Understanding transitions from hospital to retirement homes

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By Bonnie Rose

The Retirement Homes Regulatory Authority (RHRA) oversees the safety and wellbeing of over 60,000 seniors living in almost 750 retirement homes across Ontario. During the past few months, in my role as Registrar, I have met with Local Health Integration Networks (LHINs) across the province to better understand some of the emerging issues related to transitions between hospitals and retirement homes.

Health care professionals have long known that coordination is key to ensuring safe transitions of patients as they move back and forth between care settings when their health needs change. And I am truly impressed by the unwavering commitment I see, across Ontario’s health system, to work together in ways that benefit patients and enable safe, successful transitions.

Retirement homes are becoming an increasingly important part in the care of continuum. As the sector regulator, the RHRA is committed to helping both hospitals and homes support effective transitions. Most recently, we have been proactively communicating information about transitional care and retirement homes that is intended to help all system partners understand each other’s accountabilities, responsibilities and underlying interests.

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I want to share some of those key facts. For example, you may not know that under their legal obligations as “landlords,” retirement homes must allow residents to return home from hospital. At the same time, retirement homes can only provide care services they are legally permitted to deliver, and only then with appropriately trained staff and certain care standards in place.

Collaboration between the patient and his or her family or substitute decision maker, the hospital, the LHIN and the retirement home on an updated patient assessment and plan of care will also help ensure the retirement home is truly able to meet the person’s current assessed care needs: either through services already provided by the home and outlined in the lease agreement, or availability of purchased services through an external provider or provided by the LHIN. In addition, if an individual’s assessment indicates he or she may be eligible for long-term care, the retirement home must provide information about applying to a long-term care (LTC) home.

 

Incidentally, each retirement home in Ontario chooses which of 13 care services it makes available to all of its residents. Care services that are provided to the individual and the costs must be listed in the residential agreement. Hospital discharge planners can easily find out more about which retirement homes are licensed and the services they offer: information readily available on the Public Register at www.rhra.ca. Only licensed retirement homes are covered under the Retirement Homes Act.

 

One issue being looked at by RHRA and Ontario’s retirement homes is the need for short-term resident agreements for transitional care. This would protect residents from out-of-pocket costs for terminating their lease agreements early / or paying for retirement home care services and accommodation once they are eligible and waiting for a LTC bed (which is subsidized).

 

Ongoing, the RHRA is also meeting with government and other stakeholders to explore potential new options for retirement homes, for instance as places in the continuum of care patients might go for transitional stays.

More information on transitioning from hospital and the community to a retirement home is available on the RHRA website. RHRA will also continue to actively seek new opportunities to provide information, resources and guidance to support all stakeholders as they collaborate to make transitions safer between all care settings.

 

Bonnie Rose is President and CEO of the Retirement Homes Regulatory Authority, which protects the rights and wellbeing of seniors living in Ontario’s retirement homes.