Use of LTC temp workers soared during COVID-19 pandemic

The pandemic hit local long-term care homes right in the budget as they had to rely on temporary staff to replace workers off sick or isolating due to COVID-19.

But Brantford’s two local non-profit homes – John Noble Home and St. Joseph’s Lifecare – said their costs were recovered with pandemic relief funds from Ontario.

“We have an obligation to residents to always deliver care at 100 per cent and if that means using agency staff, so be it,” said Michael Bastian, the new administrator of the John Noble Home.

Bastian, who began work at the facility last April, has a long history in long-term care and is overseeing the addition of 40 new long-term care beds in a two-storey addition on the property, to be opened by January 2025.

Like many long-term care homes, John Noble didn’t need or use agency nurses and personal support workers (PSWs) before the pandemic hit in March 2020.

But over three years, use of agency staff has become a critical necessity.

The home went from spending almost nothing on agency staff, to spending less than one per cent of its budget in 2021 to more than half a million dollars or 6.4 per cent of its staffing budget on the temp workers.

“Every home is experiencing a shortage of PSW and nursing staff,” said Bastian.

A survey by association AdvantAGE Ontario, which represents not-for-profit homes, alleged that some provincial agencies are “gouging” facilities by charging exorbitant fees for temporary workers.

Calling them “predatory agencies”, AdvantAGE said many homes have to pay about $88 an hour for a temporary RN, which is more than twice the typical wage of $43 an hour. One agency charged $150 an hour for the position.

Worse, AdvantAGE CEO Lisa Levin said, is the association has found staff moving to agency work can opt out of working at certain homes where they know the workload is difficult.

“It’s a pervasive issue,” said Levin.

“The need for agency staff is quite high because so many have left long-term care and I don’t see that going away unless something significant changes.”

AdvantAGE’s survey of 100 non-for-profit homes found they were spending $6 million a month on temp workers.

“The majority of the revenue long-term care homes receives is from government money and resident fees … so ultimately we all pay.”

Bastian said a good relationship with the agencies being used and a good reputation makes a big difference under such circumstances.

“Some agency staff who are called to work at certain homes might refuse but at the John Noble, they know it’s a good place to work. We’re not short-staffed, we communicate with them and we ensure they’re properly oriented.”

That leaves John Noble, which is overseen by the City of Brantford, with few unfilled shifts and, at recent job fairs, the facility was able to hire another 40 PSWs in just a week.

“At this point, we’re only using the odd agency staff person.”

At St. Joseph’s Lifecare, interim president Sandra Ramelli, who stepped in after David Wormald’s recent retirement, said the facility also relied heavily on agency staff through much of the pandemic.

While St. Joe’s used no temp workers in 2020, by 2022 about 10 per cent of it’s budget was paying for agency staff.

“Our COVID expenses were covered using pandemic relief funds provided by the government,” said Ramelli. “The funding allowed us to stay within budget.”

Like the John Noble Home, St. Joe’s has been focused on hiring staff to try and ensure it can reduce dependency on temp workers.

Using a “robust hiring campaign”, Ramelli said St. Joe’s has filled 75 per cent of RN positions, 72 per cent of RPN roles and 93 per cent of PSW spots.

“We presently have offers out for a number of positions and hope to reach our full complement soon. We’re pleased our recruitment efforts have put us in a much better staffing position going forward.”

Levin said the staffing problems aren’t going away.

“The conditions that led to agencies being so prevalent are quite complex. One thing is that PSWs received a wage increase of $3 an hour, which is amazing, but RPNs, who often supervise them, did not. As a result, many left to work in other settings.”

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