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Care home under financial pressure due to cost of Covid regulations

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Westmeath Residential and Nursing Care Home (File photograph by Akil Simmons)

The island’s largest care home for seniors is struggling with severe financial challenges due to stringent Covid-19 regulations, The Royal Gazette can reveal.

Westmeath Residential and Nursing Home, a private facility on Pitts Bay Road, has 50 elderly residents and the island would have a long-term care “crisis” on its hands if it closed, according to a source close to the matter.

Westmeath is not the only private seniors’ home struggling financially — the source claimed they were all in “very, very serious trouble” — but it has the most residents with complex nursing needs and it is struggling to afford its operational costs.

It is understood to have virtually exhausted its reserves of more than $1 million and to be having difficulty in paying staff and maintaining the building.

The source, who did not want to be named, said: “It took a $610,000 loss in 2020.”

The source said places might be found for about 20 of the residents at other care homes if Westmeath closed, but the remainder had nursing needs that could not be met at any other private facility.

“Can the hospital manage that?” the source asked.

The Government confirmed yesterday it was aware of the crisis and how it stemmed from the pandemic, but stopped short of pledging specific aid.

Health department guidance has meant that care homes with Covid-19 cases can only be declared outbreak free when there have been no positive tests for 28 days after the last positive test was received.

The guidance is understood to have changed very recently to 14 days.

No new residents can be admitted during an outbreak so when beds have become free they have not been filled, meaning a monthly loss of tens of thousands of dollars in income in Westmeath’s case.

Its day-care programme, which used to bring in more than $100,000 in revenue a year, has also not been able to run since early 2020 because of the pandemic.

At the same time, many permanent staff have been unable to work because of either having Covid-19 or being a close contact, so relief staff must be brought in and also paid.

Recently, two staff members had to do jury duty simultaneously, so Westmeath had to pay for cover for them too.

Westmeath’s resident population is almost 100 per cent vaccinated but the number of staff to have been vaccinated is not known.

The home has been repeatedly deemed by health officials as in “outbreak” mode and now has nine empty beds.

It was finally deemed outbreak-free a few days ago, which will enable it to start admitting new residents.

The source said that would help.

“There are people who want to come into Westmeath,” they said. “But it will take some time to admit those people — it doesn’t happen in a day.”

The Gazette understands the board of trustees has discussed the situation with Tinée Furbert, the Minister of Social Development and Seniors.

Ms Furbert told The Royal Gazette in a statement yesterday: “The Government is fully examining the financial state of nursing homes that have expressed financial challenging times throughout Covid.

“Some nursing homes have expressed the need for relief, and we have been in discussions with them to make every attempt to assist where we can to keep our nursing homes open.”

She added: “The lingering effects of the pandemic have compounded nursing homes' financial difficulties. Nursing homes’ limited capacity to fundraise throughout Covid has also affected their funding. Now, with the country's relaxation of restrictions, fundraising plans and efforts should also be a part of the nursing homes’ uplift.”

The Government statement noted that most care homes are no longer in the outbreak restrictions category but emphasised the need to balance the costs and challenges of the restrictions against “the need to protect this group at the highest risk of poor outcomes from Covid-19”.

Ms Furbert added: "There is work to be done to fully examine a sustainable future for long-term care which involves all of us, as we all will be seniors, God willing. Our people need to prepare as much as possible to reduce costs associated with living longer.

“We must determine the appropriate levels of subsidy for seniors who live longer and are experiencing complex health needs. We are committed to delving into this fundamental issue over the next couple of months towards progress for improvements.”

She said: “It is important to note nursing homes globally are experiencing difficulties and closures due to the pandemic. Family members are choosing to keep seniors at home for care for many different reasons, and they have that choice as well.“

The news comes after Westmeath and three other homes were gifted $50,000 each for medical supplies by the Lady Cubitt Compassionate Association because of how hard the pandemic had hit them.

An LCCA press release described how the “sustained impact of it has resulted in significant losses of income and increased expenses for” Westmeath, Packwood Home, Matilda Smith-Williams Seniors Residence and Lorraine Rest Home.

The donation was welcomed by Westmeath, which is itself a registered charity, but the source said it was funds for operational costs that were desperately needed.

The Government pledged in the Bermuda Health Strategy in 2017 to “implement strategies to meet the long-term healthcare needs of seniors and persons with chronic illnesses and physical, cognitive and mental disabilities to better provide for the needs of vulnerable populations and manage costs”.

A Bermuda Hospitals Board spokeswoman said the board was “aware of the impact the pandemic has had” and would “continue to work closely with all our partners as we work through the challenges”.

She said: “Although we operate separately, we all recognise we are part of the same system and what happens to each of us impacts us all.”

The spokeswoman said losing any nursing home placements would make it difficult not just for long-term care, but for the entire social and healthcare system.

“It impacts BHB’s ability to discharge seniors who are medically fit,” she added.

“A lack of available beds in the community for people ready for discharge leads to fewer available beds in the hospital, causing delays in emergency and impacting available beds for surgeries.”

April Augustus, Westmeath’s executive director, declined to comment.

Graphic from the Government's Long Term Care Action Plan 2017
Age Concern: national plan needed

Age Concern executive director Claudette Fleming says a national plan for long-term care is needed now more than ever.

Asked about the financial crisis facing Westmeath and other homes, she said: “Covid restrictions, of course, haven’t helped, but rather than create the crisis we are having they have brought them to the forefront.

“Perhaps the pressure of these restrictions will force the actions necessary to get on with the dialogue and co-ordinated long-term care planning process the island and our older adults so desperately need.”

Dr Fleming agreed nursing homes had been hit by "heavy procedural requirements“ during the pandemic and the Government and homes needed to have a ”two-way dialogue … about what’s practically possible“.

She added: “Each will have to give and take over the realities of the constraints they are under so that the system doesn’t implode any further.”

Dr Fleming said: “I also understand that the Minister for Social Development and Seniors recognises that residential long-term care financing is currently not sustainable requiring an immediate plan of action.

“A coordinated and national effort is required to resolve these critical systemic problems.”

The charity boss said the question of whether struggling private care homes should be subsidised by the public purse was one for the Government.

She added: “Likewise, if Westmeath’s business model is no longer viable, then its board of directors has the ultimate fiduciary responsibility and oversight over its future and fate.

“In the longer term, the question must be answered regarding what type of long-term care system the country can afford, as traditional options of care, in some cases, simply can’t be sustained privately.”

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Published May 30, 2022 at 8:12 am (Updated May 30, 2022 at 8:12 am)

Care home under financial pressure due to cost of Covid regulations

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