St. Lawrence Lodge 2021 OPERATIONS AND FINANCIAL PLAN PRESENTATION - CITY OF BROCKVILLE FEBRUARY 16, 2021
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St. Lawrence Lodge 2021 OPERATIONS AND FINANCIAL PLAN PRESENTATION CITY OF BROCKVILLE FEBRUARY 16, 2021
Agenda 2 LTC in Ontario 2020 Resident Profile Employee Profile SLL 2020 Financial Plan On-going Challenges in the Ontario LTC Sector (2021)
LTC in Ontario 2020 3
Massive Disruption of COVID-19
2020 was the toughest year for senior’s care
Staff, residents and families have been on the frontlines of this crisis
from day one
LTC Homes have been forced to rethink , rework and restructure
almost every aspect of care delivery and operations
LTC in Ontario 2020 4
Rising to the Challenge
Faced incredible challenges (exacerbated by decades of under
funding and understaffing)
Staff have remained tireless in their dedication to keeping the
Home’s residents healthy and safe
Staff have been incredibly inventive to create ways to lift our
residents’ spirits in this difficult time
LTC in Ontario 2020 5
Provincial Budget Highlights
$540M investment in LTC ($405M/emergency prevention and
containment funding, $61.4M/IPAC capital and resource funding,
$40M/occupancy support, $30M IPAC staff and training, and 8 weeks of
PPE).
Increase direct care of LTC residents to an average of 4hrs/day
Average based on hours worked versus hours paid
Implementation over four years (2021-2025)
Initiative to recruit Resident Support Aides (RSA) in LTC
Assist residents with daily living activities during meals, nutrition breaks,
recreational activities
No additional funding to Homes
LTC in Ontario 2020 6
Provincial Budget Highlights
$5,000 incentive to recruit new PSWs to LTC for 6 months service full time
Investing in Canada Infrastructure Program (ICIP)
Federal provincial funding to support investments in COVID -19 infrastructure
Each project can cost up to $10M in eligible costs
STLL submitted four separate applications for the following: (1) HVAC, (2) windows
and doors replacement, (3) repaving parking lots, (4) renovating area for staff
scrubs and change rooms to support physical distancing. Projects must be
completed between September 30, 2021 and December 31, 2021.
Inclusivity Community Grants to connect people to their communities and
make communities more inclusive and age friendly
STLL applied for $60,000 to create an accessible and secure garden area that
overlooks the St. Lawrence River.
The Chair of the Residents Council stated in a letter of support that “it would be so
nice to feel the sun on my face and the grass under my feet”LTC in Ontario 2020 7
Response to COVID-19
LTC Commission Struck Following Military Report on May 27, 2020, with Interim
Recommendations released October 23, 2020
Increased staffing
Strengthen Healthcare Sector Relationships and Collaboration
Improve IPAC Measures
Bill 128 (Indemnity) passed
Provides “good faith efforts” protection for persons, organizations and entities
Second Wave Preparedness Assessment required by Ministry of Long-Term Care
Insurance
Providers ceased to provide insurance, reduced coverage (including exclusion
clauses and increased deductibles) and/or increased premiumsResident Profile 8
2020 Occupancy
STLL Age Spectrum CMI = 1.03
# of Residents home level
Waitlist = 215
Resident Profile
3% 6%
6% 92% have some degree of cognitive impairment
30% 87% have a neurological disease
19%
83% require extensive assistance with at least one
activities of daily living
36%
74% have cardiac/circulatory disease
73% have dementia/Alzheimer’s disease
67% have a musculoskeletal disease
0-60 61-70 71-80 62% require monitoring of an acute condition
81-90 91-100 over 100 46% take 10 or more medications
21% have had a strokeEmployee Profile 9 Total # Employees = 277 Total # CUPE = 218 Total # ONA = 12 Total # Non-Union = 17 Total # Screeners = 21 Total Full-time = 100 Total Part-time = 177 Total Clinical = 83% Total Support = 17%
10 SLL – 2020 Financial Summary
11 Revenue Summary MOHLTC – 1.5% (2.73 day) increase – applied to our Nursing and Personal Care funding envelope Preferred Accommodation revenue increase estimated at 2.17% - consistent with 2019 MOH accommodation adjustment No change in CMI Government Commitment to retain the High Wage Transition Funding ($105,900) Municipal Levies - 9% of total SLL Revenue (11% in 2020). This percentage reduction is due to increased revenue from other sources in 2021. COVID-19 and Infrastructure revenues segregated from Operations
12 Expenditure Summary Our focus for other spending has been on improving the quality of resident care. General inflation rate of 2% for 2021, 2022 and 2023 Increase in clinical minor capital purchases Increase in facility replacement activities for 2021 with planned replacement of many items pushed out to 2022 and 2023 Increases planned for IT services Additional license fees for new DOCit clinical application to be introduced in 2021
13
• Health Benefits
Salary and Benefits – • 2021 – 5% increase in Health Benefits
2020 Assumptions • We developed our labour model using
a zero-based budgeting approach with
Total Wages - $11.8M the expectation that will be staffing for
Total Benefits - $3.4M all full-time coverage.
