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The Threats of Privatization to Security in Long-Term Residential Care

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Abstract

This paper argues that privatization, especially in the form of for-profit, chain ownership, undermines security in old age. Using data from research in Canada and focusing on the specific case of long-term residential care, this paper examines four aspects of security; security of physical access, security of financial access, security of quality and security of employment for those providing care.

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Notes

  1. Data just released from the 2011 Census indicate that, although the share of the Canadian population aged 65+ is growing, it remains lower than that of any other G7 country save the US. Meanwhile, Canada’s share aged 15–64 also remains stable, and lower than that of any other G7 country. The growth rate among those aged 0–4 is higher than it has been since the 1956–61 period, which was during the baby boom (Statistics Canada 2012).

  2. The most spectacular, but not the only, recent case in England involves Southern Cross, a chain serving 31,000 residents. Its troubles stemmed from a sale and lease back scheme involving most of its 750 homes to obtain quick cash for shareholders and expansion. By early 2011, occupancy rates were falling as impoverished local (municipal) sent fewer seniors to these homes. Meanwhile, the rental agreements contained automatic escalator clauses. The firm is now being wound up, with bank and landlord creditors suffering huge losses (Wright 2011; Wachman 2011).

  3. The Regulations under Ontario’s 2010 Retirement Homes Act did not come fully into effect until 1 January 2014 “In order to allow retirement homes time to comply with the new regulations” (Ontario 2012a). The regulation on ceasing to operate a retirement home came into effect on 1 January 2013.

References

  • Alberta, Health Quality Council of Alberta (2011). Highlights of the 2010/2011 long-term care family experience survey. http://www.hqca.ca/.

  • Aminzadeh, F., Datzeil W. B., Molnar, G. J., & Alie, J. (2004). An examination of the health profile, service use and care needs of older adults in residential care facilities. Canadian Journal on Aging, 23(3), 281–294.

  • Amirkhanyan, A. (2008). Privatizing public nursing homes: examining the effects on quality and access. Public Administration Review, 68(4), 665–680.

    Article  Google Scholar 

  • Amirkhanyan, A., Kim, H. J., & Lambright, K. T. (2008). Does the public sector outperform the nonprofit and for-profit sectors? Evidence from a national panel on nursing home quality and access. Journal of Policy Analysis and Management, 27(2), 326–353.

    Article  Google Scholar 

  • Armstrong, P., Boscoe, M., Clow, B., Grant, K., et al. (2009). A place to call home: Long term care in Canada. Halifax: Fernwood Books.

  • Atchison, C. (2009). Chartwell’s silver-haired lining Globe & Mail (October 18, 2009): B13.

  • BCGEU (British Columbia Government Employees Union) (2012). BCGEU calls on Minister of Health and Interior Health Authority to investigate public funding and contract flipping at privately owned Spring Valley. (July 12, 2012). http://www.bcgeu.ca/BCGEU_calls_on_Minister_of_Health_and_Interior_Health_Authority_to_investigate_public_funding_and_contract_flipping.

  • Berta, W., Laporte, A., & Valdmanis, V. (2005). Observations on institutional long-term care in Ontario: 1996–2002. Canadian Journal on Aging, 24(1), 71–84.

    Article  Google Scholar 

  • Bourbonniere, M., Feng, Z., Intrator, O., Angelelli, J., Mor, V., & Zinn, J. S. (2006). The use of contract licensed nursing staff in U.S. nursing homes. Medical Care Research and Review, 63(1), 88–109.

    Article  Google Scholar 

  • Boyle, T. (2011). Nursing homes take healthier residents over sicker ones, expert charges. (December 16, 2011) Source: http://www.healthzone.ca/health/yourhealth/article/1101499--nursing-homes-take-healthier-residents-over-sicker-ones-expert-charges?bn=1.

  • Buchanan, D. (2011). The not-for-profit contribution and issues from the provider perspective. Presentation to “Reimagining long-term residential care” annual meeting (June 2, 2011).

  • Canadian Press (2012). Chartwell, U.S. partner buy retirement homes for $931 million. Guelph Mercury (Februrary15, 2012) http://www.guelphmercury.com/news/business/article/715663--chartwell-partner-buy--retirement-homes-for-$931-million.

