TRURO, N.S. — Residents at select Shannex nursing homes in Truro and Debert are expressing concern about changes they fear could leave them homeless if they become ill and are admitted to hospital.
“Currently, we have no primary care physician available to care for residents who do not have their own physician from the community,” says a recent letter distributed to residents of Victoria Way at the Cedarstone Enhanced Care home in Truro.
The letter goes on to explain “this is a critical situation” that Shannex has been trying for months to address with the Department of Health and Wellness and the Nova Scotia Health Authority (NSHA).
“Despite our best efforts, we have not had success,” the letter says.
Residents at the Cedarstone facility and at another Shannex nursing home in Debert have been informed that if they do not have a family doctor and they become ill and are admitted to hospital, there is no guarantee their room will still be available when they are released.
“It puts families and residents in a predicament,” said the daughter of one resident who asked that their names not be published.
“If they admit her, she loses her bed,” the woman said, of her elderly mother who suffers from advanced dementia. “It’s just not acceptable.”
Another resident, who lives in the Victoria Way home, and who suffers with a number of debilitating issues, said she is living in fear of being “out in the cold” if she has to be admitted to the hospital again.
“We are left without a doctor on the unit and Shannex is trying to send a message to the government by punishing the residents,” said the woman, who also asked not to be publicly identified.
“I’m definitely worried because if I have another … attack, I’ll be back (in the hospital).”
“We are able to admit only new residents who have an existing physician in the community who agrees to continue to provide care for them in the nursing home." - Katherine VanBuskirk
Following inquiries by Truro News, Shannex said in an emailed response that its current physician shortage involves 61 residents.
Katherine VanBuskirk, the company’s director of Communications and Community Affairs, said nursing homes are responsible for and are mandated through the Nova Scotia Long Term Care Program, which requires all residents to be under the care of a qualified medical practitioner.
Although Shannex doesn’t actually employ the physicians, the company partners with physicians who are responsible for caring for individual groups of residents.
“They treat residents at our homes and are compensated the same as they are in their individual practices,” VanBuskirk said. “That said, we are required to ensure that there is a physician available for each resident.”
In the case of Debert and the Cedarstone-Victoria Way residences, however, the doctors Shannex had partnered with are no longer available, which means those residents do not have physician coverage.
Following meetings with the affected residents and families on Tuesday, VanBuskirk said a temporary effective solution for physician coverage is being offered “through a virtual platform of local physicians” as well as actively working with the province’s health department and the NSHA to explore further potential.
“It is a program where residents could have access to physician care online,” she said.
VanBuskirk said that is similar to a program being used in an acute care setting in Western P.E.I., but it is just one idea and “we are open to any solution” that addresses the shortage of primary care coverage in long-term care settings.
“In the meantime, understanding the critical nature of a physician’s role in our homes, we have had to take steps to ensure that any resident requiring medical attention is able to be seen and treated by a physician,” VanBuskirk said.
To that end, she said, Shannex will review all potential new admissions to each affected facility on a case-by-case basis.
“We are able to admit only new residents who have an existing physician in the community who agrees to continue to provide care for them in the nursing home,” she said.
If a resident must go to hospital, the possibility of their readmission will also be reviewed on a case-by-case basis in consultation with the company’s partners at Continuing Care “to ensure that we can safely care for residents who may have experienced a change in health status and do not have access to a physician.”
Residents who do have a family doctor will be required to attend the physician’s office for treatment or checkups as opposed to having a doctor come to them.
The woman, who serves as the voice for her dementia-inflicted mother, said the change in wording does little to address her concerns.
“It’s kind of a wait-and-see thing, actually,” she said. “That does not alleviate my concern at all.”
Although Shannex says it will review its readmission policy on a case-by-case basis for residents who have been admitted into the hospital, what is not clear is how particular the requirements will be for a hospital patient to reclaim their placement in the facility, when it is time to be released.
“It doesn’t really make me feel any better,” the woman said, “and I don’t think that it made anybody else there feel any better either.”
In an emailed response late Tuesday afternoon, Health and Wellness Minister Randy Delorey said the situation is being looked at.
"I became aware of the issue yesterday and am deeply concerned for the residents," he said. "I asked my department to look into it immediately. We are working with all of our partners to find a solution, to ensure appropriate care is available at the facilities."
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