Ontario moved 424 people into nursing homes they didn’t choose

Health Fitness

More than 400 patients have been forced into Ontario nursing homes they did not want to go to and the rate of those moves is increasing, The Canadian Press has learned.

There were 424 discharged patients who moved to a nursing home not of their choosing out of 20,261 patients who were moved to long-term care homes since a law allowing such moves came into force in late 2022, the long-term care minister’s office said.

About one-third of those patients were moved in just February and March, the last two months for which data was available.

And one woman faces a $26,000 hospital charge under the provisions of the law that her family doesn’t plan to pay.

Controversial bill forces tough choices for families

In the summer of 2022, a few months after Doug Ford and his Progressive Conservatives won a landslide victory in the election, the government introduced Bill 7 in an effort to open up much-needed hospital space. The province passed the bill into law within days, bypassing a study at committee, which sparked a firestorm of anger from the opposition and seniors.

The law is aimed at so-called alternate level of care patients who are discharged from hospital but need a long-term care bed and don’t have one yet. Hospitals can send those patients to nursing homes not of their choosing up to 70 kilometres away, or up to 150 kilometres away in northern Ontario, if spaces open up there first.

If patients flat out refuse those transfers, hospitals can charge them $400 a day under the law.

WATCH | Opposition parties critical of Ontario’s long-term care policy: 

Opposition parties take aim at controversial long-term care policy

NDP leader Marit Stiles, Liberal MPP John Fraser and Green leader Mike Schreiner criticized the provincial government Thursday over a policy that allows seniors in hospital to be discharged to long-term care homes not of their choosing in order to free up beds. Their comments come after CBC Windsor reported on a $8,400 bill received by a family that refused a transfer to a facility they said was inadequate.

Critics have said the vast majority of people in that situation would feel threatened enough by the prospect of massive fees that they would comply.

The Ministry of Health has said seven people across the province have been charged the $400-a-day penalty. It refuses to disclose the total amounts patients are being asked to pay, but at least one family has received a $26,000 bill.

‘I will not stop until this bill is dead’

Ruth Poupard and her daughter, Michele Campeau, are refusing to pay the bill and experts say it’s unclear what will happen next.

“It’s never gonna happen,” Campeau said. “I will not stop until this bill is dead.”

The southwestern Ontario family could face a lawsuit, collection agency — or nothing — by ignoring the hospital bill, experts say.

An elderly woman in a hospital bed and a middle-aged woman sitting beside her. They are both looking out a window out of the frame.
Michele Campeau, left, visits with her mother, Ruth Poupard, 83, at Hotel-Dieu Grace Healthcare where she was recovering from a broken hip, in Windsor, Ont., on April 3, 2024. Poupard has racked up over $20,000 in hospital bills after refusing to move to a nursing home she didn’t choose. (Dax Melmer/CP)

Poupard, who has lived through cancer, a heart valve transplant and progressing dementia, began her most recent health-care journey a few days after Christmas. The 83-year-old fell at home, where she lived with Campeau, who is also her power of attorney. Poupard broke her hip and needed emergency surgery.

She moved to Hotel-Dieu Grace Healthcare in Windsor, Ont., in February for rehabilitation. Her attending doctor discharged Poupard on Feb. 21, but she needed more care than her children could provide. The family decided on long-term care and made a list of five nursing homes Poupard preferred.

Those were full, like the vast majority of long-term care homes in the province, so the family agreed to add a few more. In early March, the hospital’s placement co-ordinator found a nursing home in downtown Windsor and gave Campeau 24 hours to check it out and decide. Campeau walked through the home, said it was disgusting and refused to move her mother there.

A $26K hospital bill, with no plans to pay

A standoff began in March when Hotel-Dieu began charging Poupard $400 a day under the provisions of the law. On May 14, Poupard left the hospital after getting into her top choice for a nursing home.

That two-month journey came with a $26,000 bill but so far there have been no followups from the hospital to pay.

“I have no idea what’s happening,” Campeau said.

Shortly after the first charge, Campeau went public with her family’s plight. She phoned politicians of all stripes and got a return call from her provincial representative, Andrew Dowie, a conservative backbencher who told her homes the hospital co-ordinator asked the family to add to her mother’s list were slated for demolition because they did not meet accessibility standards.

“I am downright angry,” Campeau said. “I said to him, ‘you wanted me to put my mother in there and when I refuse a place that you’re going to demolish, you’re charging me $26,000? It’s borderline insanity.'”

Ministry says ‘system is working’

What happens next is unclear.

The hospital refused to answer questions about Bill 7, as did the Ontario Hospital Association. Health Minister Sylvia Jones has said billing is the hospital’s responsibility.

Ontario Health Minister Sylvia Jones makes an announcement on health care with Premier Doug Ford in Toronto on Jan. 16, 2023.
How hospital billing is enforced under Bill 7 is unclear. Ontario Health Minister Sylvia Jones says it’s the hospital’s responsibility. (Frank Gunn/The Canadian Press)

Stan Cho, speaking as long-term care minister before recently being appointed tourism minister, said he was happy with how the law was working.

“When it comes to caring for our most vulnerable seniors, a hospital is no place for them to be at, period, and that bed is needed for more acute needs,” Cho said.

“Overall, the system is working, but the bigger problem here is that we have a giant capacity issue from decades of not building.”

The province is in the middle of a massive redevelopment of the long-term care system, with plans to build enough spots for 60,000 people.

Unclear how hospitals will enforce bill collection

Several experts say the only options left for the hospital seeking penalty payouts from patients would be to get a collection agency involved, sue Poupard or let it slide.

If the hospital wanted its money, it would likely start by enrolling a collection agency to try to get it, said Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, which is taking the province to court in a Charter challenge over the law.

“If that wasn’t successful then they could sue the senior,” Meadus said.

Pensions are non-garnishable, Meadus said, which means they cannot be taken in a lawsuit. Campeau said her mother’s money comes from a pension.

WATCH | Hospital CEO explains when Bill 7 policy is used: 

Hospital CEO explains when Bill 7 policy is used

Bill Marra, CEO of Hôtel-Dieu Grace Healthcare, breaks down what the hospital does when it has a patient who is ready to move out of its care and into a long-term care facility.

Unpaid bills can mean a hit to a credit rating and the often-unpleasant experience of dealing with collection agents, said personal-injury lawyer Michael Smitiuch.

“Collection agencies are horrible to deal with, they are persistent, and unrelenting and it’s very, very stressful,” Smitiuch said.

If the hospital took Poupard to court, it would take years to get in front a judge as the civil court system is plagued by backlogs, he said.

The legislation itself does not contemplate enforcement remedies like other laws do, Smitiuch explained. If a driver loses a civil case over a car crash injury or death and does not pay the award, the legislation allows for suspension of that driver’s licence.

There is nothing similar in Bill 7, he said.

“It’s like they didn’t think through the whole thing,” Smitiuch said.

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