Ottawa Valley long-term care homes facing a staffing crisis

The COVID-19 pandemic took its toll on thousands of front line healthcare workers including personal support workers (PSWs) and registered nurses (RNs), many of them left their positions for other opportunities.

The pandemic accelerated the issue of staff burnout and a staffing crisis in two of the Ottawa Valley’s largest long-term care facilities.  

Miramichi Lodge in Pembroke and Bonnechere Manor in Renfrew, both owned and operated by the County of Renfrew, have reached a point where quality care for the residents may be compromised due to the increasing number of staff who are leaving these institutions. Many of them leaving in favour of higher pay and incentives offered by various health care agencies. 

That was the unsettling message delivered by Mike Blackmore, the County of Renfrew's director of long-term care. His report was delivered to both the county’s health committee and all 17 members of Renfrew County Council last week.  

“It was a challenge before the pandemic began and it certainly worsened as the pandemic went on and it still remains a major challenge not only for our home, but for healthcare across the province, across the nation,” Blackmore told the elected officials, many of whom are newly elected representatives. “The immediate impact is shifts are going unfilled and although the province has provided funding for additional care for residents, it is impossible to find staff to do the work. Staff are leaving the homes for better pay from agencies and when the long-term care homes must bring in agency staff, they pay those premiums which is taking up a bigger portion of the budget.”  

He outlined the costs for the elected members and the overall effect on the annual budget.  He said some agencies charge between $96 and $150 an hour for an RN, which is double or triple the salary level the homes are paying of $43 an hour. As a result, when agency registered practical nurses (RPNs), RNs and PSWs fill in at the home, they may only work for seven percent of the total hours the home has scheduled but were paid 16.4 percent of the wages.  

When asked by Whitewater Region Mayor Neil Nicholson why workers with permanent employment and a generous benefits package are choosing to leave to pursue careers with agencies that sometimes cannot match the county’s compensation, Blackmore said much of it is based on generational change. 

“It is more than just money,” Blackmore said. “There is the flexibility that goes along with working for a staffing agency that is attractive. And they may pay, depending on the home, they may pay slightly more.”  

He added the younger generation are not as concerned with pensions as previous generations of workers, but many express a concern regarding when and how much they work.  

“The ability to pick and choose their shifts, versus being scheduled a weekend, night shift is very important to them,” he said. 

During his report, Blackmore told the committee that it is not just an Ottawa Valley problem, but it has, and continues to be a growing problem across the province.  

“Ontario tended to lag behind most provinces in Canada,” he said. “Recently, the ministry went so far as to put funding for four hours of direct resident staffing per day into place which was an unprecedented level of funding. The challenge is everyone is in the same boat across the province and not just long-term care, but all health care.” 

He provided a recent survey of 100 homes across the province which highlighted many of the same issues experienced at the two county homes and several institutions are falling behind in terms of level of care per resident. 

He noted the survey showed an average of 26 per cent of all RN shifts are not filled, citing burnout and changes in work preference. Homes are losing staff to agencies where they can receive significantly higher wages and flexible working hours. 

One eye-opening fact for council members was the trend is being felt in all areas of long-term care. 

“It is not just nursing,” he added. “Agencies are also taking cleaners, cooks, dietitians, physiotherapists and nurse practitioners. The agencies are taking a big chunk out of the budget and are more expensive. 

He said the province is also stepping in to help with the shortages through a PSW wage enhancement of $3 an hour and a RN incentive of $5,000. There is also additional funding for professional development and paid tuition for PSW programs.  

It is not just the agencies that are adding pressure on the two homes. The upcoming addition of more than 100 long-term care beds means competition for healthcare workers.  

“We are kind of in competition with each other,” Blackmore said. “We have to look at new initiatives to keep up our level of care for our residents.” 

He concluded by informing council members of additional pressures brought down on the homes, and they include ongoing evaluation and quality assurance levels required by the province.  

“Even though Bonnechere Manor received the highest rating in 2019 and Miramichi Lodge in 2018, the homes must continually re-invest in training and accreditation status which have an impact on the annual budget.”  

He said it is those additional costs, which predate the pandemic, draws money away from direct one-on-one resident care and cautioned the impact could affect current and future funding models for resident care.