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Care Needs and Care Funding
This report was prepared by Bev McKay for Citizen Watch, and
forwarded to the Alberta Auditor General in June, 2007.
Dear Mr. Dunn,
This submission has been prepared by Citizen Watch, Continuing Care in Alberta
-- the group of
citizens who submitted to you, in September 2003, a formal request for a value-for-money-audit
of the province's long-term care facilities. We take this opportunity to thank
you once again for
examining the systems used to deliver services in these settings and seniors'
lodges. Your Report
on Seniors Care and Programs, released May 9th 2005, remains a constant
reminder of the
reforms that can and must be achieved for better care and a better quality of
life for Alberta
seniors.
Over the past 18 months, we have attempted to gather information on certain
care funding
issues identified in your report for the purposes of analyzing the data
and sharing our findings
with you.
The funding issue examined in the attachments relates to the audit finding:
"funding varies by
up to $10,000 per year per bed" ... an incongruity your team could
not explain due to a lack of
information [page 36].
The data we collected applies to the 2005/2006 fiscal year and derives from
Health & Wellness
sources (See page 2, footnote). This information, while not always complete
or consistent,
allowed us to calculate the average 2005/2006 care funding per bed for 31 private
facilities and
24 voluntary facilities within 7 health regions. It also enabled us to examine
the range of care
funding against the range of case mix indices (CMI) within a region and among
regions. As well,
we were able to assess for perceived incongruities between funding allocations
and assigned
CMI. Since funding information for individual "public" long-term care centres
is not available
in RHA financial statement, we could not include these settings in this work.
Our findings are recorded on the following pages for your review. We respectfully
request that
you offer us feedback and advise us whether your follow-up audit in September
2007 will pursue
the reasons behind "the large range in funding" found in your
audit and in this submission.
Sincerely yours,
Lucille Gleddie
on behalf of Citizen Watch
2
Care Centre Facility Funding and CMI ratings
CHART 1
CALGARY HEALTH REGION (R3)
Facility
# of long
CMI
2005/2006
Average
term care
(Spring
Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
VOLUNTARY
Bethany Care Centre Airdrie
74
111.10
$2,971,000
$40,150
Bethany Calgary
442
108.50
$20,984,000
$47,500
Bethany Cochrane
78
101.05
$3,036,000
$39,000
Bethany Harvest Hills
60 100.07
$3,003,000
$50,000
Bow View Manor (Brenda Strafford Foundation) 185
112.59
$8,314,000
$45,000
Wing Kei Care Centre (Opened May 2005)
113 -------
$2,714,000
$24,000
Father Lacombe Nursing Home
110
105.10
$4,674,000
$42,500
Mineral Springs Hospital
24
90.10
$7,558,000
$314,900
Wentworth Court (Brenda Strafford Foundation) 73
96.53 $4,164,000
$57,000
PRIVATE
AgeCare - Beverly Glenmore
197 118.59
$8,377,000
$42,500
AgeCare - Beverly Midnapore
178
98.06
$7,663,000
$43,000
Central Park Lodge - Bow Crest
150
101.73
$5,754,000
$38,350
Central Park Lodge Eau Claire
-----
------
$1,843,000
-------
Central Park Lodge - Edgemont ----- ------
$1,534,000
-------
Central Park Lodge McKenzie Town
142
94.81
$7,401,000
$52,120
Central Park Lodge - Mount Royal
93 86.09
$3,047,000
$32,700
Central Park Lodge - Renoir -----
------
$2,045,000
------
Central Park Lodge Scenic Acres
-----
------
$1,581,000
------
Extendicare Cedars Villa
248 94.02
$8,909,000
$35,900
Extendicare Hillcrest
112
100.37
$4,147,000
$37,000
Extendicare Vulcan
46
92.02
$1,895,000
$41,200
Forest Grove Care Centre
239
96.33
$8,891,000
$37,200
Glamorgan Care Centre- Travois Holdings 52
95.49
$1,989,000
$38,250
Holy Cross Chronic Care
42
94.15
$1,736,000
$41,300
Intercare Brentwood
159
99.11
$6,265,000
$39,400
Intercare Chinook
103
110.31
$5,825,000
$56,000
Intercare Millrise
------
------
$1,959,000
-------
Intercare Southwood
147
99.18
$6,490,000
$44,150
Mayfair Care Centre -Travois Holdings 142
95.19 $5,068,000 $35,600
Newport Harbour - Summit Corp.
