The United Counties of Prescott and Russell (UCPR) council stuck to its guns as it heard the results of the Prescott-Russell Residence operations review.
Extendicare, the firm hired by the UCPR to do the review, showed a $4-million “variance” between the current operational structure when compared to its own management scheme. Extendicare is a private service provider for long-term care home management and does so for a number of private and municipal facilities across the province. The company used its own management model as a baseline to compare the residence operations. The vast majority of possible suggested savings, about $3.3 million, came from staffing hours, salaries and benefits—all of which fall under the collective agreements between the UCPR and unions.
Stéphane Parisien, the CAO of the UCPR, explained these cannot be changed “unilaterally”.
There was one other “significant reason” for the variance: excess allocated fees. Operational costs like human resources and finances, etc. at the residence are handled by the UCPR, like all of its other departments. Those services are billed to each department based on the number of employees. Since the residence has more employees than public works, for example, it’ll pay more for those shared services. Extendicare’s report showed a $685,000 discrepancy between the current fee allocation and its management model; it recommended these allocated fees be re-evaluated to ensure the residence isn’t paying more than it’s fair share for these services.
Again, Extendicare is only one private service provider and it used its own management model for comparison. This came through in the report’s recommendation to purchase the firm’s policy and procedure manual to “ensure current and standardized policies are maintained and meet legislative requirements.” This was despite the report saying the residence was “better than provincial averages” when it came to legislation compliance.
Warden François St. Amour called this recommendation “a sales pitch”.
Gary Loder, vice president of Extendicare’s management program, clarified to say that wasn’t the intention, for the UCPR to buy Extendicare products.
The operations review cost about $117,000. Asked if it was worth it in a follow-up interview, St. Amour said, “They are private providers of the same service, I do not think we got a fair, unbiased opinion.” He added that council had made “conscientious” decisions to spend more on the residence for better service.
Other smaller recommendations included charging for certain services currently offered for free at the home, like a beautician.
Hawkesbury Mayor Jeanne Charlebois, a staunch defender of the residence dismissed this analysis as “nickel and diming.”
In non-finance-related improvements, the report suggested a more secure way to communicate resident information than by email.
“The use of email as a communication tool for resident information poses a significant risk to the home,” reads the report.
Another recommendation was to implement more resident-specific care plans, as required by the Ministry of Health and Long-Term Care.
“Many nursing care plans were found to be generic and were absent of SMART (Specific, Measurable, Attainable, Realistic and Time-specific) goals,” says the report.
Asked about these kinds of recommendations, residence administrator Louise Lalonde deflected and pointed to its award from Accreditation Canada received earlier this year after complying with 99.3 per cent of requirements. Lalonde didn’t go into more detail.
See Extendicare’s full report below:
‘Enough is enough’
Pierre Leroux was one of several mayors around the table to point out there was no mention of the residence’s layout in the report. The UCPR is currently in the process of building a new residence for 2022, which will likely house more than 200 beds.
Mr. Loder said that other homes managed by Extendicare have similar layouts and are being redeveloped. However, “There’s not a significant enough difference in the layout of the home to affect the overall operation, in our experience… It does create some inefficient processes but it hasn’t significantly impacted our cost.”
It’s worth mentioning this process is largely due to Clarence-Rockland Mayor Guy Desjardins’ insistence on getting a review. He has consistently been the most vocal critic of the residence’s operations, but was absent during the report’s presentation.
To Leroux and others around the table, this report, he said, showed that it was time to say “enough is enough” for criticism of the residence.
Later he added, “I know some members of council were hoping that this report would shine a light and show that we were mismanaging or we were spending a lot of money where we shouldn’t be but we’re spending this money where we want to spend it.”