  • Canadian Union of Public Employees. (2005). CUPE wins major victory for former Royal Crest long-term care workers in out-of-court settlement. Ottawa: Canadian Union of Public Employees.

    Google Scholar 

  • CBC News (2012b). Family protests 80-year-old’s care home eviction (March 14, 2012). http://www.cbc.ca/news/canada/edmonton/story/2012/03/14/edmonton-homecare-eviction-protest.html.

  • CBC Radio (2012a). Nursing home complaint (March 14, 2012). ww.cbc.ca/…/ID/2210154506/?page=25 - 8k - 2012-03-14 and http://www.cbc.ca/gsa/?q=tranquility+care+homes.

  • CMA (Canadian Medical Association) (2010). Health care system: Canadians fear effect of the silver tsunami. Niagara Falls: Author. http://www.cma.ca/advocacy/silver-tsunami.

  • CTV News (2004). (April 8, 2004). http://www.ctv.ca/serviet/Articlenews/printi/CTVNews/20040408/royal_crest_040410/20040408/?hub=WFi.

  • Clarke, B. (2008). Private-care home is costing more, seniors say; Residents of new ‘P3’ facility say they are paying more than at public home, despite health authority’s assurances to the contrary. Globe & Mail. (December 10, 2008).

  • Cohen, M., Murphy, J. M., Nutland, K., & Ostry, A. (2005). Continuing care renewal or retreat? BC Residential and Home Health Care Restructuring 2001–2004 (Vancouver: Canadian Centre for Policy Alternatives). http://www.policyalternatives.ca/documents/BC_Office_Pubs/bc_2005/continuing_care.pdf.

  • Collier, E., & Harrington, C. (2008). Staffing characteristics, turnover rates, and quality of resident care in nursing facilities. Research in Gerontological Nursing, 1(3), 157–164.

    Article  Google Scholar 

  • Conference Board of Canada. (2010). Dispelling the myths. Ottawa: Conference Board of Canada.

    Google Scholar 

  • Egan, K. (1997a). Cobden nursing home to close: ‘Devastated’ seniors may be forced to leave village. Ottawa Citizen (July 10, 1997): D6.

  • Egan, K. (1997b). Heartbroken in Cobden: Many are ‘wounded in the mind,’ but residents of Lakeview Nursing Home are part of community’s fabric. Ottawa Citizen (September 11, 1997): B1.

  • Evans, R. G., McGrail, K. M., Morgan, S. G., Barer, M. L., & Hertzman, C. (2001) Apocalypse no: Population aging and the future of health care systems. SEDAP Research Paper No. 9. Hamilton: McMaster University. http://socserv.mcmaster.ca/sedap/p/sedap59.pdf.

  • Frank, R. (2012). Too frail to fail. Too frail to fail: A look at seniors’ residence failures. Métropolitain (May 18, 2012) http://www.themetropolitain.ca/articles/view/1106.

  • Galt, V. (2012). Affluent boomers expect cruise ship living on land. Globe & Mail (11 July, 2012): B3.

  • Gilchrist, J. (2012). Undercover—and appalled at the food served to seniors. Calgary Herald (June 15, 2012).

  • Globe & Mail (2012). Canada’s aging population will strain the health care system (February 6, 2012).

  • Goodsell, D. (2012). B.C.’s privatization of seniors’ care raises concerns. CBC News (May 8, 2012) http://www.cbc.ca/news/canada/british-columbia/story/2012/05/07/bc-seniors-business-private.html.

  • Hamilton Spectator (2008). Royal Crest business being reviewed by OPP (February 25, 2008) http://www.thespec.com/news/local/article/172985-Royal-crest-business-being-reviewed-by-opp.

  • Harrington, C. (2007). Trends in nursing home ownership and quality. Testimony before the U.S. House of Representatives Committee on Ways and Means, Subcommittee on Health. www.leg.bc.ca/…/Harrington_Trends_in_Nursing_Home_Ownership.

  • Harrington, C., Kovner, C., Mezey, M., Kayser-Jones J., et al. (2000). Experts recommend minimum nurse staffing standards for nursing facilities in the US. Gerontologist, 40(1), 5–16.

