Nursing staff – and the funding needed to pay for it– is one of many challenge being faced by healthcare across Ontario, and Riverside Health Care is no exception.
According to a statement from Riverside Healthcare, significant human resource shortages since the pandemic has forced Riverside to look to alternate staffing methods, including the use of agency nurses, which have contributed to a strain on Riverside’s finances.
In Riverside’s most recent audited statement, the auditors noted, “the Organization, which is primarily funded by the Ontario Ministry of Health and Long-Term Care and the North West Local Health Integration Network has been facing financial difficulties for continuous years.”
According to audited financial statements, Riverside showed a deficit of $3,562,113 in 2019 and $6,179,870 in 2020. It showed a $551,615 surplus in March 2021, though without one-time working capital relief from the province to offset the impacts of Covid, it would have shown a deficit of $5,010,285, noted the auditor. 2022 saw a surplus of 219,910. March of 2023 saw a $3,669,127 deficit. The most recent audit, from the year ending March 31, 2024 showed a deficit of $1,567,117. However, the auditor noted that the deficit is despite $9,700,000 in one-time provincial funding to relieve operational pressures.
“Deficit management is inherently challenging in nature, often including operational funding deficiencies, a lack of change management funding, legislative impacts, unique and changing health human resource environments, and inflationary challenges,” noted a spokesperson for Riverside. “Post-pandemic, our organization and much of the health care system began to experience significant health human resource challenges. This required the onboarding of agency staff and rental homes to sustain services and has served as the single greatest contributor to our financial challenges. We appreciate the financial support from Ontario Health and the Ministry of Health in sustaining operations, despite the unique challenges we face.”
According to Riverside, resolving its challenges, “involves a number of factors, including advocating for new funding, exploring creative program and system models, seeking system efficiencies, continuing to focus on quality initiatives, and investing in recruitment and retention initiatives in support of all our staff. One of the most significant initiatives that we have utilized to reduce reliance on high-cost agency staff is foreign worker recruitment.”
Agency nurses are contract workers, paid by an agency, which adds fees on top of the nurse’s wages.
“Agency fees vary significantly, with costs ranging anywhere from 125% to 225%,” said Riverside. “It is important to note these are the total costs paid to agencies; a share of which are the wages paid to agency staff.”
Riverside did not provide a percentage of staff vs agency vs temporary foreign workers servicing Riverside. However, it is working on multiple fronts to reduce the organization’s dependance on agency staff.
“Riverside has made significant strides in reducing Rainycrest’s reliance on agency staff,” said Riverside. “However, the need for agency resources has increased in our hospital environments, particularly areas requiring speciality services.”
There has been some success in transitioning agency workers to Riverside staff, and the goal of the temporary foreign workers, “while addressing an immediate staffing shortage, our use of foreign worker recruitment programs is ultimately intended to assist these workers through their journey towards immigration and citizenship and joining the team at Riverside on a permanent basis.”
Riverside’s financial pressures and cash flow struggles at the start of 2023 were cited as one reason why an initial request for extra nursing staff was denied for Rainy River Health Centre. Doctors at the facility had requested a second RN, to cover the night shift, noting that many nurses felt nervous working alone. That denial was one contributing factor to the mass resignation of the facility’s three doctors.
However, Dr Joe Ennett, one of the doctors who has resigned, feels Riverside should look to its senior management’s salaries if it would like to find savings, citing the Sunshine List.
Ontariosunshinelist.com is a public website provided and maintained by the government of Ontario, “to provide the Ontario citizen with a comprehensive and unbiased tool to analyze the Ontario sunshine lists. It operates as a free public service, with the belief that a more informed citizenry leads to greater transparency in government.”
According to the Sunshine List, the current president and CEO received a 29.6 per cent raise in 2021, and a 23.4 per cent raise in 2023, bringing him to his last posted salary of $314,365. In 2022, his raise was 1.1 per cent. He received a $20.4 per cent raise in 2020, as he transitioned from Executive Vice President and COO to his current position.
Other members of senior management have also received double digit raises. Carla Larson, the Chief Financial Officer, received a 17.0 per cent raise in 2021 and a 23.4 per cent raise in 2023. In 2020, the year she assumed her new role, her raise was 3.2 per cent, and in 2022, it was 0.3 per cent. Her last posted salary was $184,949.
In contrast, wage increases for the Administrator of Long Term Care have been between 0.9 and 3.3 per cent since 2021. The Director of Community Services received a raise of 1 per cent in 2022, and 1.9 per cent in 2023. The Director of Quality and Support Services posted a 2.4 per cent raise in 2022, and 1.9 per cent in 2023.
According to Riverside, “wage increases for the CEO consider increased scope of responsibility, wage compression, and wage adjustments across peer organizations.”
Riverside noted that the wage increase caps imposed by the province also impacted senior management. Legislation had temporarily capped public service wage increases at one per cent. That legislation has been repealed.
“Implementation of salary increases resulting from the Bill 124 repeal was implemented for all staff, including senior leaders, to ensure we remain competitive with similar health-care organizations and recognize such investment is necessary as part of our recruitment and retention efforts,” said Riverside in a statement. “The appeal of Bill 124 resulted in wage adjustments for all union and non-union staff, including the senior leadership team. This was retroactive for multiple years. The increase for senior leaders is consistent with that for managers and non-union staff but was implemented at the very end of 2023. Other staff received some wage adjustments during the retroactive period with a further increase in 2024. Despite the timing difference in processing these changes, they represent the same total percentage increase and retroactive period.”
Riverside stated that the Board of Directors employs the CEO. “All other employees are under the auspices of the CEO. The Board ensures appropriate and competitive compensation for the President and CEO. The Board’s Governance Committee recommends any CEO salary adjustments, which require Board approval.”
“Riverside Health Care is a multi-continuum, multi-site service provider across the Rainy River District. In addition to hospitals and long-term care, our organization also oversees a housing corporation, transportation services and an expanding community services division,” stated Riverside.
“The Board of Directors recognizes that Riverside Health Care is a small-big organization,” stated the Board of Directors in a written statement. “It is small in terms of funding but big in terms of complexity. We are proud of our Team and their ability to not only continue to provide quality service but also seek new opportunities to better serve the residents of the Rainy River District. Our culture is focused on our Code of Conduct, which stresses the three pillars of Care, Compassion, and Commitment.”
In terms of Board Composition, the Riverside Board of Directors strives to ensure the right blend of skills, experience, and qualities; ensure the board reflects the diversity of the communities served, including demographic, cultural, linguistic, economic, geographical, gender and ethnic, to best support the achievement of RHC’s mission, vision, values and strategic direction; and ensure a commitment to the One Riverside philosophy, which means a “Board of Directors and Team that works diligently to balance the needs of our communities with those of our District.”