125 99.04
$5,480,000
$43,800
Other private providers
------
------
$9,853,000
-------
Observation: Within the Calgary Health Region, six of the 9 voluntary facilities have a 100+ CMI.
In contrast, only 4 of 16 private facilities have a 100+ CMI.
References
1. Funding Information: Alberta Health and Wellness Annual Report 2005/2006
2. Bed Numbers: Alberta Health and Wellness Correspondence, September 2005
3. Spring 2005 Case Mix Index Report by Facility: Alberta Health and Wellness Correspondence July 2006
4. Case Mix Index Information: Health and Wellness Correspondence, July 18, 2006
3
CHART 2
CALGARY HEALTH REGION (R3)
Facility
# of long
CMI
2005/2006
Average
term care
(Spring Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
Mineral Springs Hospital
24
90.10
$7,558,000
$314,900
Bethany Calgary, Auxiliary Hospital
442
108.50 $20,984,000
$47,500
PERCEIVED INCONGRUITY
FUNDING FOR MINERAL SPRINGS HOSPITAL IS $267,000 MORE PER YEAR PER BED
YET ITS CMI AND BED COUNT ARE SIGNIFICANTLY LOWER.
CHART 3
CALGARY HEALTH REGION (R3)
Facility
# of long
CMI
2005/2006
Average
term care
(Spring Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
AgeCare - Beverly Glenmore
197 118.59
$8,377,000
$42,500
Wentworth Court (Brenda Strafford Foundation) 73
96.53 $4,164,000
$57,000
PERCEIVED INCONGRUITY
FUNDING FOR BEVERLY GLENMORE IS LESS BY $15,000 PER YEAR PER BED YET
ITS CMI AND BED COUNT ARE SIGNIFICANTLY HIGHER.
CHART 4
CALGARY HEALTH REGION (R3)
Two groups of facilities with similar
# of long
CMI
2005/2006
Average
CMI
term care
(Spring Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
Central Park Lodge, McKenzie Town 142
94.81
$7,401,000 $52,120
Extendicare Cedars Villa
248 94.02
$8,909,000
$35,900
Wentworth Court (Brenda Strafford Foundation) 73
96.53 $4,164,000
$57,000
Forest Grove Care Centre
239
96.33
$8,891,000
$37,200
PERCEIVED INCONGRUITIES
GROUP 1: McKENZIE TOWN HAS SIGNIFICANTLY FEWER BEDS YET RECEIVES
$16,000 MORE PER YEAR PER BED.
GROUP 2: WENTWORTH COURT HAS SIGNIFICANTLY FEWER BEDS YET RECEIVES
$20,000 MORE PER YEAR PER BED.
4
CHART 5
CHINOOK HEALTH REGION (R1)
Facility
# of long
CMI
2005/2006
Average
term care
(Spring Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
Extendicare Lethbridge (Private) 120 97.02
$5,148,000
$42,900
Coaldale Health Care Centre (Voluntary) 40
96.44 $1,701,000
$42,525
PERCEIVED INCONGRUITY
FUNDING AND CMI FOR THE 2 FACILITIES ARE SIMILAR, YET EXTENDICARE
LETHBRIDGE HAS 3 TIMES THE NUMBER OF BEDS.
CHART 6
PALLISER HEALTH REGION (R2)
Facility
# of long
CMI
2005/2006 Care
Average
term care
(Spring Funding by
2005/2006
beds
2005)
Region
funding per bed
(March 2005)
(rounded)
AgeCare (Private)
Total: 1,942,000
- Orchard Manor
15
97.79
$700,944
$46,720
- Valleyview
30
103.69 $1,242,056
$41,400
(Breakdown
provided by
facility admin.)
