Nonprofit nursing homes in Ontario are spending millions of dollars on temporary health workers because the agencies they work for “take advantage of the health care workforce crisis,” a provincial association says.
A voluntary survey conducted among members of AdvantAge — the association representing the majority of the province’s nonprofit and community nursing homes — found one agency charging households as much as $150 an hour for a registered nurse puts. 249 percent more than the typical rate.
“We have agencies waiting in our parking lot and talking to our employees when they leave their day of work,” said Steven Harrison, the CEO of Tri-County Mennonite Homes, which operates homes in Stratford and the Kitchener-Waterloo area.
Harrison’s group is among the 100 institutions that took part in the survey – approximately half of AdvantAge’s membership. The findings come as many Ontario healthcare workers, including nurses, personal caregivers and others, have left permanent public sector jobs. Some have reached out to agencies, which often promise more flexibility and higher wages in the face of chronic understaffing, overwork and burnout from the pandemic.
Agencies then tell employees, “You don’t have to work as long or as hard with as much dedication, and we can get you more money to do basically the same job,” Harrison said.
“People are tired; there is currently no reprieve for anyone on the front lines and resilience is starting to wane,” he added.
“What [the agencies] doing is taking advantage of a very desperate public health situation.”
Harrison said nonprofit homes like his continue to lose staff to agencies but have not been able to increase salaries significantly because of Bill 124 — a law passed by the Ford administration to limit pay increases for public sector workers. He says they are at the mercy of agencies wanting to charge fees to meet their staffing shortages.
“It’s really wild west for the agencies,” Harrison said.
He says his homes are expected to spend more than $3 million on contract workers in the fiscal year ending March 31, compared with nearly $150,000 a year before the pandemic. They originally planned to spend just under $300,000 this fiscal year.
“These are taxpayer dollars that fund us, and they’re being wasted … in ways that were never anticipated when we were allocated the dollars to provide this care,” he said.
Harrison, AdvantAge and others are calling on the provincial government to put in place a framework that limits what agencies can charge and what additional fees are reasonable. They say such a move would bring accountability to a situation where homes may no longer be able to provide adequate care because they cannot afford to pay wages at those rates.
Every day, 28% of registered nurse positions go vacant
“It’s a really serious situation,” said Lisa Levin, CEO of AdvantAge. With agencies charging more than twice the typical wage for a registered nurse, the government “needs to limit these agency hourly rates, and they urgently need to do so,” she said.
AdvantAge’s survey found that temporary healthcare workers performed about seven percent of the work but received more than 16 percent of wages in long-term care homes in the last six months of 2022.
With more than 28 percent of nurse positions in these homes going vacant every day, she says homes are more likely to rely on temporary workers to meet urgent needs.
The Ontario Nurses’ Association (ONA) said it had repeatedly expressed concern that “registered nurses (RNs) were leaving their long-term care employment to join private, for-profit nursing agencies.”
“For caregivers who have been repeatedly traumatized by COVID-19 outbreaks in long-term care facilities and are suffering from PTSD and utter exhaustion due to the caregiver shortage, the prospect of working for a care agency is more appealing than ever,” said Angela Preocanin, the VP of ONA , in a statement emailed to CBC Toronto.
Preocanin says caregivers suffering from burnout would logically see the appeal of an option that allows them to spend more time with their families and earn much higher salaries.
She says the Ford government’s decision to appeal a court ruling that nullified Bill 124 sends a message to workers, such as registered nurses, that their wages are being suppressed and that they are working in poor conditions.
The situation also hurts long-term care residents, Preocanin says, by reducing continuity of care, especially if they have complex care needs. The ONA is urging the government to do more to address the problem.
Ontario NDP health critic France Gélinas said, “You cannot provide quality care without continuity of care, and agencies cannot provide you with continuity of care.”
She says organizations are now telling her they need to scale back services or the number of clients they serve because agency fees are “just going through the roof.”
Gélinas says she would rather invest in permanent staff to address the problem than focus on capping temp agency fees. She says not challenging Bill 124 would be the simplest step the government could take to keep employees.
Jake Roseman, a spokesman for the Ontario Secretary of Long-Term Care, is unwilling to comment on Bill 124 as he says he is in court. But he says the government is continuing to monitor staffing challenges in long-term care.
“The government is investing $4.9 billion to hire and retain nurses, personal caregivers and related health professionals,” Roseman said.
He says the government is hiring 27,000 long-term caregivers as the government nears its goal of four hours of care per resident per day by 2025, and is providing $673 million for households to hire and retain workers.
