New Brunswick's auditor general says the province has failed to address the increased demand for nursing homes.
Kim Adair-MacPherson outlined her concerns Tuesday morning when she presented her report to the Standing Committee on Public Accounts.
"My biggest concern is the lack of progress since we last did work on this area back in 2016," she told reporters after her report.
And ready or not, she said, the province's "aging demographic is going to continue and double in New Brunswick."
She told the committee that the number of seniors over the age of 75 would double by 2036 — something she warned the government about in her last report.
"I was disappointed to find significant delays in the implementation of nursing home plans since our 2016 report," she said.
"In my view, the province is failing to address the nursing home capacity demand. The province is not ready for the increase in seniors requiring placement in a residential facility."
Although some beds have been added in the last few years, Adair-MacPherson said it's nowhere near enough. She said there continues to be long wait time for nursing home placements, which is causing added pressure and costs for hospitals, since about half of those seniors are waiting in hospitals.
Adair-MacPherson was also critical in her report of the province's accountability.
She called out the Department of Social Development on the accuracy of its status report on recommendations she made in 2016.
Adair-MacPherson drew attention to three recommendations the department reported were "implemented."
"But when we went in to examine the evidence to determine whether or not they had been implemented, we found something quite different … two have not been implemented and one has been partially implemented."
Failing to implement nursing home plans and obtain the needed services for seniors will result in a crisis. - Kim Adair-MacPherson
She told the standing committee on public accounts that "this is a concern."
After presenting her report, Adair-MacPherson said it's now up to the committee to hold the government to account.
Social Development Minister Bruce Fitch said 2036 is a long way off, but "we're doing everything we can do today to answer the needs of the present and future 75-year-olds plus."
He said his department plans to add another 600 nursing home beds over the next five years. It's also looking at a number of things "to answer those alarm bells that have been rung," including taking "advantage of the special care home beds that may be available," and working with other groups to try to keep seniors in their homes longer.
The executive director of the Coalition for Seniors and Nursing Home Residents' Rights said she was angry when she heard today's report from the Auditor General.
"This is alarming," said Cecile Cassista.
"Governments day after day — and it's not just one government, it's all of them — basically, they make all these promises, but they don't have a vision to move the senior care forward."
Cassista said there's been no progress since the Auditor General's last report in 2016.
She said there were 72 on waiting lists in 2000 and now it's 817.
"Nothing has changed. And the longer you languish in a hospital bed, you are depriving people opportunities to have their surgery, their other care, and you're also depriving these seniors from having a quality of life."
Long-term strategy needed
Adair-MacPherson said that while the Department of Social Development created a 10-year aging strategy in consultation with the Department of Health, it failed to develop an appropriate implementation plan.
"Failing to implement nursing home plans and obtain the needed services for seniors will result in a crisis," she said.
"A severe shortage of available placements will occur. Growing pressure on hospitals and related costs, and inadequate care for a growing number of vulnerable seniors will result."
That, too, was mentioned in 2016, Adair-MacPherson reminded the committee. She said the plan isn't just about adding more beds. It should also include a comprehensive plan to address the needs of the increasing seniors population.
While the department did develop two five-year plans — one from 2011-2016 and one from 2018-2023 — Adair-MacPherson said there hasn't been enough progress on either one of them.
"Essentially," she said, "the province is failing to address nursing home capacity demand."
PPP vs. traditional model
She also said the province still hasn't done a cost-benefit analysis to determine whether public-private partnerships are more economical than the traditional non-profit model.
It surfaced in her 2016 report as a recommendation after the province entered into a public-private partnership in 2008 to open 216 new nursing home beds.
"That's a recommendation that we made quite some time ago and it has not yet been done," she said, even though the department reported that it was complete.
Fitch said that analysis has been done, although maybe "not in the way the A.G. wanted it done."
And the answers may not be as clear as the Auditor General may have wanted either. She wants to know which approach is more efficient.
Fitch said it depends.
He said there are a lot of factors to consider and it's not as easy as picking one over the other without doing an analysis each time.
"The scrutiny was done," said Fitch. "The A.G. didn't like the form that was put in. So we're saying, 'OK, if we need to formalize that some and put it into a form that, you know, satisfies the A.G., we're more than happy to do that."
Some of the Auditor General's other findings, include:
Millions of dollars in additional costs every year due to individuals waiting in hospital for a nursing home bed
Percentage of acute care hospital days used by patients awaiting alternate care is higher than national average
Only 428 of 704 new memory care beds under 2011-2016 plan completed
Significant delays and potential additional costs in relation to Miramichi nursing homes. After 10 years and $11 million spent on repairs and financial assistance, two homes replaced in Miramichi, with 28 additional beds
2018-2023 Nursing Home Plan behind in adding new beds by at least two years
Significant ongoing delays — system is failing to address nursing home capacity demand
No targets to address services to growing numbers of seniors
No implementation plan for Aging Strategy