Bluewater Health projects $18M budget deficit

Bluewater Health, overwhelmed with generally older and medically complex patients and recovering after last year’s cyberattack, is projecting an $18-million budget deficit.

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The hospital group’s board approved a hospital group expense plan and budget update this week.

Normally, the plan would be set before the fiscal year starts in April, but cyberattack complications delayed the process until now, said Marlene Kerwin, corporate vice-president and chief financial officer.

About half the projected deficit amount is linked to a pending government payout for hospital workers whose wages were capped under Bill 124before that legislation was declared unconstitutional and repealed, she said.

When Bluewater Health’s estimated $9.3-million payout will come isn’t clear, she said.

But it’s not alone in that uncertainty, she said, noting it’s working closely with the Ontario Hospital Association to get clarity for all hospitals awaiting more than $6 billion from the province.

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It’s a frustrating situation, said Bluewater Health board vice chair Kirk Wilson. “We’re spinning our wheels here waiting for the government to do something.”

And it’s just one part of Bluewater Health’s financial puzzle.

About $1.5-million of the projected deficit is tied to inflation on things like medical supplies, and not covered by a three per cent base funding increase Bluewater Health received for its April 2024 to March 2025 fiscal year, Kerwin said.

The rest is largely tied to overtime and sick time, related in part to operating at about 100 per cent capacity for the last two months, said care transitions vice-president Lisa Regan.

Part of that is more patients with respiratory illnesses showing up en masse earlier in the year in Sarnia’s emergency room, where volume has been up 10 to 15 per cent, she said.

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Similar surges have been happening elsewhere in the Erie-St. Clair region, which includes Windsor-Essex and Chatham-Kent, she said.

Bluewater Health staff, meanwhile, have continued to work without bed management tools, lost amid last October’s cyberattackshe said.

Data on waits for inpatient beds was presented to the hospital group’s board this month for the first time since the attack, and showed wait times for inpatient beds this spring — the most recent data available — had roughly doubled from a year earlier.

Teams nonetheless did “an amazing job” in a difficult situation, Regan said. “It’s very manual work, and communication was really key to understanding what department was experiencing challenges or needed help.”

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A regional population older than the provincial average also means many admitted patients have multiple underlying, chronic illnesses, and aren’t always able to leave hospital immediately after their acute needs are treated, said chief of staff Michel Haddad.

“They’re not safe to be discharged because they’re so frail,” he said.

That’s complicated by long waits for long-term care beds, and that some patients have no family in the area to support them, he said. “So you can’t send them home, and that kind of occupies the bed and that further increases pressure.”

Construction projects at long-term care homes that have hampered Bluewater Health’s ability to discharge medically complex patients, who can’t leave hospital without supports, have mostly wrapped up, Regan said.

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Bluewater Health’s number of alternate level of care (ALC) patients, who shouldn’t be in hospital, but can’t leave, was recently in the 30s, chief executive Paula Reaume-Zimmer said, down from double that number earlier this year.

Bluewater Health also is working with other community agencies to co-ordinate getting patients home from hospital with supports, via an Ontario Health atHome initiative launched in July, Regan said.

It “gives. . . strategies for all sectors how to help with the ALC situation and help build capacity in hospitals,” she said.

There are more expenses to come that haven’t been budgeted, Kerwin said, as Bluewater Health prepares to update its hospital information system in November.

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The $40-million upgrade, expected to strengthen Bluewater Health’s cybersecurity, will require staff training and plans to support staff who need help understanding the new system when it goes live, Kerwin said.

“So that’s why we’re planning for increased staffing and potential slowdowns in some or the areas,” she said, noting those budget pressures will be calculated later.

Training for that upgrade amid system shortfalls and demands to care for more and more complex patients has been a challenging balance, she said, commending staff for their resilience.

“It’s a huge transition at a time when we’re a very, very busy organization,” she said.

Bluewater Health is not alone in dealing with deficits and there are no provincial requirements for balanced budgets in 2024-25, Kerwin said.

“It’s just a pause and a wait-and-see what’s going to happen with the financials for hospitals across the sector. . . because there’s all the unknowns related to Bill 124,” she said.

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