Bloodletting in RPA | The Press

(Quebec) At least 150 private residences for seniors (RPA), the vast majority of which have less than 50 places, have closed their doors since January 2021. A “bleeding” which is likely to accelerate, according to the Regroupement québécois des residences for seniors (RQRA), which calls for the rapid intervention of the Legault government.

“The pandemic has caused the phenomenon to explode. I foresee that within six months, we will have a series of closures, and especially residences that offer care, ”worries the president and CEO of the RQRA, Marc Fortin. “It’s not too strong to speak of a bloodletting and it’s only just beginning,” he warns.

According to the most recent official report compiled by the RQRA, 118 residences closed between January and November 2021. About thirty others have done the same since, assures Mr. Fortin. For comparison, you have to combine the figures for 2019 and 2020 to arrive at such a high number of closures.

The smallest residences suffer the most. Of the 118 RPA affected, more than half had 9 residents or less and almost all of the others had fewer than 50 users. Only a few residences had 50 or more units.

In total, these closures will have resulted in the loss of 1,963 accommodation places, according to data from the RQRA.

Groups representing seniors and an expert are “very concerned” about this phenomenon, which forces the displacement of seniors and causes them financial stress and anxiety.

Some regions are particularly affected. Chaudière-Appalaches alone lost 12 residences in 2021 and the Capitale-Nationale, 9. Montérégie sits at the top of the closures with 20 fewer RPAs. This data also includes RPAs that have changed vocation or no longer have certification.

It should be noted that 29 residences, on the other hand, opened their doors in 2021.

The labor shortage, the increase in expenses related to health care services, the significant increase in insurance costs and recently inflation are adding pressure that is difficult for owners to bear. The scarcity of personnel is particularly bad, according to the testimonies collected.

In Lanaudière, the residence L’Oasis sous les pins, which accommodates 15 users with a loss of autonomy, will cease its activities on 1^er July, after 27 years. On the eve of retirement, co-owner Francine Lanctôt cannot find a replacement.

“People are no longer interested with everything that has happened for two years,” she explains.

“We’ve been working every day, seven days a week for two years. […] This is not obvious. There is a lot of staff turnover,” says Ms.^me Lanctôt, who operates the residence with his sister.

“The closure is due because we have returned [à la retraite], but I would be 10 years younger and I would be in the same predicament. »

To maintain premiums

RPAs fear the post-pandemic backlash as Quebec lifts the health emergency this spring, which means the end of most of the “COVID” bonuses paid to caregivers in the public sector, but also private. The decree capping the fees of private employment agencies will also be abolished.

The RQRA asks Quebec to maintain this order in Bill 28 aimed at ending the health emergency to prevent prices for independent labor from “going crazy”. We are also calling for the extension of premiums to maintain “a balance” in the market and avoid an exodus to the public.

“The government’s decision will only cause other closures,” said the Chairman and CEO of the Lokia Group, Dr.^r Guy Tremblay, speaking of the withdrawal on April 16 of the $4 per hour bonus offered since the start of the pandemic to private beneficiary attendants (PAB).

“If someone asks me if I’m more afraid of COVID or of the end of $4, right away, I answer: it’s $4,” says Mr. Tremblay. Compensating for this subsidy would cost him 2 million a year, he estimates. “I can’t afford that. The Lokia Group has 2,400 units in 14 residences, many of which offer “advanced healthcare”.

According to the RQRA, it is the residences that must hire more nursing staff that are the most weakened and that are struggling to compete with the public sector, where Quebec is deploying major means to attract workers.

The Legault government has planned a salary transition program for nursing staff in RPA in order to organize “an orderly withdrawal of this financial assistance”. Over five years, this measure will cost the Quebec government $335 million.

Residences of 149 units or less, for example, will continue to be reimbursed at 80% in the first year. This proportion decreases over time and is lower for larger residences.

“The end of these bonuses will therefore be in the form of a gentle regression,” writes the office of the minister responsible for seniors, Marguerite Blais.

“I will lose my staff”

If this compensation will allow some owners to keep their heads above water over the next year, others do not dare to consider the rest.

“The government has put this measure in place for everyone, it should withdraw and treat everyone the same,” laments Gaston Gendreau, who operates the Lord Lepage residence in Rimouski. The RPA has 180 units and will therefore receive compensation representing 40% for the year following the end of the health emergency.

“We can’t get there, it’s not possible,” he says. And if I can’t afford to compensate for that, I’m going to lose my staff. »

According to Mr. Gendreau, the government’s method of compensation is “arbitrary”. His residence is the one that hires the most PABs in the region because it also offers assistance to the CLSC. “You understand that it doesn’t make sense,” he says.

The RQRA also anticipates that residences will have no choice but to reduce their care supply because the costs will be too high.

Faced with this scenario, users would take the path of the CHSLD or intermediate resources. “It’s the government that will be caught with the problem,” argues Marc Fortin.

“We cannot tell seniors: you are going to pay more. It doesn’t work the same way,” he adds, asserting that the “ability to pay” of residents is affected.

Minister Blais’ office argued in a statement sent to The Press that “RPAs are important partners of the government” and that Quebec has responded since the start of the health crisis. “We have supported them in a big way with the help of new programs,” one writes.

Emergency aid of 40 million has been extended for RPAs, in addition to bonuses related to COVID-19. Quebec has invested $394.2 million over 5 years to improve the refundable tax credit for home support for seniors, in addition to setting up a modernization assistance program.

Hard blow for seniors

“An emotional shock”

The Quebec Association for the Defense of the Rights of Retired and Pre-Retired Persons is “very concerned” by the wave of RPA closures. “People who are in these residences [qui ferment] experience a lot of stress and anxiety. The people who are there are often over 75 years old. It is an emotional shock to move or be uprooted from a place where they have been for years. They wonder if they will be able to financially assume another place and if they will find one. This impact is significant and can lead to mental health problems and even lead to early death for people, ”says the president, Pierre Lynch.

“Leaving his hometown”

The Réseau FADOQ is concerned about the closure of smaller residences, which will reduce the accommodation offer. “When you are in big cities, this may be less true, but in smaller cities, if the residence closes, people have to move and even leave their hometown,” argues the general manager, Danis Prud. ‘man. “The closures of 90 units and less are also to the detriment of the largest consortia. The cost of rent can go up to 30% more for one person, depending on the size of the residence. […] Despite the tax credit for home support, not a lot of money remains in the pockets of seniors,” he laments.

“Multiple bereavements”

According to Nathalie Delli Colli, associate professor and co-head of gerontology programs at the Université de Sherbrooke, the effects of moving seniors from one residence to another should not be underestimated, especially when they “do not participate not to the decision to relocate”, as during a closure. “Adjusting to the new environment can be difficult, the person may become isolated, may develop symptoms of depression, sadness, difficulty with appetite. These are multiple bereavements: the bereavement of friends, stakeholders, a neighborhood and an environment that was your home,” lists the researcher.