A public campaign for private property owners to send in details on buildings suitable for care home conversion has yielded three potential opportunities as the island comes under mounting pressure to develop more long-term care capacity.

The call came in May from the Bermuda Health Council, to a backdrop of crisis conditions exposed at King Edward VII Memorial Hospital when Edward Schultz, a former Chief of Emergency Services, went public in April on “critical” hospital overcrowding and bed shortages — leading to significant waiting times for patients admitted to the emergency department.

The shortfalls have been under independent review since June by Acumentice, a British healthcare consultancy firm.

At the time, the Bermuda Hospitals Board said its review would take about six weeks, with the report to be made public.

The BHB has repeatedly highlighted the challenge of patients medically fit for discharge but taking up hospital space. The island’s inadequate long-term care for seniors has also been confirmed by the charity Age Concern.

As part of an effort to boost care options in the community, the Bermuda Health Council is compiling an internal database of privately owned properties potentially suitable for use as residential care homes and nursing homes.

Ricky Brathwaite, its chief executive officer, told The Royal Gazette: “To date, the health council has received three potential property opportunities, one of which is currently operating as a daycare centre, as well as one undeveloped parcel of land.

“These are potential opportunities rather than facilities that have completed the assessment and licensing process, so we are not yet in a position to say that any of them meet all code of practice requirements, including the bedroom space requirements of 120 sq ft for single occupancy and 180 sq ft for double occupancy.”

He added: “The projected need for more than 1,000 long-term care beds includes both residential and nursing care.

“Approximately 31 per cent of that projected need would be for nursing-level care, while the majority, approximately 69 per cent, would be residential care.”

Dr Brathwaite emphasised that the requirements did not “necessarily mean Bermuda needs to physically build all of those residential care beds”.

“With stronger home care programmes, community supports and appropriate financing, a significant proportion of people who would otherwise require residential care could potentially be supported safely in their own homes.”

Dr Schultz said in June that “bed-flow processes throughout the hospital … create ‘exit block’ once emergency patients have been fully assessed and are awaiting transfer to one of the wards”.

He attributed it to “inadequate” inpatient beds and “a dearth of step-down, ‘skilled’ nursing home, and ‘unskilled’ nursing home beds in our community”.

Dr Schultz’s comments followed a joint statement in May from the Ministry of Health and BHB, which reported that approximately 40 patients each day are medically fit for discharge but remain in hospital while awaiting appropriate placement or support, with about 46 per cent of acute care beds regularly getting held up by patients ready to go home.

The statement added: “Strengthening community-based care options, expanding home care supports and improving placement pathways are all contributing to better patient flow.”

It said the burden of patients fit for discharge in acute care beds consumed an estimated 14,600 bed-days annually at an additional cost of roughly $2 million per year in staffing alone.

Additionally, BHB statistics online showed discharges from the acute care wing dropping over the records available for the four most recent fiscal years.

The discharge figure was 3,254 in 2021-22, and fell to 2,479 for 2024-25.

The health council’s Residential Care Facilities report 2024 predicted that the island’s demand for extra long-term care beds would surpass the number of beds available by about 1,000 by 2039.

Another ministry-BHB joint statement, issued in April, announced that the BHB was “establishing a 30-bed transitional care unit to improve patient flow” with government support.

Dr Brathwaite acknowledged that while plans such as the transitional unit and the refurbishment of the Lefroy House seniors home were “important, the longer-term response has to be broader than simply adding institutional beds”.

However, he added: “It also needs to include strengthening home and community-based care so that residential facilities are used for those who genuinely require that level of support.”