternative.

Montreal Gazette Wed Jan 7 2015

But Dr. Gaétan Barrette, Quebec's health minister since April, seems to thrive offthe criticism as he pushes ahead with major reforms to the province's health-care system.

The big question, though, is whether the minister has the support of the public and the medical community to accomplish those reforms - already dubbed "la révolution Barrette" - when the National Assembly reconvenes on Feb. 10.

Hamilton Spectator Fri Dec 12 2014

"Try to think of a word more hated than "taxes"! Right! Let's lay our cards on the table and say we are talking taxes. Politicians promise lower taxes and, therefore, more disposable income if we vote for them. They turn "taxes" into a hated word. The promise of lowering them is like luring a bear to a honey pot because many of the electorate believe they will be better off financially. This is a myth. One has only to note all the "extras" for which you would fork out on a daily basis - that is, if you are fortunate enough to have the income. It's been said "taxes are what one pays for a civilized society."

And we are civilized, aren't we? Taxes pay for all the services we expect to receive in a first-world country: health care, social workers, schools, libraries, bridges, roads, clean drinking water and sanitation, parks, food and building inspectors - and more. If these necessities are not being delivered it's likely taxes are being misappropriated or are insufficient - or maybe both. It's clear we have allowed ourselves to be bamboozled by politicians who promise that if we vote for whoever is electioneering, we shall have halcyon shopping days using the extra money that otherwise would have been lifted from us in taxes. The word "bamboozled" is used advisedly. Take our hospitals. In the 21st century, in Canada, are these institutions meeting the needs of all Canadians, no matter the income? The answer is no. This is not to say that there are not many patients who feel they have received good care. But we are talking about "all Canadians" and not only those who have spun the wheel and been lucky. There are so many horror stories in the media concerning mistakes made and neglect of patients that you feel sorry for conscientious staff from all hospital departments who may feel their efforts are not appreciated. These employees go to work each day and do their best, despite being overworked and stressed.

Toronto Star Sun Mar 15 2015

Patients are being discharged from hospitals without any home care or are being cut off from services they desperately need due to a lack of adequate funding for home and community care, says Natalie Mehra, the coalition's executive director. The government spends just $4.3 billion a year of its overall $50-billion health budget for care at home and in the community. In its report, the Donner panel made 16 recommendations ranging from developing a system that focuses on patient needs instead of those of service providers to putting more money into the system. Importantly, though, the expert panel has opened the door for Premier Kathleen Wynne and new Health Minister Eric Hoskins to completely overhaul the entire structure of the home-care system.

Such an overhaul could mean the demise of much-criticized Community Care Access Centres (CCACs), which co-ordinate home and community care for patients who are discharged from hospitals, and increase the role of Local Health Integration Networks (LHINs), which oversee health-care planning in regions across the province. Many health-care experts contend that former health minister Deb Matthews spent years making the CCACs the centre of power for home care, despite mounting evidence they were ineffective and obstructionist. Under Matthews, the CCACs operated with little oversight, creating fiefdoms where private-service providers who were critical of their practices saw their contracts not renewed or their funding reduced.

The Globe and Mail Wed Apr 15 2015

An $842-million project to transfer patient health-care records to an integrated, digital database has gone off the rails after three B.C. health authorities abandoned their contract with IBM, leaving 85 per cent of the job unfinished. Health Minister Terry Lake insisted on Tuesday that the project, known as One Person, One Record, "is alive and well" and he still expects the work to be completed on budget. He described it as one of the largest health-care projects in British Columbia's history However, the ambitious IT venture involving an estimated 1.1 million patients is behind schedule and project managers are now searching for a new vendor to take over where IBM left off. Mr. Lake said a confidentiality agreement prevents him from explaining why the health organizations and the company "decided to part ways."

NDP health critic Judy Darcy released a leaked memo from the project-management team dated March 23 that states the three health authorities that serve Lower Mainland communities were unable to "resolve a difference of opinion about the project and the best way to conclude the design." Ms. Darcy told the legislature the government had plenty of advance warning that the project was in trouble. "The government had an IT project that they knew or should have known was doomed to fail, yet they continued to pour more and more money into it." She said the money would have been better invested in direct patient care. "They did this at a time when, according to the seniors advocate of British Columbia, frail seniors in B.C. desperately need more home support and rehab therapy in order to live independently in their homes for as long as they possibly can - programs that this government refuses to fund the way they should be funding."