Chris Wilkinson column: Private seniors care homes must be more accountable

The lack of transparency of where the public funds are allocated is alarming

By Chris Wilkinson

The latest report released from the Office of the BC Seniors Advocate, entitled A Billion Reasons to Care, paints a rather appalling picture for seniors care in privately owned care homes. The report is the first provincial review of the $1.4 billion, publicly funded ($1.3B), contracted long-term care sector in British Columbia.

Some of the most interesting findings of the report are the following:

• Financial reporting was inconsistent across the many facilities and health authorities and lacked openness and transparency

• Some significant expenditures related to management fees, head office allocation and some administrative costs had a glaring lack of detail; i.e. where did this money go?

• In many cases there was no way to verify the reported hours worked by caregivers/nurses was actually performed; Did shifts get fully staffed? Were seniors left without care?

• A net profit for the entire sector of $37 million was calculated, which is only 2.6 per cent of overall revenue; however, as noted, much lack of transparency around certain management fees and head office allocation of funds makes it difficult to find out where other significant portions of the public funds ended up

NOTE: for-profit care homes generated 12 times the amount of profit generated in the not-for-profit sector, $34.4 million versus $2.8 million

• Care homes in the not-for profit sector spent 59 per cent of revenues on direct care versus 49 per cent in the for-profit sector

• Not-for-profit care homes spend $10,000 or 24 per cent more per year on care for each resident

Personally, I’m not against the private sector providing health care to those in need. If I said or indicated anything to the contrary I’d be a hypocrite given my line of work (private home care). In theory, having private contractors compete in business to deliver efficient and accountable service/care makes sense to me. Private businesses must run lean and more efficient as funds (revenues) are never guaranteed. There is competition who will try to do it better. But when left unchecked and unaccountable for the transparency of spending public dollars, what do you think happens?

In my opinion the public system does the best it can under the circumstances it has created and operates in, and the need for additional private services to complement public health care seems obvious. However, the lack of transparency of where the public funds are allocated, and more importantly, the lack of care provided to our seniors as a result is more than alarming.

Recommendations from the Office of the BC Seniors Advocate to improve the transparency, standardization and detail in the reporting of the usage of public funds for long-term care was made clear in their report. Admirably, the report also recommended that financial incentive for operators to do anything other than provide as many care hours as possible with the public money they receive to deliver direct care must be removed. That is, if an operator can find staff who will work for lower wages than their funded rate, they should use their surplus funds to provide more hours of care or return the funding.

Obviously, this report is only as effective as the action that results. That remains to be seen and is too early to state on the heels of this report. What’s clear is the Office of the BC Seniors Advocate has been effective at identifying where gaps and financial reporting holes are in the care of our seniors in long-term care facilities.

For a copy of the full report, visit


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