Acute care beds at the Stella-Maris-de-Kent Hospital will temporarily be converted to palliative and long-term care beds, due to a shortage of medical resources, Vitalité Health Network has announced.
The transition will take place gradually, starting immediately with patients from the emergency department or the community who require hospital admission being transferred to the Dr. Georges-L.-Dumont University Hospital Centre in Moncton, according to a news release issued late Monday afternoon.
Stella-Maris-de-Kent is a 20-bed hospital in Saint-Marie-de-Kent, about 40 kilometres north of Moncton, roughly a 40- to 50-minute drive.
Meanwhile, some patients at the Dumont who are awaiting placement at a long-term care facility in the Kent region will be transferred to the Stella-Maris-de-Kent Hospital, the release said.
The measure could remain in effect for "a few months," according to Dr. Natalie Banville, senior vice-president of client programs and medical affairs.
"It is intended to reduce the workload for care teams and improve community access to physicians, while maintaining the quality of care and patient safety," she said in a statement.
The move comes as a number of hospitals have struggled with high occupancy rates, staffing shortages and long wait times. The emergency room at Stella-Maris-de-Kent was closed overnight for several days over the holidays due to a "critical shortage of nursing staff."
Horizon Health Network has started using a new provincial regulation to fast-track patients waiting in certain hospitals for a nursing home bed.
Fears temporary fix will become permanent
Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, described the Vitalité announcement as "a nightmare, to say the least.
"I believe this is a quick fix that will become permanent," she said in an emailed statement.
"We continue to patch without a vision.… People in Kent County deserve better services," not a reduction.
Cecile Cassista, executive director of Coalition for Seniors and Nursing Home Residents’ Rights, says New Brunswick has had issues with seniors occupying acute care hospital beds 'for some time' but 'fail to address the issue unless it’s a crisis [and] then they patch.' (Submitted by Cecile Cassista)
Banville, in her statement, said the Stella-Maris-de-Kent Hospital and its emergency department will remain open and "continue to provide services to the region's population, despite this temporary measure."
Vitalité remains committed to ongoing recruitment efforts to "resume regular operations at the hospital," the release said.
The government needs to address staffing quickly, said Cassista, noting at least 245 nursing home beds are vacant in New Brunswick because the homes don't have enough employees to take care of more residents.
"Seniors deserve better living conditions than [to] continue to languish in a hospital setting," she said.
Cassista also wants the province to increase subsidies for special care home beds, provide more support to enable seniors to continue to live at home longer, and address assessment delays.
Health department sets 'targets'
Health Minister Bruce Fitch told reporters Monday more hospital beds in New Brunswick could soon be freed up through the temporary bumping of hospitalized patients to the top of the nursing home waitlist, which should help alleviate congestion in emergency departments.
"There's targets that we've asked them to meet in the last little while and I know they were working towards [moving out] 20 in the month of January," he said, referring to alternative level of care patients — people who have been medically discharged but are waiting in hospital for placement in a nursing home or other long-term care setting.
"And then more into February," he said.
Health Minister Bruce Fitch says the government is working to ensure 'people get the right care at the right place at the right time.' (Shane Magee/CBC)
Fitch could not immediately say how many alternative level of care patients have been discharged so far using the "critical state admission prioritization" protocol implemented earlier this month at the Saint John Regional Hospital, St. Joseph's Hospital in Saint John and the Dr. Everett Chalmers Regional Hospital in Fredericton.
"I don't have that number right off the top of my head because it's changing all the time," he said.
CBC has requested the number from both departments and is awaiting a response.
'Dire situation' continues
"As everyone knows … there was a real dire situation over the holidays, Christmas and New Year's, and it continues because of a high [level of] flu, RSV and COVID still being present in the community," Fitch said.
"People were saying, 'Need to do something about the emergency room. What are you going to do?' So one of the situations that would alleviate that stressor and that pressure is to have some of the long-term care patients move to a nursing home or a special care home" with the clinical services they need, said Fitch.
"This will alleviate some of the backlog, or congestions, or the availability of beds, and will allow people that are admitted through the emergency department to have a place to stay."
It also helps ensure people "get the right care at the right place at the right time," he said. "To languish in the hospital for a long-term care patient is really not the best place to spend their time."
Hospitals over national capacity benchmark
Normally, nursing home admission is done chronologically.
But the "critical state admission prioritization," which received royal ascent in June, may be enacted by the minister of Social Development at the request of a regional health authority for up to 30 days when:
A hospital's emergency room is over capacity and there are prolonged off-loading delays from ambulance bays.
Acute care units are over capacity.
Critical surgeries are cancelled because of a lack of hospital beds.
Earlier this month, Horizon's interim president and CEO Margaret Melanson told reporters Horizon's four regional hospitals remained over capacity following a "major surge" of emergency room visits over the holidays because of a rise in respiratory illnesses, staff shortages, and a slowdown in discharging patients waiting for long-term care.
As of last week, the Saint John Regional Hospital had an occupancy rate of 101 per cent and the Chalmers had an occupancy rate of 110 per cent, according to Horizon spokesperson Kris McDavid. He could not immediately provide the occupancy rate for St. Joseph's Hospital.
The national benchmark is 85 per cent.
The Moncton Hospital's occupancy rate stood at 101 per cent and the Miramichi Regional Hospital, at 105 per cent.
935 people on nursing home waitlist
A total of 463 people were waiting in hospitals across the province for a nursing home placement, as of Jan. 1, and another 472 people were waiting in the community, either at home or in special care homes, Social Development has said.
The regional breakdown includes:
On Jan. 23, Social Development Minister Jill Green authorized giving priority to alternative level of care patients waiting in the Dr. Everett Chalmers Regional Hospital for admission to nursing homes, said department spokesperson Rebecca Howland.
She did not say where Horizon's request for the prioritization of patients at its other three Fredericton-region hospitals stands — the Oromocto Public Hospital, the Upper River Valley Hospital in Waterville, and Hotel-Dieu of St. Joseph in Perth-Andover.
Green extended prioritization of alternative level of care patients at the Saint John Regional Hospital for 30 days, following a review, said Howland, "however, St. Joseph's Hospital had the prioritization lifted," she said, without elaborating.
Although other placements are put on hold for 30 days, that does not mean people lose their standing on the waitlist. — Rebecca Howland, Social Development spokesperson
"Although other placements are put on hold for 30 days, that does not mean people lose their standing on the waitlist" through the prioritization of hospitalized patients, said Howland.
"It is a necessary balance to the needs in the community as well as hospital and we do not take the critical state decision lightly," she said in an emailed statement.
"In the meantime, the department is working with the regional health authorities, extramural program, and other community stakeholders to find the best solution for all."
Social Development has been contacting clients in the Saint John and Fredericton areas who are waiting in the community for placements to ensure they have the appropriate support, said Howland.
The department is also working to shorten waitlists in other regions, she said, noting Mount Saint Joseph Nursing Home in Miramichi has added 30 beds to help with the discharge of patients from the Miramichi Regional Hospital as well as those waiting in community. Fifteen beds opened in December, and the remaining 15 opened earlier this month.