The CIUSSS de l’Estrie-Centre hospitalier universitaire de Sherbrooke (CHUS) has raised more than four million dollars in three years by imposing fees on patients who no longer require acute care in the hospital and who refuse a place in a transitional housing environment. The establishment charges users $429 per day. If the practice is legal, the Council for the protection of the sick judges the amount “scandalous”.
The CIUSSS de l’Estrie-CHUS demanded hospital accommodation fees for 2,152 patients between 1er April 2019 and March 31, 2022, reveal data obtained by The duty following an access to information request. Almost all (99%) of users have paid their bill; they paid an average of nearly $1,900.
Victoria Della Porta refused to pay a bill worthy of a “five-star hotel” for the hospital accommodation of her 86-year-old unfit mother. “The way it was done, it was a threat. I was told: “If you don’t accept [cette place en CHSLD], you pay $429 a day.” »
His mother was hospitalized in mid-January at Brome-Missisquoi-Perkins Hospital in Cowansville due to a broken hip. She was discharged from the hospital approximately six weeks later. The CIUSSS de l’Estrie then asked her daughter to sign a document in which she promised that her mother would leave the hospital when a residential resource was offered to her.
“I am aware that each day spent in a hospital centre, once a transitional residential environment is offered to me, will be billed to me as an uninsured service at a cost of $429, which I will have to pay,” the letter indicates. that The duty was able to consult.
Victoria Della Porta refused to affix her signature. “I told them: ‘We are in a situation of a system [de santé] broken. You just wanna get rid of my mom ’cause she’s taking a bed [d’hospitalisation].” »
The CIUSSS offered him a place in a CHSLD in Granby the next day. A place that did not suit the caregiver. “It’s 50 kilometers from us,” says the consultant and co-owner of a hotel.
Before her hospital stay, her mother lived in a private residence for semi-autonomous seniors in Cowansville, 10 minutes from her home. She saw her almost every day. “It allowed me to have her with us two nights a week,” says the only daughter.
Victoria Della Porta protested, and the health establishment offered her mother a room in a CHSLD in Sutton, a little closer to the family residence. She accepted even though she would have preferred her mother to be housed in the same CHSLD as her sister, in Bedford. The family lives in the area.
Victoria Della Porta points out that the CHSLD de Sutton team is “incredible”. But she does not understand why her mother inherited this place, when one of her roommates had been coveting it for months. “His wife told me: ‘I hope my husband will be able to go to Sutton so that I can see him,'” she says.
In his view, this amount of $429 per day, billed following a refusal related to a family situation, is unacceptable. “Imagine an elder saying [au CIUSSS] that her husband cannot go to such a CHSLD because it is too far from her home, says the caregiver, who ultimately paid nothing. We don’t care about the human part. »
A legal practice
In accordance with a regulation implementing the Act respecting health services and social services, health establishments must charge accommodation costs to a patient who has been discharged from hospital “for whom a place is guaranteed in another establishment, but who refuses to leave the establishment which accommodates him”.
Questioned by The duty, the CIUSSS de l’Estrie-CHUS indicates that the amount of $429 per day is “determined by the provincial government”. In the letter it gives to users or their relatives, the establishment argues that the costs are “much lower” in a transitional environment. He adds that he will do his “best to make this transitional place as close as possible” to their home.
The CEO of the Council for the Protection of the Sick, Mr.e Paul G. Brunet, finds this bill of $429 per day “scandalous”. “In a CHSLD, it’s $2,000 per month maximum,” he says. He considers it “unfair” that patients have to pay high hospital accommodation costs if the place offered is far from the residence of their relatives.
Of course, he adds, citizens should not be choosy when offered a place in a CHSLD. “But it’s the fault of the network if we have trouble placing people where they will be well and where they will be close to their families in their region,” says Ms.e Brunett. It is the network that is guilty and responsible for the very small number of beds for the elderly who are waiting to be accommodated. »
The demand for places in CHSLDs is “quite strong” in Estrie, according to the regional CIUSSS. As of March 17, the average occupancy rate for hospitalized users no longer requiring hospital care was 15.5% in the region, compared to 11.6% provincially. Quebec wants to reach the 8% target in order to free up beds and allow patients stuck in the emergency room to go upstairs.
The Dr Félix Pageau, internist-geriatrician and researcher in ethics, reminds us that hospital beds must be granted to those who need them “most”. However, he thinks that geriatric patients who no longer require acute care are “disadvantaged” in the current system. “Do we give enough money to geriatric care, to CHSLDs, to the creation of places in CHSLDs? he wonders. Probably not, compared to other countries like France and Britain. »
The Ministry of Health and Social Services had still not responded to questions from the Duty at the time these lines were written.