  • HEU (2009b). VIHA cleaning-contractor-compass-cited-for-health & safety violations. www.heu.org/news-media/news-release/VIHAcleaning contractor Compass cited.

  • HEU (B.C. Health Employees Union) (2009a). Quality care in B.C.’s residential care facilities. A submission to the Office of the B.C. Ombudsman on Seniors’ Care. January www.heu.org/.

  • Hunter, J. (2004). Ramada Inn closing money-losing retirement home. Timmins Daily Press, (March 30, 2004): 1.

  • Hutchins, B. (2011). Private sector hired for ‘cultural change’ at Rideaucrest nursing home. The Kingston Heritage EMC (March 3, 2011): 1.

  • Jenkins, A., & Braithwaite, J. (1993). Profits, pressure, and corporate lawbreaking. Crime, Law and Social Change, 20, 221–232.

    Article  Google Scholar 

  • Keenan, L. (2008). N.B. contemplates more public-private pratfalls. Telegraph-Journal (July 25, 2008): A7.

  • Kleiss, K. (2012). Mom’s private-care costs shock family into action: long-term care facility says rent increase justified by level of care needed. Edmonton Journal (March 14, 2012).

  • Kramer, A., & Fish, R. (2001). The relationship between nurse staffing levels and the quality of nursing home care. In US Department of Health and Human Services (Ed.), Appropriateness of minimum nurse staffing ratios in nursing homes: Phase II final report (pp. 2.1–2.26). Washington: Health Care Financing Administration.

    Google Scholar 

  • Lake Cowichan Gazette (2009). Lake resident urges people to get behind effort to save Cowichan Lodge. Lake Cowichan Gazette (March 23, 2009).

  • Leys, C., & Player, S. (2011). The Plot Against the NHS. London: Merlin.

  • Martin, B. (1993). In the public interest? Privatization and public sector reform. London: Zed Books.

    Google Scholar 

  • McGregor, M. J., & Ronald, L. A. (2011). Residential long-term. Care for Canadian seniors. Nonprofit, for-profit or does it matter? IRPP Study 14. Ottawa: IRPP.

    Google Scholar 

  • McGregor, M. J., Tate, R. B., McGrail, K. M., Ronald, L. A., Broemeling, A.-M., & Cohen, M. (2006). Care outcomes in long-term care facilities in British Columbia, Canada: does ownership matter? Medical Care, 44(10), 929–935.

    Article  Google Scholar 

  • McGregor, M., Tate, R. B., Ronald L. A., McGrail K., et al. (2010). Staffing in long-term care in B.C. Canada: a longtitudinal study of differences in facility ownership, 1999–2006. Health Reports, 21(4), 1–7.

  • McGregor, M. J., Baumbusch, J., Abu-Laban, R. B., McGrail, K. M., Andrusiek, D., Globerman, J., et al. (2011). A survey of nursing home organizational characteristics associated with potentially avoidable hospital transfers and care quality in one large British Columbia Health Region. Canadian Journal on Aging, 30, 551–561.

    Article  Google Scholar 

  • McKay, P. (2003a). Taxpayers finance construction boom. Ontario’s Nursing Home Crisis—part 4. Ottawa Citizen (April 29, 2003): A11.

  • McKay, P. (2003b). Seniors gold: Ontario’s nursing home crisis—part 3. Ottawa Citizen (April 28, 2003).

  • McKay, P. (2003c). The missing millions of a nursing home empire-Ontario nursing home crisis—Part 2. Ottawa Citizen (April 27, 2003).

  • Mercury Staff (2012). Chartwell re-acquires south Guelph retirement home. Guelph Mercury, May 2012) 1. http://www.guelphmercury.com/news/local/article/715663--chartwell-re-acquires-south-guelph-retirement-home.

  • Morgan, S., & Cunningham, C. (2011). Population aging and the determinants of healthcare expenditures: the case of hospital, medical and pharmaceutical care in British Columbia, 1996 to 2006. Healthcare Policy, 7(1), 68–79.

    Google Scholar 

  • Murphy, J. M. (2006). Residential care quality: A review of the literature on nurse and personal care staffing and quality of care. (Nursing Directorate, British Columbia Ministry of Health). http://www.health.gov.bc.ca/library/publications/year/2006/residential-care-quality-a-review-of-the-literature-on-nurse-and-personal-care-staffing-and-quality-of-care.pdf. 447.1KB.

