St. Joseph’s has transformed the third floor of its former acute care hospital into a temporary but attractive long-term care facility, until Island Health can build a promised 150 new beds in the Comox Valley. The announcement of contracts on the new beds has been delayed
An almost brand new long-term care facility will open in the Comox Valley this week. Island Health is moving 21 patients who are currently in acute care beds at the Comox Valley Hospital to Mountain View, the renamed and completely renovated third floor of the former St. Joseph’s General Hospital.
The move, which begins on Wednesday, Sept. 5, is necessary because patients needing an alternate level of care have contributed to chronic over-capacity at the one-year-old Comox Valley Hospital (CVH).
A facility planned and budgeted for 129 admitted patients has been overcapacity since it opened last October, reaching as high as 178 patients, roughly 40 of those are patients who no longer need acute care but have nowhere to go given the Comox Valley’s critical shortage of long-term care beds.
Island Health has promised up to 150 new long-term care beds for the Valley, but has yet to award contracts for them.
The Request For Proposal said contracts would be awarded on Aug. 31, but an Island Health spokesperson has told Decafnation that the health authority hasn’t finished evaluating all the proposals. It’s now expected the contracts will be awarded later this fall.
In the meantime, Michael Aikins, Administrative Officer of The Views at St. Joseph’s, said reopening and renovating space in the former hospital for the 21 patients and three respite beds has created a flurry of activity.
St. Joseph’s has had just a few weeks to transform the medical/surgical third floor into a secure and comfortable long-term care facility.
“We’re doing everything we can to create a home-like environment for our new residents,” he said. “This will be their new home, and we want to make it a good one.”
St. Joseph’s has purchased new furniture and 32-inch televisions for each room, taken out walls, repainted everything, brought in a piano and a pool table and built custom cabinetry.
The former Intensive Care Unit was gutted and turned into a bright dining area. Other room have been opened up and combined into an activity area, a bistro and a lounge that features a wall of windows facing south overlooking Baynes Sound and the Beaufort Mountains.
The contract to reopen St. Joseph’s for long-term care is only for three years, until facilities to house the promised 150 new beds can be constructed. But Aikins said St. Joseph’s is doing “everything we can” to make it a first-class facility.
“We recognize that this will be their new home,” he said. “For some, it will be their last home, so we’re trying to make it special.”
The three-year contract will create approximately 35 new jobs in nursing, housekeeping and other services.
The St. Joseph’s kitchen, located in the basement of the 100-year-old hospital building currently serves more than 100 residents of The Views and the four hospice beds. It will also provide meals for the new Mountain View residents.
The former St. Joseph’s Hospital is being called back into action. Some patients in acute care beds at the Comox Valley Hospital, who are waiting for residential care beds, will move to St. Joseph’s to alleviate the new facility’s chronic overcapacity
Eleven months after the new Comox Valley Hospital opened, the Vancouver Island Health Authority (VIHA) will finally unburden its staff from chronic overcapacity.
And it will give Comox Valley family caregivers some extra opportunity for relief with three additional respite care beds.
VIHA has contracted with St. Joseph’s to open 21 residential care beds in the former acute care hospital site at the top of Comox hill. The beds will be available in September.
And the health authority said they will also convert space on the new hospital’s fourth floor, which was reserved for expansion, into a 17-bed residential care unit for mostly elderly patients who need an alternate level of care.
Norm Peters, Executive Director, Surgery, End of Life Care & Residential Care at Island Health told Decafnation that “By moving (ALC patients) to St. Joseph’s, it opens up acute care beds at the hospital for people who require acute care.”
Almost every day since the new hospital opened with 129 acute care beds, it has been dramatically overcapacity. The number of admitted patients has soared to 178 on occasion, nearly 50 percent higher than planned.
That has stressed workers at the hospital, which was budgeted for 129 patients.
FURTHER READING: Record 178 patients at CVH; Flawed planning at root of hospital’s problems
Most of the overcapacity has been due to patients in more expensive acute care beds who are waiting to transition to long-term care facilities. But the Comox Valley has had a dearth of long-term care beds for many years, so these patients have had no option but to stay in the hospital.
In fact, those in charge of designing the new hospital never planned for any ALC patients (alternate level of care). Hospital planners naively assumed that VIHA would have provided enough beds at residential care facilities such as The Views at St. Joseph’s, Glacier View Lodge or the Seniors Village.
The new 21 beds at St. Joseph’s are temporary until VIHA opens a proposed 151 new complex care beds sometime in 2020, if they can be built that fast. Contracts for those beds, spread among multiple providers, won’t be awarded until at least Aug. 31.
