Ombudswoman wants Quebec to create a central database for CHSLDs and retirement homes

Up to 21,000 people face an unnecessarily complicated access process, says Marie Rinfret

A special report released last week by the Quebec Ombudswoman’s office on access to provincial retirement and long-term care residences recommends the government develop by September next year a centralized data base allowing information on vacancies and available rooms to be shared across Quebec.

The report documents the reality of elderly people who are waiting for a place in a substitute environment and spells out what needs to take place immediately to correct the access process.

Complicated access

At the end of a systemic investigation into the rules and practices surrounding access, the Quebec ombudswoman made 14 recommendations to the Quebec Ministry of Health and Social Services (MSSS), under four orientations corresponding to the main findings.

“Every year in Quebec, 21,000 people who can’t remain safely at home come up against a complicated access machine that is hard to understand, that involves lengthy wait times and is discouraging,” said Quebec ombudsperson Marie Rinfret.

“These people, who are experiencing a crucial stage of their life, suddenly find themselves in complete disarray, uprooted and forced to move to a new environment which is often not the one they expected,” she added.

The report’s four orientations were as follows:

Show consideration to would-be residents

As part of the access process, various practices seen in CISSSs and CIUSSSs result in the denial of rights or needless upheaval.

  • The right to choose a resource (in keeping with available resources) is regularly breached or denied would-be residents, as is the right to be adequately informed.
  • Forced moves within 48 hours, in all likelihood hasty, are a recurrent source of distress.
  • Cancellation of an application if a person refuses the place offered violates the elderly person’s rights.
  • Frequent and extended recourse to temporary placement causes a form of homelessness at the end of life.

Standardize practices Quebec-wide

  • Because the access mechanism is not standard, there are sizable disparities from one region to another regarding the access process itself and average wait times. In addition to yielding a misleading portrait of access, the lack of uniform practices creates inequalities between regions.

Review application prioritization

  • Elderly people’s social and emotional needs are scarcely considered in prioritizing applications. This means that it may be difficult for informal caregivers to help residents, spouses may end up at different residential resources, or significant persons may live far away.
  • The network’s limited resources and the imperatives of the hospital-care system have created a fast track to placement – hospitalization. The upshot is that people at home wait longer for a place in a residential resource.

Produce an exhaustive portrait

  • The MSSS’s management of access data is inefficient: some data are not collated the same way by different institutions, other data are ignored or made inaccessible, while some are only partly distributed.

In her report’s recommendations, Rinfret also said the provincial government should develop by March 31 2022 all the resources necessary to process the centralized data on vacancies at the establishments, especially with regards to admission processes, temporary users and interterritorial requests.

She said the ministry should implement, no later than Sept. 1 2022, a single and centralized system for assigning, managing and sharing relevant data throughout the MSSS and all its retirement, long-term care and other public housing establishments.

Wants recommendations followed

As well, she said the health and social services ministry should be able to verify by Dec. 31 next year that all the establishments are using the new system to centralize and coordinate all of their data.

Finally, Rinfret’s office asks the MSSS to provide, no later than Dec. 10 this year, a work plan indicating the actions to be taken and the schedule that will be followed for the implementation of each of her recommendations.