Benefits as a percentage of Wages – • 2020 vacancies were not always
28%
replaced or staffed – rather they were
left unfilled or managed with overtime.
• An overall increase in our direct indirect
clinical functions14
Salary and Benefits –
Contract Terms
ONA – Contract Terms
April 1, 2020-March 31, 2022 – 1.0%, 1.0%
April 1, 2022-March 31, 2024 – 1.0%, 1.0%
(estimate)
CUPE – Contract Terms
April 1, 2019-March 31, 2022 – 1.4%,1.4%,
1.4%
Non-Bargaining Group –Calendar Year
Adjustments
2021 – 1.0%
WSIB – Costing for a Move to Schedule
1 effective July 1, 202015 Major Expenditures StLL Foundation support planned for Resident Living expenditures (beds, dining room furnishings, clinical equipment, etc.)
StLL – Significant Initiatives for 2020 16
Applied for, and received Modernization Funding to support point-of-care
documentation, installation of wifi throughout the building, security cameras,
and ensuring our resident’s have access to wifi in their rooms.
Transitioned to MediSystems with an electronic pharmacy system.
Payroll Conversion
This project was completed in 2020 despite major delays. Our plan for 2021 is continue
to address the change impact of this transition. We are also expecting to introduce a
master schedule for our home in early 2021.
Insurance Renewal
Currently exploring moving insurance coverage to HIROC
Current insurer policy rate increased 62.5%, increased deductible in all areas despite
no claims since 2018, no coverage for any communicable diseases (COVID) and
general aggregate of $5 million.
HIROC provides communicable disease and COVID-19 coverage, Officers and
Directors Liability $10 million (increase from $5 million with our current provider), limited
deductible costs and no aggregates. Coverage under HIROC is an additional 16.2%17 Municipal Levy 2021 – 3.57% 2020 – 5.5% 2019 – 3.85% 2018 – 9.41%
Ongoing Challenges in Ontario LTC 18
Sector
PIVOTING….PIVOTING….and PIVOTING
Vaccines
Rapid antigen testing
All staff, essential visitors, contracted workers daily before entering the Home
Logistical NightmareOngoing Challenges in Ontario LTC 19
Sector
Resident challenges
1 in 3 residents have severe cognitive impairment
45% of residents exhibit some form of aggressive behavior
Most residents entering LTC have many complex chronic medical conditions requiring
registered staff who are able work to their full scope of practice
Additional medical equipment is needed to proactively manage changes in these
residents health status and avoid hospital transfers
Ongoing shortage of RNs, RPNs and PSWs
Recruitment and retention
$10,000 incentive for RNs, RPNs, and NPs
Must not have worked in last 6 months to qualifyOngoing Challenges in Ontario LTC 20
Sector
Unpredictable funding
Current staff funding is 2 hours/resident/day
The 2020 provincial budget has committed 4 hours/resident day by 2025
Current funding is based on reported Case Mix Index that identifies
the intensity of each resident’s care needs
Unfortunately, this funding is based on data that is 18 months old21 Discussion
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