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Temporary staffing agencies overcharging Ontario long-term care homes: association

TORONTO — Ontario's non-profit nursing homes are being overcharged by nursing agencies, a long-term care association said Tuesday.
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A worker cleans surfaces inside a long-term care home in Vancouver, on Thursday, January 7, 2021. An Ontario long-term care association says nursing agencies are overcharging homes. THE CANADIAN PRESS/Darryl Dyck

TORONTO — Ontario's non-profit nursing homes are being overcharged by nursing agencies, a long-term care association said Tuesday.

AdvantAge Ontario said the homes are spending tens of millions of dollars on temporary nurses and that places the province's target of four hours of care per day per resident by 2025 in jeopardy.

"This is a serious problem," said Lisa Levin, the CEO of AdvantAge Ontario.

Non-profit nursing homes across the province have had to turn to these agencies because competition for nurses and personal support workers is fierce across the entire health-care system as it grapples with a staffing shortage.

AdvantAge Ontario, which represents non-profit, municipal and hospital nursing homes, surveyed 100 of its long-term care homes across the province. It found that, collectively, they are paying $6 million per month to nursing agencies.

The survey also found that 28 per cent of registered nurse positions, 16 per cent of registered practical nurse positions, and 12 per cent of personal support worker positions were unfilled per day.

That creates a huge demand for temporary nurses, Levin said.

"Staffing shortages have been exacerbated over time during the last couple of years, and some staffing agencies have taken advantage of this situation and have been price gouging," she said.

The association wants the province to step in and cap the hourly rate nursing agencies charge.

"The Ministry of Long-Term Care is listening, but they haven't taken any action," Levin said.

Levin said the industry needs a long-term staffing strategy across the province.

A spokesman for Long-Term Care Minister Paul Calandra said the ministry has heard the agency staffing challenges some nursing homes face.

"It is an issue we continue to monitor," said Jake Roseman.

He said they are hiring 27,000 long-term care staff as the province strives to achieve the four-hours of care standard by 2025.

But Levin said it will be difficult for their homes to meet an interim target of three hours and 15 minutes of care per resident per day by March 31. 

"I think that's going to be in jeopardy unless this situation with the agency rates is addressed because we won't be able to provide as many hours of care if the homes have to use more and more temporary staff," Levin said.

The survey found the 100 homes pay, on average, $88 per hour for a temporary registered nurse.

That is more than double the usual $43 hourly rate, AdvantAge said. One agency charged $150 per hour for the same position.

The situation is particularly acute in northern and rural Ontario where agency rates are 30 per cent higher than what is charged homes in urban areas, the survey found.

Steven Harrison, the CEO of Tri-County Mennonite Homes that operates a nursing homes in Stratford, Ont., and New Hamburg, Ont., said the costs for temporary nurses and personal support workers is "taking their toll."

Before the pandemic, the organization would allocate about $150,000 toward agency expenses. 

This year, Tri-County Mennonite Homes plans to spend about $3 million on agency staffing, 20 times more than they paid before COVID-19 arrived, Harrison said.

He said the organization had to open a line of credit to pay for temporary staffing.

"If we were able to hire nurses and personal support workers, it would only be about 60 per cent of that," Harrison said.

"This is not sustainable in the short term, let alone the long term."

A staffing shortage combined with an aging population driving increased demand for beds in long-term care has created "the perfect storm," Harrison said.

He said nursing agencies have become very aggressive as they recruit nurses and personal support workers with the lure of much higher pay.

"Agencies will sit in our parking lots and wait for staff to finish a shift and offer them jobs," Harrison said.

"We need a more comprehensive strategy to exist at a provincial level for how we as a health-care system are going to tackle this problem."

This report by The Canadian Press was first published Feb. 14, 2023. 

Liam Casey, The Canadian Press

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