  • Norris, G. (2006). Shares in nursing home firm skyrocket: Extendicare sale talk boosts stock. Toronto Star (February 24, 2006): FO3.

  • Ombudsperson [British Columbia] (2009). The best of care: Getting it right for seniors in BC (Part 1). www.ombudsman.bc.ca/seniors/seniors-care…/seniors-report-part-one.

  • Ombudsperson [British Columbia] (2012). The best of care: Getting it right for seniors in BC (Part 2). www.ombudsman.bc.ca/seniors/seniors-care…/seniors-report-part-two.

  • Ontario (2010). Retirement Homes Act, 2010. S.O. 2010 C.11.

  • Ontario (2012a). McGuinty government takes steps to license retirement homes. Press release (April 16, 2012).

  • Ontario (2012b). Long-Term Care Homes Act, 2007. Ontario Regulation 79/10 (last amendment: O. Reg. 108/12).

  • Ontario, Office of the Auditor General (2002). 2002 Annual Report. www.auditor.on.ca/reprots_en11/2001en.pdf.

  • Organization for Economic Cooperation and Development (2011). Help wanted? Providing and paying for long-term care. Executive Summary. Paris: OECD.

  • Poynter, R. (1999). Don’t bypass the workers with public appeals. Hamilton Spectator (March 25, 1999): A10.

  • Prada, G. (2011). Innovation procurement in health care. A compelling opportunity for Canada. Ottawa: Conference Board of Canada.

    Google Scholar 

  • SachsGoldblattMitchells (2010). Legal Opinion on Retirement Homes Act (Bill 21) for Ontario Health Coalition. (May 27, 2010) http://www.web.net/ohc/bill21opinion.pdf.

  • Shapiro, E., & Tate. (1995). Monitoring the outcomes of quality of care in nursing homes using administrative data. Canadian Journal of Aging, 14(44), 755–768.

    Article  Google Scholar 

  • Shiva, V. (2002). Sustainable agriculture and food security: The impact of globalisation. Thousand Oaks: Sage.

    Google Scholar 

  • Spilsbury, K., Hewitt, C., Stirk, L., & Bowman, C. (2012). The relationship between nurse staffing and quality of care in nursing homes: a systematic review. International Journal of Nursing Studies, 48(6), 732–750.

    Article  Google Scholar 

  • Statistics Canada. (2012). 2011 Census. The Canadian Population in 2011: Age and sex. Ottawa: Minister of Industry.

    Google Scholar 

  • Struthers, J. (1997). Reluctant partners: State regulation of private nursing homes in Ontario, 1941–1972. In R. B. Blake, P. E. Bryden, & J. F. Strain (Eds.), The welfare state in Canada: Past, present, and future (pp. 171–192). Concord: Irwin Publishing.

    Google Scholar 

  • Tam, P. (2012). 50-bed seniors’ project nixed; Move highlights hospitals’ competing visions on elder care. Ottawa Citizen (January 7, 2012): D1.

  • Wachman, R. (2011). Barclays and Lloyds swallow £50m Southern Cross debt. The Guardian (December 2, 2011).

  • Welsh, M. (2012). Inspectors of nursing homes warn of big delays: Union says investigators swamped with caseload. Toronto Star (June 12, 2012): A3.

  • Windsor and District Labour Council (2012). La Chaumiere retirement residence. (February 25) http://www.wdlc.ca/index.php?option=com_content&view…id.

  • Wright, O. (2011). Care homes operator to close after rents soar. The Independent (March 15, 2011).

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Acknowledgments

This paper is a product of a seven-year team project on ‘Re-imagining Long-term Residential Care: An International Study of Promising Practices’ funded by the Social Sciences and Humanities Research Council of Canada (File# 412-2010-1004: Pat Armstrong, Principal Investigator), with additional funding from the European Research Area in Ageing 2 project for a study on ‘Healthy Ageing In Residential Places’.

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Armstrong, P., Armstrong, H. & MacLeod, K.K. The Threats of Privatization to Security in Long-Term Residential Care. Ageing Int 41, 99–116 (2016). https://doi.org/10.1007/s12126-015-9228-0

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