The way long-term care is funded frustrating: Pierce
Tuesday, December 31, 2003 Roderick Benns
The model used to fund long-term care homes is flawed and creates frustration for a home's entire team, according to an OMNI administrator.

Linda Pierce of Village Green says the Province needs to seriously reconsider the way it allocates money to the long-term care sector, given the disruption the model causes by virtue of its fluctuating funding formula.

"We need to be looking at a new model. Homes so often have to revisit their staffing levels, reducing their numbers (of staff members) on the floor. That's frustrating for the whole team," says Linda.

"There is a constant revisiting of plans. Goal-setting, planning, is so difficult," she adds.

Linda, who has been at Village Green for 15 years, is responding to questions being asked by OMNIway on ideas about how to strengthen long-term care.

The complex funding formula used by the Province means nursing and personal care needs are determined by assessing a set of criteria, which include activities of daily living, behaviours and continence. The data is then grouped together to determine the total care requirements of all residents in each home. This measure is used to determine the home's level of funding, so it is constantly changing.

Between the time that CMI is assessed and when the funding is delivered (eight months later), the home could have a dramatic increase or decrease in care needs, due to the changing health of residents. If care needs increase, then a home may be left under-funded, with no recourse until the next year.

Linda offers an example about how the funding formula can impact a home. "We introduced an RN to work a 12-8 shift. If our case mix index (the way in which a home is funded) were to go down, we'd have to get rid of that shift," she says.

This, in turn, says Linda, would impact the whole team, who are being supported by having an RN work an evening shift.

Linda says in addition to the funding formula changes, there should also be more constancy in the way compliance advisors respond to set standards. She says Village Green has always had a great relationship with its compliance advisor. But, she notes a home may have an advisor for years who interprets standards in a different way than the next person who comes through the door.