Michael Aikins, administrative officer for The Views at St. Joseph’s, told Decafnation that the 21 residential care beds and the three respite beds will be located on the third floor of the former acute care hospital.
While the new beds are detached from other Views patients, they will be cared for by Views staff who will follow St. Joseph’s policies.
Aikins said The Views was in the process of hiring care aides, LPN’s, housekeepers, dietary aides and will add hours in other support areas such as maintenance, payroll. They will reinforce their casual workers in all areas.
There will be crossover opportunities to maximize The Views’ resources, but the temporary ALC unit will have dedicated staff to provide day-to-day care to the residents.
St. Joseph’s will make some modest improvements to the hospital rooms that have sat vacant for nearly a year with some fresh paint, new furnishings and improved wayfinding.
St. Joseph’s Board of Directors Chair Chris Kelsey said the board is happy to help and provide support.
FURTHER READING: Island Health press release
In presentations to the Island Health board of directors, three Comox Valley seniors advocacy groups criticized the recent residential care bed RFP, said Island Health doesn’t provide us with an equitable share of resources and exposed mistreatment of seniors and a new hospital that isn’t clean
Judging by the “surprisingly” large number of Comox Valley citizens who flooded the Crown Isle ballroom March 29 to hear their concerns presented to the Island Health board of directors, there is a widespread belief that the health authority has shortchanged the north Island, especially in health care for seniors.
Five community groups made presentations to the board, which did not speak or respond, except for brief remarks by chair Leah Hollins.
Three of the five presentations bemoaned gaps in health care for seniors, one asked Island Health to give back land it owns in Cumberland and another asked the board to include breathing clean air as a criteria in awarding Community Wellness Grants.
Here is a summary of the three presentations relating to health care.
Comox Valley Elders Take Action
Jennifer Pass, representing more than 70 members of this group, criticized Island Health for how seniors are treated at the Comox Valley Hospital, the cleanliness of the hospital and for its slow response to a critical lack of residential care beds in the region.
Pass recounted the story of an 88-year-old woman, an avid gardener, who experienced serious hand pain and, on the advice of friends, called an ambulance at 7:30 p.m. to take her to the hospital. She waited 14 hours, until 10 a.m. the next morning, before a doctor told her she had arthritis and lectured her on wasting ambulance time for such a trivial matter.
But a second opinion the woman sought later revealed she actually a severe nerve condition relating to her spine. She’s been scheduled for neurosurgery this summer.
Pass also told the board about an 88-year-old woman who experienced a possible Transient Ischemic Attack (TIA — a mini-stroke) and arrived at the emergency department with blood pressure of 185. She was told she “wasn’t a spring chicken anymore” and that she was wasting the ER’s time.
It was later determined by her own doctor that a conflict between two of her drug prescriptions had caused the problem.
These two anecdotes showed that hospital medical staff are “making assumptions about people’s health and diagnoses based on their age … and the elderly are being treated with disrespect,” Pass said, “as if their medical conditions aren’t important.”
Decafnation has received numerous similar reports of mistreatment, which have been reported in a series of articles and as recently as this week.
But Island Health CEO Kathy MacNeil told reporters after the meeting she hasn’t heard of these or similar incidents. That’s surprising from the CEO because people have filed complaints through the official VIHA process.
FURTHER READING: Island Health CEO disappointed by poor treatment of elderly
Pass also commented on the lack of cleanliness in the hospital. During a visit for day surgery, she tried to use one bathroom that had feces on the seat, and other bathrooms that were also filthy.
She was told the dirty bathrooms were a consequence of having so many elderly patients awaiting placement in residential care who were incontinent.
“Seems like the preconditions for a perfect storm,” Pass said.
Pass cleaned one bathroom herself. She also observed beds that hadn’t been cleaned or remade for days.
Sources have told Decafnation that the hospital is generally dirty — dirtier than St. Joseph’s Hospital ever was. They said the uncleanliness is a result of the inefficiencies of public-private partnerships (P3), where housekeeping is contracted out and not as closely managed.
FURTHER READING: Dissecting a a P3 — Part 1
Pass also criticized the recent Request for Proposals to build “up to 120” additional residential care beds that Island Health hopes to open sometime in 2020.
“That’s too long to wait for new beds,” she said.
In response, Island Health board chair Leah Hollins said, “Bad news is good information. It’s good to hear these stories.”
Power of 5
Melanie Olson spoke on behalf a group of five “frustrated” family caregivers who are trying to keep their loved ones who are suffering with dementia at home.
Olson said their group shares the distress of more than one million unpaid, family caregivers in British Columbia, but with the added frustration of accessing too little support services provided by Island Health for the Comox Valley.
