Should the federal and provincial governments end for-profit long-term care?

Photo: Chad Hipolito

Bristish Columbia Seniors Advocate Isobel Mackenzie.

A report from British Columbia's advocate for seniors says profits for contracted long-term care facilities are growing significantly faster than expenses such as as direct care costs and staff wages.

Isobel Mackenzie says in her latest report that a review of 181 facilities contracted to provide long-term care shows profit in 2022 increased 113 per cent over five years.

Mackenzie says the cost of supplies and administration during that same time time rose 61 per cent, while direct care costs and non-direct-care staff pay increased by 33 per cent during that time.

The advocate says in the report that while there have clearly been efforts to improve long-term care, there are underlying issues that prevent the investment made by the province from making progress.

The report also shows "distinct patterns of spending" depending on whether a facility is run by a for-profit company or by a not-for-profit society.

The review found not-for-profit facilities spent about 25 per cent more per resident on direct care when compared with for-profit care.

For-profit facilities spent 42 per cent more per bed than their non-profit counterparts on capital building costs, the report says.

"The public is entitled to know how their money is spent," Mackenzie concludes in the report. "Residents and their families are entitled to access information about revenues, expenditures and delivered care hours for their facility."

The report also makes a number of recommendations, including ways to ensure that funding for direct care goes only towards that purpose and not be shifted to fund other operational costs.

That effort would also include a more standardized definition of "what is counted as profit" to paint a clearer picture of whether items such as mortgages, head office allocations, management fees and executive compensation are providing long-term care facilities with additional revenue.

"A greater understanding of the details of these expenses is required to begin to address the issue of what expenditures will be allowed, what are reasonable and equitable building costs and what is a reasonable profit," Mackenzie says in the report.

She also called for a more accurate tracking of care hours, since the current self-reporting system "is vulnerable to inaccuracies."