Central Park Lodges (Private)
128 107.81
$4,971,000
$38,800
- Riverview
Good Samaritan (Voluntary)
80 86.11
$3,309,000
$41,360
- South Ridge Village
PERCEIVED INCONGRUITY
RIVERVIEW RECEIVES UP TO $8,000 LESS PER YEAR PER BED THAN THE 3 OTHER
FACILITIES, YET IT HAS THE HIGHEST CMI AND THE GREATEST NUMBER OF
BEDS.
5
CHART 7
DAVID THOMPSON HEALTH REGION (R4)
Facility
# of long
CMI
2005/2006 Care
Average
term care
(Spring Funding by Region
2005/2006
beds
2005)
funding per bed
(March 2005)
(rounded)
Bethany Collegeside (Voluntary) 112
123.45
$6,560,000
$58,500
Bethany Sylvan Lake (Voluntary)
40 115.07
$2,378,000 $59,450
Castor Our Lady of the Rosary
24 135.05
$2,915,000 $121,450
Hospital and Care Centre
(Voluntary)
St. Mary's Health Care Centre
28 102.17
$1,593,000 $56,890
(Voluntary)
Northcott Care Centre (Private)
73 94.00
$2,863,000 $39,200
Linden Nursing Home (Private) 37
88.97 $1,309,000
$35,370
PERCEIVED INCONGRUITIES
FUNDING FOR BETHANY COLLEGESIDE AND ST. MARY'S HEALTH CARE CENTRE
IS SIMILAR, YET BETHANY HAS A SIGNIFICANTLY HIGHER CMI AND 4 TIMES THE
NUMBER OF BEDS.
FUNDING FOR THE 2 BETHANY FACILITIES IS SIMILAR, YET SYLVAN HAS A
LOWER CMI AND APPROXIMATELY ONE-THIRD THE NUMBER OF BEDS.
THE HIGH CMI FOR BETHANY COLLEGESIDE AND CASTOR OUR LADY INDICATES
A HIGH LEVEL OF NEED AMONG THE RESIDENTS OF BOTH FACILITIES, YET THE
FUNDING DIFFERS BY $63,000 PER YEAR PER BED.
CHART 8
EAST CENTRAL HEALTH REGION (R5)
Facility
# of long
CMI
2005/2006 Care
Average
term care
(Spring Funding by Region
2005/2006
beds
2005)
funding per bed
(March 2005)
(rounded)
Lamont Health Centre (Voluntary)
105 89.85
$8,910,000 $84,857
Mary Immaculate Mundare
30 86.10
$1,726,000 $57,533
Auxiliary Hospital (Voluntary)
Extendicare Viking (Private) 60
94.17
$2,715,000
$45,250
PERCEIVED INCONGRUITIES
MARY IMMACULATE HAS A LOWER CMI AND 50% FEWER BEDS THAN
EXTENDICARE VIKING YET IT RECEIVES $12,000 MORE PER YEAR PER BED.
LAMONTE HEALTH CENTRE HAS 300 FEWER BEDS AND A SIGNIFCANTLY LOWER
CMI THAN BETHANY CALGARY (R3) YET RECEIVES $37,000 MORE PER YEAR PER
BED.
6
CHART 9
CAPITAL HEALTH REGION (R6)
Financial statements for Capital Health, as for some other Authorities, show only "gross" funding
allocations to voluntary and private service providers. As a result, care funding information for individual
facilities operated by the voluntary and private sectors is unavailable in Health & Wellness Annual
reports. This limited our review to 6 of the 14 voluntary facilities within the region and 4 of the 12 private
facilities.