She noted that people over age 65 comprise a higher percentage of the Valley’s population than Victoria, and that it’s nearly 50 percent higher than the provincial average. And, that demographic is growing rapidly.
Yet, residential care beds and support services for family caregivers lags most other communities.
The shortage of residential care beds in the Comox Valley, which Olson estimated at a minimum of 160 beds, is only one of the factors plaguing caregivers.
But the experience of trying to get a loved one onto the list for a residential care bed can be long and frustrating. It’s at least a 12-month wait list, and the patient must not only meet the “complex care” requirement, but must also exceed the care that Community Health Services (formally called Home and Community Care) are able to provide.
But the lack of access to Adult Day Care (ADC) programs and respite beds is just as concerning for Olson’s group.
Respite beds give caregivers a chance to take an extended break (up to two weeks) from the 24/7 job of caring for loved ones. There are only three publicly subsidized respite beds in the Valley and one is not secure enough to accept dementia patients.
That leaves two for a large population of caregiving families. Caregivers are entitled to five weeks respite a year, but they don’t get it. Last time one caregiver needed respite, the entire next year was booked by the end of December or early January. A shortage of beds, means caregivers have to schedule respites too far in advance.
There is one private respite bed available at $223 per day, which most families cannot afford.
The situation is similar for ADC programs, where caregivers can take their loved ones for one or more days per week. But multiple times are virtually unavailable to due the area’s large demand. There’s a two-month wait list just to get ADC for one day per week.
Olson told the board she was disappointed the RFP for “up to 120” new residential care beds doesn’t include any requirement for ADC programs or respite beds.
Olson also asked the board for more access to home support services. She said the home support policy is to provide 120 hours, but only provides about 20 hours in the Comox Valley.
She said funding more caregiving training programs and providing practicum opportunities at Comox Valley facilities could help ease caregiver stress, which has reached the breaking point in many cases.
In an August 2017 report, B.C. Seniors Advocate Isobel Mackenzie said 31 percent of unpaid caregivers were in distress in 2016, the highest in Canada.
Board chair Hollins said in response that “there’s no question we need to put more dollars into the community.”
Seniors Voices Comox Valley
Peggy Stirrett spoke on behalf of a grassroots seniors advocacy group that has collected data from a broad spectrum of community inputs to put a big picture perspective on a local crisis.
Stirrett’s PowerPoint presentation used data to show that the demand for seniors health care and related services has already outstripped local capability and is destined to get worse.
She told the Island Health board that the RFP for “up to 120” new residential care beds does not adequately address the Comox Valley’s demographics or the rate at which the population will grow.
The group’s data suggests there is an urgent need for up to 506 additional residential care beds.
Seniors Voices chart shows the Comox Valley has a higher concentration of seniors
Therefore, building “up to 120” beds by 2020 will neither solve the problem for seniors needing complex care facilities, reduce the distress of family caregivers or diminish the overcapacity problems afflicting the Comox Valley Hospital.
Stirrett said the Comox Valley has a higher concentration of low income households than the provincial average and a higher percentage of them are low income seniors. We also have almost 13 percent more people over the age of 75 than the Greater Victoria area.
But, Stirrett said, “the Comox Valley gets less than its fair share of the resources.”
She plugged data into two different formulas used by the provincial government for calculating a community’s need for residential care beds.
In the first formula, based on 75 beds per 1,000 people aged 75 and over, the Comox Valley should have 525 residential care beds, but has only 374 available.
Calculated as a percent of of the age 75 and over population, the Comox Valley has only 5.4 beds while Victoria, with a lower concentration of over 75 population, has 12.6 beds. The Valley’s ratio is the lowest on Vancouver Island.
“By any calculation we could develop,” Stirrett said, “an equitable allocation could be anywhere between 151 and 506 additional beds … This suggests that 120 additional beds is not enough ….”
She said the group is alarmed by wait times for residential care beds of a year or more and a hospital operating at 138 percent capacity.
“We can only imagine how difficult an experience this is for those seniors who are directly affected … and how much the uncertainty adds to their anxiety,” she said.
Stirrett implored the board to add more residential care beds immediately, even considering using St. Joseph’s capacity as an interim solution.
They also asked Island Health to develop a long-term residential care bed plan for the Valley that addresses the equity issue and takes our unique elderly demographic into consideration.
Finally, Stirrett asked the board to publish information specific to our local area on a regular, timely and transparent basis to help community groups assist seniors with their healthcare needs.
