Auditor general backs surprise inspections of long-term care facilities

For years, Albertans have sounded the alarm about inadequate staffing for family members in long-term care.

For years, Albertans have sounded the alarm about inadequate staffing for family members in long-term care.

Now Alberta auditor general Merwan Saher says surprise inspections to check on staffing are not a bad idea.

On Tuesday, the auditor general’s report said Alberta Health Services fails to periodically verify that staffing is adequate to meet the care needs of residents on every shift in the province’s 170 long-term care facilities. The facilities contain 14,370 beds.

According to the report: “AHS does not obtain sufficient assurance that facilities implement individual resident care plans, and meet basic and fundamental daily needs of residents.”

Brenda Corney, Friends of Medicare Red Deer chapter chair, said sometimes Red Deer facilities are really short on staff.

“You’ve got this beautiful care plan but it doesn’t go anywhere if there aren’t enough people to implement it, or have the motivation to implement it,” Corney said on Wednesday. “They are human beings lying in those beds, in incontinence pads that need to be changed, and waiting to go to the toilet. Can you imagine how awful that is? We’re dealing with people. I think the report kind of emphasizes that.”

The report said that long-term care is often end-of-life care and many residents die within two years of admission.

It also said that although medical interventions and medications play an important role, the success of care depends largely on help with the seemingly simple activities of daily living.

“For example, proper bathing, management of continence, body rotation and foot care are critical for preventing sores and skin ulcers, which can often lead to severe health complications and death. Proper cognitive stimulation, daily interaction, social activities and communication are important for preventing and managing depression. Help with these basic activities of daily living prevents seemingly minor health issues that can easily snowball into rapid health deterioration and even untimely death,” the report said.

The auditor general did say the long-term care system has significantly improved since the 2005 audit.

But Public Interest Alberta was disappointed that the auditor general did not look at the whether the care has improved since 2005.

PIA executive director Bill Moore-Kilgannon said the 2005 report said 31 per cent of long-term care facilities were not meeting care standards.

“We still don’t have a sense as to whether or not the government’s strategy on long-term care is providing the necessary care,” Moore-Kilgannon said.

Even the idea to do surprise inspections was simply an example, rather than a recommendation, on how to verify if staffing is adequate to meet the needs of residents, he said.

Meanwhile, families are being encouraged to hire their own caregivers to look after their loved ones in facilities, he said.

“That’s a sign that the system is not properly supported and funding.”

More beds are now operated by corporations and the auditor general did not investigate whether the province is getting value for the taxpayers’ dollars companies are receiving, he said.

“If he’s not even asking that question, then nobody can find out that information,” Moore-Kilgannon said.

Thirty-six per cent of Alberta’s long-term care beds, or 5,239 beds, are at for-profit facilities. That compares to 32 per cent, or 4,540 beds, at not-for-profits, and 32 per cent, or 4,591 beds, at AHS facilities.

According to a November 2013 report from Parkland Institute, corporations made an average return on investment of 2.1 per cent between 1999 and 2009 and that was higher than the 1.23 per cent average return on the U.S. stock market.

“These people are making profit,” Corney said.

The auditor general’s report said it was unclear who has the responsibility and authority at AHS to manage the overall performance at facilities that costs the province $910 million last year.

The Wildrose Party said the auditor’s report outlines a pattern of secrecy within AHS that fails to publicly report on the performance of the provincial long-term care system.

“We have a crisis in our acute-care system, patients are desperately waiting to get access to long-term care beds, while our entire system is failing to properly monitor the quality of care being delivered,” said Wildrose seniors critic Kerry Towle.

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