Facility
# of long
CMI
2005/2006
Average
term care
(Spring
Care Funding 2005/2006
beds
2005)
by Region
funding per bed
(March 2005)
(rounded)
VOLUNTARY
Allen Grey Continuing Care
133 96.40
6,416,000
$48,200
Centre
Salem Manor Nursing Home
102
93.15
3,683,000
$36,100
Sherwood Park Care Centre
100
100.30
3,887,000
$38,870
St. Joseph's Auxiliary Hospital 204
113.11
10,290,000 $50,400
St. Michael's Long Term Care
145 100.83
6,665,000
$45,900
Centre
Youville Nursing Home
162
103.76
6,747,000
$41,600
PRIVATE
Chinatown Care Centre
75
101.52
3,363,000
$44,800
Hardisty Nursing Home
182
87.29
6,192,000
$34,000
Devonshire Care Centre 120 94.95
5,708,000
$47,500
Venta Care Centre
132
90.59
5,092,000
$38,500
PERCEIVED INCONGRUITIES
FUNDING FOR SHERWOOD PARK AND ST. MICHAEL'S DIFFERS BY $7,000 PER
YEAR PER BED YET THEIR CMI AND BED NUMBERS ARE SIMILAR.
ALLEN GREY, SALEM MANOR, DEVONSHIRE AND VENTA HAVE A MODERATE
CMI AND BED NUMBER RANGE YET THE FUNDING VARIES BY UP TO $12,000
PER YEAR PER BED.
FUNDING FOR VENTA AND LAMONTE HEALTH CENTRE (R5) DIFFERS BY
$46,000 PER YEAR PER BED YET THEIR CMI AND BED NUMBERS ARE SIMILAR.
Observation: Within the Capital Health Region, 7 of the 14 voluntary facilities have a 100+
CMI. In contrast, just 2 of the 12 private facilities have a 100+ CMI.
7
CHART 10
ASPEN HEALTH REGION (R7)
Facility
# of long term
CMI
2005/2006
Average
care beds
(Spring Care Funding 2005/2006
(March 2005)
2005)
by Region
funding per bed
(rounded)
Extendicare Athabaska (Private)
50 93.60
$1,954,000
$39,000
Extendicare Bonnyville (Private)
50 81.55
$1,770,000
$35,400
Extendicare Mayerthorpe (Private)
50 93.12
$1,959,000
$39,100
Extendicare St. Paul (Private) 76
91.23
$3,085,000
$40,500
Bonnyville Health Care Centre
32 106.77
$12,622,000
$394,400
(Voluntary)
OBSERVATION
FUNDING FOR THE EXTENDICARE FACILITIES APPEARS CONSISTENT WITH CMI
RANGES AND BED NUMBERS. BONNYVILLE HEALTH CARE CENTRE IS THE
EXCEPTION.
FACILITIES IN PEACE COUNTRY (R8) AND NORTHERN LIGHTS (R9) HEALTH
AUTHORITIES ARE PREDOMINANTLY PUBLIC.
June 2007
Bev McKay for Citizen Watch
8
In August 2007, the Auditor General acknowledged the submission:
Dear Ms Gleddie: (on behalf of Citizen Watch, Continuing Care in Alberta)
Thank you for the June 5, 2007 submission regarding the funding issue identified in our May
2005 Seniors Care and Programs Report. We will be pleased to consider the submission as we
plan our seniors care follow-up audit work that is scheduled to begin this fall.
You asked whether we intend to examine the reasons behind the large range in funding. The
purpose of our follow-up audit work is to assess whether the Departments have implemented our
recommendations. Our work will include an assessment of whether the Department of Health
and Wellness, working with the Department of Seniors and Community Supports, now collects
sufficient information about facility cost from the Regional Health Authorities and long-term
care facilities to make accommodation rate and funding decisions (see recommendation #4 on
page 35 of our May 2005 Report).
If you have any questions or would like to provide any further information to us , please contact
my Communications Coordinator, Lori Trudgeon at 780-422.6655 or ltrudgeon@oag.ab.ca
Yours truly,
Fred J. Dunn
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