FURTHER READING: Decafnation series on the Comox Valley Hospital; Island Health RFP for residential care beds; The Views considering a bid for more beds
Without public notice, Island Health holds its March board meeting a day early in Victoria, doesn’t address Comox Valley Hospital issues at “public forum” in Courtenay. But seniors health care advocates make passionate pleas for more resources
Those among the several hundred people who packed the Crown Isle Ballroom yesterday (March 29) expecting to attend a meeting of the board of directors of the Vancouver Island Health Authority (Island Health) came away confused.
Those in the standing-room-only audience hoping to hear the Island Health board address well-known problems at the Comox Valley and Campbell River hospitals, and perhaps announce some bold corrective measures, came away disappointed.
Yet, everyone left inspired by five community groups who spoke passionately, and pleaded with the board to serve the Comox Valley more equitably.
FURTHER READING: Pleas for better seniors care, supportive housing and clean air
The confusion arose because Island Health advertised the March 29 event on its website as a regular, official board meeting. It was not.
The board of directors actually met the day before, March 28, in Victoria, without any public notice on its website, probably breaking the government’s own rules on transparency.
Screen shot taken from the Island Health website at 3:53 p.m. March 29
There was no notice by Island Health that the March board meeting would occur at any time other than March 29, or in any other location than Courtenay.
When Decafnation contacted board liaison Louise Carlow via email after the meeting about the lack of public notice, she did not respond. Government workers are off now for the long Easter weekend holiday.
The only director to utter even a sound in Courtenay was board chair Leah Hollins, who opened the meeting by looking over the crowd spilling out into the Crown Isle lobby and saying:
“Fair to say, we weren’t anticipating this many people.”
After all the publicity given to the hospital’s poor planning, overcapacity, long emergency waits, staff shortages and low employee morale, she shouldn’t have been surprised. It would have been surprising if there wasn’t a large turnout.
Concern about the performance of our hospital and how Island Health has underserved the north Island runs that high.
Perhaps the board did fear a large gathering, which might explain why they held their official board meeting the day before in Victoria without any public notice, and did not adhere to their published agenda.
The meeting bypassed the agenda it posted on its website — most notably not allowing any time for questions from the floor — and launched into informative presentations by north Island Medical Health Officer Dr. Charmaine Enns, Island Health CEO Kathy MacNeil and five community organizations.
Not once did Hollins or MacNeil discuss problems at the Comox Valley or Campbell River hospitals, except at the tail end of the CEO’s report when she called the issues, which were first raised in a series of articles on Decafnation, as “growing pains.”
All that was missing in Island Health’s attempt to downplay issues that are having a serious effect on the lives of their employees and patients was a chorus of happy hospital workers smiling behind them on the podium.
Ironically, MacNeil inadvertently pinpointed the source of problems by noting that only about 15 percent of the people who at the two North Island Hospitals were consulted in the design process.
The 300 people MacNeil said were involved in the design process — out of more than 1,900 staff and doctors — were mostly senior managers and physicians. The few frontline workers who were consulted have told Decafnation their input obviously wasn’t heard or was ignored.
But while the board chair and the CEO shied away from addressing problems head-on in public, several of the presenters were more direct.
Jennifer Pass, representing the Comox Valley Elders Take Action group, told the board that CVH staff are disrespecting people based on age, and recounted two personal stories in support.
Pass also criticized the lack of cleanliness in the hospital. She shared a personal experience in the hospital where she saw beds left unmade for days and filthy bathrooms. Her observations coincide with those of several staff members who have spoken with Decafnation.
On health care for seniors, Pass said 2020 was too long to wait for new residential care beds. Island Health has issued a Request for Proposals to build “up to 120” new complex care beds, which MacNeil estimated would be opened “sometime in 2020.”
That concern was also voiced by Peggy Stirrett of the seniors advocacy group, Senior Voices Comox Valley.
Stirrett said the “up to 120” beds sometime in 2020 is not enough, and not soon enough.
“By 2020, (the Comox Valley) will need 100 or more beds than that, and by 2021 we’ll be back in the same situation as today,” she said.
Screen shot of agenda as posted on the Island Health website
Seniors Voices believes there is a current need for between 151 to 506 additional residential care beds based on several formulas used by the government itself.
“The Comox Valley has not received an equitable share of the resources,” she said.
Melanie Olson, spoke on behalf of the Power of 5, a group of “frustrated caregivers trying to keep their loved ones (with dementia) at home as long as possible.”
Olson told the board that Island Health’s support for family, unpaid caregivers is lacking, especially considering that they save the province an estimated $3.5 billion per year.
Hollins skipped over the 10 minutes set aside for questions from the floor (as specified in the agenda) and then abruptly closed the meeting with a tone-deaf remark.
“It’s clear there are many issues in health care. We’ll never be able to meet them all,” she said. “But we appreciate hearing from you today.”