Volume 2 | October 2019

I am pleased to share our second Continuing Care Access and Flow bulletin. We want to keep you informed about the trends related to continuing care programs and services in the province. In this edition, we look at Quarter 1 (Q1) data from April 1–June 30, 2019 compared to Q1 and full fiscal year (FY) data for 2018-19. We hope you will find this information helpful. We welcome any and all feedback. Susan Stevens Senior Director, Continuing Care, NSHA

Continuing Care Referrals

In this section we report on the total number of referrals for home care, long-term care and other continuing care programs. Referrals are most often received through our intake line: 1-800-225-7225

Measurement:  Data includes number of referrals to all 17 continuing care programs and services, such as home care, long-term care, caregiver benefit, health equipment loan program, home oxygen, etc.  Summary:  5,664 referrals were made to continuing care in Q1 2019-20, this is approximately two per cent lower than Q1 2018-19. The majority of referrals (36 per cent) are in Central Zone with the lowest amount of referrals coming in from Northern Zone (17 per cent).

Home Care NSHA’s Home First philosophy promotes safe and timely care, services and supports to help people live in the place they call home for as long as possible.   Home Care is an important part of our Home First approach and includes Home Support and Nursing services .

Wait Lists

Home Support services include personal care, respite, meal preparation and essential housekeeping delivered by c ontinuing care assistants .

Measurement: The wait list is comprised of new/existing clients authorized to receive home support services that are not yet in place. The number of people waiting for some or all of their home support services to be initiated. The number of outstanding hours per week for all clients on the wait list. When in a wait list situation, we prioritize services for people discharged from hospital and people at the end of life. Quarterly data is based on the home support wait list information from the last week of that quarter. Summary: Clients in Western Zone make up 51 per cent of all the wait list clients across the province. The number of hours on the home support wait list in Q1 2019-20 increased by approximately 198 per cent compared to Q1 2018-19. The number of people on the home support wait list in Q1 2019-20 increased by approximately 366 per cent compared to Q1 2018-19.

Nursing Services include short term and long-term nursing care by RNs and LPNs in a person’s home including but not limited to, IV therapy, nursing assessment, pain management, and wound care.

Measurement:  VON provides 96 per cent of the home care nursing services in the province while NSHA provides 4 per cent.   VON and NSHA issue capacity alerts when their ability to accept new referrals is in question. In these situations, referrals are considered and prioritized on a case by case basis. Total refers to the total number of nursing capacity alerts issued by both NSHA and VON. Summary Eastern Zone experienced the largest number of nursing capacity alerts in the province in Q1 2019-20. Western Zone did not experience any nursing capacity alerts. Compared to last year (Q1 2018-19) VON and NSHA nursing capacity alerts remained consistent with an increase of four alerts from a total of 88 alerts last year to 92 this quarter.

Authorizations

Measurement: Nursing services refers to clients authorized to receive nursing services. Home support refers to clients authorized to receive home support.  Both services refers to clients authorized to receive both home support and nursing services.  Not all clients authorized to receive home support, receive it immediately due to to wait lists for services, hospitalizations, etc. Quarterly data is based on the client authorization information from the last week of that quarter. Summary:  17,683 people were authorized to receive home care services in Q1 2019-20, up by approximately 3 per cent from Q1 2018-19. At the end of Q1 2019-20, 46 per cent of home care clients were authorized to receive home support, 34 per cent were authorized to receive nursing services and 20 per cent were authorized to receive both nursing and home care services.

Long-term Care When all home and community resources have been explored and a person’s needs can no longer be met at home, placement to a Department of Health & Wellness (DHW) licensed long-term care (LTC) facility may be considered.     LTC includes both Nursing Home (NH) and Residential Care Facility (RCF).

Wait Lists (waiting for initial placement)

Measurement: Community refers to the number of clients waiting in community who are in process or have completed the wait list registration process and are waiting at home for placement to LTC.  Hospital refers to the number of clients waiting in hospital who are in the process or have completed the wait list registration process and are waiting in hospital for placement to LTC.  These numbers include people waiting for their initial placement to a NH or RCF. The vast majority of people are waiting for NH placement.  Clients are assigned to a zone based on the location of their preferred community to be placed in.  These wait lists do not include transfers (transfer refers to clients waiting to move from their current LTC facility to another LTC facility). Quarterly data is based on the LTC wait list information from the last week of that quarter. Summary: There are currently, 135 LTC facilities: 6,923 nursing home beds and 927 residential care facility beds.  1,201 clients are waiting in both hospital and at home for initial placement in a LTC facility. At the end of Q1 2019-20, 38 per cent of people on the wait list were waiting for a placement in Central Zone, 29 per cent waiting for placement in Eastern Zone, 20 per cent waiting for placement in Western Zone and the remaining 13 per cent in Northern Zone. At the end of Q1 2019-20, approximately 82 per cent of people were waiting for LTC in the community and 18 percent were waiting in hospital compared to last year (Q1 2018-19) where 81 percent of people waited in the community and 19 per cent waited in hospital. The DHW reports information about the LTC wait list (number of people) and wait times (number of days) quarterly, on the Nova Scotia Wait Times website. You can find both the wait list and wait times for Residential Care Facility Placement (from home) and Nursing Home Placement (from home).

Preferred Facility Transfer Wait Lists

Measurement: Transfer refers to clients on the LTC transfer wait list waiting to transfer to their preferred facility. Quarterly data is based on the LTC transfer wait list information from the last week of that quarter. Summary:  In 2018, we initiated the process of an annual review of the existing long-term care placement transfer list to ensure it is up to date and reflective of residents' wishes. Last year’s review helped to improve timely access for individuals on the wait list by reducing the transfer wait list by approximately 20 per cent. Mid-June 2019, we initiated another review of the wait list and similar to last year’s results, we saw a notable decrease in the transfer wait list reducing the wait list by 20 per cent in the first six weeks.  The number of people on the LTC transfer wait list decreased by approximately two percent (23 people) in Q1 2019-20 compared to Q1 2018-19. Central Zone had the highest number of people on the transfer wait list (421 people) while Northern Zone had the lowest (113 people).

Placements (Initial Placement)

Long-term care placement numbers show the people who accepted a bed offer in a nursing home (NH) or residential care facility (RCF).

Measurement: Community refers to the number of people living at home who have accepted placement into a LTC facility. Hospital refers to the number of people who moved into LTC facilities from hospital. Total refers to the total number of people across the province placed in LTC facilities. Clients transferred from one LTC facility to another were not included. Summary: Notably, Central Zone due to the large number of beds, continues to have the majority of placements, with approximately 33 per cent of all placements across the province. Provincially, in Q1 2019-20 43 per cent of all initial placements into LTC were from hospital and 57 per cent from home.  The percentage of placements into LTC facilities from hospital in Q1 2019-20 remained consistent with Q1 2018-19 with 43 per cent of placements from hospital and 57 percent from community. The number of people placed in LTC facilities decreased by approximately three per cent (21 people) in Q1 2019-20 compared to Q1 2018-19.

Preferred Facility Transfers

Measurement: Data includes clients transferred from one LTC facility to another. Summary: Preferred facility transfers decreased by approximately 15 per cent from last quarter (Q4 2018-19) to Q1 2019-20. Preferred facility transfers decreased by approximately eight percent in Q1 2019-20 compared to Q1 2018-19. Central Zone due to the large number of beds, continues to have the majority of transfer placements, with approximately 34 per cent of all preferred facility transfers across the province.

Please send feedback to:  Jaimee Dobson, Communications Advisor,  Continuing Care Jaimee.Dobson@nshealth.ca

Visit our Continuing Care page, for more information.