Nursing homes 'intending to leave' Toronto over rebuilding costs

The operators of eight long-term-care homes in Toronto with nearly 1,300 residents have told the province they intend to shut down and move their operations elsewhere, CBC News has learned.

Six other nursing homes, with more than 500 residents, are considered "at risk" of leaving the city, according to an assessment by the Toronto Central Local HealthIntegrationNetwork (LHIN), a regional administration agency under the province's Health Ministry.

The agency is refusing to revealwhich homesare under threat ofrelocating.

• Nursing home wait-lists keepToronto couple apart
• Province considers mothballed hospital to ease long-term care jam

"The information you have requested is not publicly available as the long-term care homes have not consented its release," said Megan Primeau, communications director for Toronto Central LHIN, in an email to CBC News.

The umbrella groups representing nursing homes in Ontario are also declining to name the facilities.

The potential for 14 homes to leave Toronto, disrupting the lives of some 1,800 residents and their families,comes amid a chronic shortage of long-term care beds across the province. About 28,000 people are currently on the waiting list for the 79,000 spaces in Ontario nursing homes.

Industry officials say the long-term care operators are considering leaving Toronto because the provincial government is not giving nursing homes in the city an adequate subsidy to rebuild to meet the Health Ministry's new design requirements, such as eliminating four-bed wards.

More than 300long-term care homes across Ontario are slated for redevelopmentover the coming decade to meet the new standards, including 20 in Toronto CentralLHIN.

Toronto Mayor John Tory said Tuesday morning he intends to contactcounterparts in the provincial government to discuss how the situation can be resolved. He added thisis simply one more instance in which provincial regulations fail to account for the fact that providing long-term care on a consistent basis in Toronto "is going to be different and more expensive than it'sgoing to be in Sudbury or Guelph.

"I would just hope that the province would take a second look at this," Tory told reporters.

Construction subsidy 'doesn't work' for Toronto

"The problem with Toronto is the cost of land is astronomical, the development fees are quite high," saidCandaceChartier, CEO of the Ontario Long-Term Care Association, representing 437 homes, the majority run by for-profit companies.

"If you can find land it's millions of dollars, and with the current construction funding subsidy itself, the land would not work because of that," said Chartier in an interview with CBCToronto.

It's a similar message from the association that represents non-profit long-term care providers, AdvantAge Ontario. Its CEO, Robert Morton, said long-term care facilities in central Toronto can't meet the government's requirements for more space on their existing properties, and buying more land is too expensive.

"It becomes unaffordable for a not-for-profit or municipal home to find a site,"said Morton.

Subsidy adequate, health minister says

Health Minister Eric Hoskins rejects the notion the provincial subsidy is inadequate for Toronto and saysthat some homes in the city are rebuilding.

"I do appreciate the cost of land in Toronto is higher than in other parts of the province, but there is new construction of long-term care happening in Toronto so I'm confident that it can be done," said Hoskins in an interview.

Provincial subsidies will fund60 to 80 per cent of the cost of rebuilding long-term care homes, he said.

The news that long-term care homes could shut down and leave Toronto is revealed in the latest annual report by the CEO ofToronto Central LHIN, which covers an area from Islington Avenue to Warden Avenue, generally south of Eglinton Avenue. The document says the agency contacted the operators of the 20 long-term care homes in this area that need to be redeveloped to meet the new design standards.

"Based on the discussions with[long-term care]home operators, three groups have emerged," saysthe report:

• Committed to stay in Toronto CentralLHIN six homes (1,011 beds).
• At risk of leaving sixhomes (519 beds).
• Intending to leave eight homes (1,270 beds).

Those 20 homes arelisted below.

'Holding the government hostage'

Advocates for people living in long-term care question the operators' motives.

"They're holding the government hostage," said Kathy Pearsall, spokesperson for Concerned Friends of Ontario Citizens in Care Facilities. "I don't know why they would threaten that way unless they think they can boost their stocks by closing these homes down and maybe reinvesting somewhere else."

For-profit companies run 57 per cent of long-term care homes in Ontario, charities run 24 per cent and municipalities 17 per cent, according to figures from the Ontario Long Term Care Association.

"It is always a concern that homes may have to move outside the city, because it involves moving a vulnerable population from their home and creates stress for the family caregivers," said LorrainePurdon,executivedirector of Family Councils of Ontario, representing the loved ones of people living in long-term care.

"On the other hand, many homes do need to be rebuilt," saidPurdonin an email to CBCToronto. "It really is a very challenging project."

The Liberal government promised in 2007 to redevelop 35,000 long-term care beds over the decade to come. It did not hit that target. By 2014, the number of beds to be redeveloped stood at 30,000.The government revised the program, offering a higherconstruction funding subsidy to reflect inflation.

• Ontarians petition province for better long-term care
• Wait times to grow for long-term care in northern Ontario

Chartiersaid the current construction funding subsidy "does not work at all" for long-term care facilities in Toronto.

"The ones that are intending to leave have done all their duediligence, they've worked with their architects, their financial lenders, theavailabilityof land, and it's not working," said Chartier. "So what they're probablydoing is lookingat transferring those beds outside of theTorontoCentralLHINto where they can find land at a price that works for them."

Chartierrejects describing the homes' message as a threat.

"Nobody wants to uproot residents and move them out of the city and out of the area that they'velivedin, but what they do want to do is to sit around a table andstrategizeof what we can do better," she said.

Chartier would not say how much more the government should contribute, but said the association will make public its budget proposal later this month. "We've given [the government]some options of how the construction funding subsidy could be increased at low or no cost to them," she said.

The lengthy wait-lists to get into nursing homes contribute to hospital overcrowding in Ontario, as manyacute care beds are occupied by patients who don't need to be in hospital but are waiting for a long-term care bed to become available.

• Condo + long-term care home combination could help seniors stay downtown
• NDP wants broader inquiry into long-term care