Staffing levels in long-term care facilities

In their recent CMAJ commentary,1 Kimberlyn McGrail and associates correctly noted that in British Columbia private and not-for-profit providers of long-term care have different staffing levels at their sites. However, these differences are driven not by type of ownership but by health authority funding level. Funding varies from $130 to $190 per day for each resident even though the facilities care for the same types of clients requiring complex care. With such a wide range in funding, it is expected that there would be differences in staffing levels.

The authors also state that the aggregated superiority of the not-for-profit sector in hospital admission rates was driven by “not-for-profit facilities that were attached to acute care hospitals, were amalgamated to a health authority or had more than one site.” Sites that are owned and operated by health authorities have an advantage over stand-alone private and not-for-profit facilities in that they have access to additional staff.

We would expect that the ratio of staff to patients would have an impact on quality of care; the role of government should be to determine an adequate funding level for the desired staffing ratio and then to provide it to all sites, regardless of whether they are run by for-profit or not-for-profit agencies.