A 90-year-old man received bills totaling more than $27,000 from the CIUSSS de l’Estrie — Center hospitalier universitaire de Sherbrooke (CHUS) because he refused to allow his 83-year-old wife, who no longer required hospital care, or transferred to a transitional accommodation facility located more than 40 kilometers from their residence. The couple’s only son denounces this “inhuman” practice, which remains legal according to Quebec. His complaint to the Québec Ombudsman has just been rejected.
“We are treated as if we were numbers,” says the son, Pierre Laliberté. We are told, “There’s a place there, and that’s where you’re going”, without taking into account all the aspects that are associated with the person. »
Suffering from Alzheimer’s disease, his mother 83-year-old Madeleine Pellerin was hospitalized at Hôtel-Dieu in Sherbrooke on May 4 due to a deterioration in her general condition. She lived until then with her husband in a house in Sherbrooke. At the end of her hospitalization, two weeks later, it was agreed that she could not return to her home.
During a meeting with a social worker, Pierre Laliberté signed a form in which he agreed to pay a fee of $282 per day if he refused the transitional accommodation offered by the CIUSSS. He believed then that the health establishment would be able to offer his mother a place in a CHSLD in Sherbrooke.
Nearly two months later, the CIUSSS offered the family a transitional accommodation in Richmond, more than 40 km from the family residence. Pierre Laliberté refused, because his father would not have been able to visit his mother regularly. His parents have been married for sixty years. “My father has his driver’s license, but he didn’t want the CHSLD to be too far away. He’s the caregiver, because I live in Lorraine, a two and a half hour drive from Sherbrooke,” he explains.
The CIUSSS offered Madeleine Pellerin a place in a second accommodation facility, in Coaticook, in October. Pierre Laliberté declined for the same reasons. His mother finally obtained a place in a CHSLD in Sherbrooke on November 27. The CIUSSS billed the family more than $27,000 in hospital accommodation costs. The three invoices, of which The duty was able to become aware, have not yet been paid.
Pierre Laliberté says he is ready to pay part of the amount, that is, the amount corresponding to the amount billed to users who have been discharged from the hospital and who are waiting for a place of accommodation. The costs amount to approximately $55 per day, the equivalent of those in a CHSLD. ” It is fair play, he believes. But not the penalty. »
According to him, the amount demanded by the CIUSSS would exceed the amount remaining in his parents’ bank account. “Is there a discussion we can have?” asks Pierre Laliberté. It is excessive in terms of fees. “He challenges Minister Christian Dubé: “If he had been in the same situation as my parents and me, what would he have done? “Would he have transferred his mother to a CHSLD, far from his father? he asks.
Pierre Laliberté filed complaints with the CIUSSS de l’Estrie as well as with the Québec Ombudsman. They were rejected. The family had been informed of the existence of the costs of $ 282 per day in the event of refusal, underline the two authorities. Health establishments are required to require them under a regulation under the Act respecting health services and social services.
Excessive fees
These hospital accommodation costs are the subject of debate in the National Assembly. Following a report by Duty, the opposition parties denounced last week the amount of $429 per day imposed on patients no longer requiring acute care and refusing a place in transitional accommodation. Asked about this high rate, the Ministry of Health and Social Services (MSSS) replied that the CIUSSS de l’Estrie “bills the right amount” determined by the government.
And why $282 a day rather than $429 for Madeleine Pellerin? The CIUSSS made a mistake by having the family sign an old form, writes the CIUSSS’s service quality and complaints commissioner in a letter to Pierre Laliberté in December. Until March 31, 2022, the daily amount was set at $282. It has since risen to $429.
Questioned by The duty, the CIUSSS de l’Estrie indicates that prolonged hospitalization is detrimental to the functional abilities of the users concerned and that it prevents patients, stuck in the emergency room, from having access to a hospital bed on the upper floors. It ensures that the proposed transitional environment “is as close as possible to the user’s home, within a maximum radius of 70 kilometres”.
“We know that the change of living environment is an important step and that the support of loved ones is also important, we add. However, we must look at access to care and services as a whole for the benefit of the population. »
We are treated as if we were numbers. We are told “There is a place there, and this is where you are going”, without taking into account all the aspects that are associated with the person
The facility says it has only been applying the hospital accommodation fee of $429 per day since 1er April 2022. Previously, it did not impose them, he specifies. “The CIUSSS de L’Estrie – CHUS only billed the costs associated with the CHSLD according to the type of room occupied”, we wrote in an email. This amount ranged from $41.89 per day to $67.31.
“Since we followed the provision of the law, less than five people have refused the offer of a transitional environment, ensuring that they remain in a hospital center after obtaining their discharge”, we continue. Between 1er April 2019 and March 31, 2022, 2,152 patients refused a transitional living environment, according to data obtained by The duty through an access to information request. In three years, the CIUSSS has raised more than four million dollars in accommodation costs.
A complex problem
Transitional accommodations are far from the ideal solution, according to Dr David Lussier, geriatrician at the University Institute of Geriatrics of Montreal. But they are “a lesser evil” in the current context. He believes that it is better to stay in a CHSLD – “no matter which one” – than to stay in a hospital centre. “In the hospital, there is a much higher risk of infections,” he says. There’s not all the stimulation [qu’on a en CHSLD]. »
However, the support of caregivers remains “essential” to prevent the person housed from deteriorating, according to him. The Dr Lussier believes that accommodation costs should be applied according to family situation. “If you want to go to a CHSLD in Outremont and you are offered a place in the southwest of Montreal, you are billed [si tu refuses], does he think. But if you want to go to Sherbrooke and they offer you Coaticook, I can understand that it’s almost inhuman to do that to someone. »