Who will run Rainycrest still up in air

A closed meeting last week on the state of Rainycrest Home for the Aged here revealed some encouraging facts, but the future of the home still has to be decided.
“The ministry [of Health and Long-Term Care] told us there have been some tremendous improvements at Rainycrest,” said Emo Reeve Russ Fortier.
Last Thursday’s meeting was the result of Rainycrest’s board of management making a request to the ministry to provide them with a status report on the home.
Municipal mayors, reeves, and councillors from across the district also were on hand.
“It was an update on the current status of admissions, an update on compliance issues that are getting better,” Fort Frances Mayor Dan Onichuk, who chairs Rainycrest’s board of management, said Friday morning.
“The number of witnessed and unwitnessed falls has been greatly reduced, as has been the number of residents transferred to hospital,” noted Atikokan Mayor Dennis Brown, also the vice-chair of the Rainycrest board.
As well, the home no longer is under sanction. Admissions had been suspended back in February due to compliance issues.
The ministry took control of the home on March 18, placing it under the temporary management of Riverside Health Care Facilities, Inc. with assistance from Extendicare, a private health care company.
Admissions resumed in September.
At that time, Riverside decided to implement a gradual admissions process, admitting one-two new residents a week so as not to overwhelm the staff.
The home should be back up to its full capacity of 145 residents by the end of the year.
With resident care well in hand, the question now is who should manage the home.
“The municipalities will have to sit down between now and next March,” Reeve Fortier noted. “A decision will have to be made.”
According to the Homes for the Aged and Rest Homes Act, the ministry only can assume control of a home for a period of up to one year.
As such, Rainycrest will be returned to the hands of local municipalities—or to whomever they choose to run the home—on March 19, 2006.
“Because of the marked increase in improvements since March 18, my council is happy to see [Rainycrest] remain under the management of Riverside,” said La Vallee Reeve Emily Watson.
“Too many of the things now—HR, payroll—too many of those functions have been taken over by the hospital,” she noted. “Things are being done efficiently and effectively.
“To go back, I just don’t know how they would divorce the two,” Reeve Watson stressed. “It is a perfect fit for those two to go together.”
Before being taken over by the ministry, Rainycrest was run by a board of management made up of municipal reps and provincial appointees.
While it would be possible to return to the original model, Reeve Watson said that is not the preferred option.
“Absolutely not,” she remarked. “The board has no long-term care experience, they have no nursing experience. They may be able to operate a business, but not this type of a business. . . .
“That was very obvious from the information we were provided with.”
The problems surrounding Rainycrest date further back than the last 12 months, Reeve Watson added. And the information provided by the ministry at last Thursday’s meeting was proof the previous model was not working.
“Things deteriorated and deteriorated. No matter what kind of help the ministry offered, no matter what kinds of things the ministry put in place, it never got any better.
“It was there in black and white.”
Rainycrest also had been under sanction from May to September, 2003.
But while Reeve Fortier agreed Riverside, under the direction of the ministry, was making improvements at Rainycrest, he expressed concern about the long-term implications for the district.
“The only thing I don’t like is that under the current set-up, if it stayed with Riverside, then you’ve got another corporation able to send bills to the municipalities without any say from the municipalities.
“We have no input on their board,” he stressed.
“I think the service is good,” he noted. “There’s a good job happening there. [But] how do we maintain some control at the municipal level?”
Mayor Onichuk noted taxation is an important part of the equation.
“We, as municipalities, have to sort out what we want to do into the future. And it really all revolves around the right to tax,” he said. “Right now, the municipalities put $1.3 million into the home annually out of property taxes.
“If costs can be reduced, more efficiencies can be found, it will make it a lot easier transition should we decide to do something different than maintaining municipal control,” he added.
“The ministry has given Riverside and the private contractor a lot of aid in the last year to make this thing happen that we didn’t have to pay for as municipalities,” Reeve Fortier said.
“I don’t know if that’s going to happen in the future.”
“We want to provide service to our seniors that are there. We’re concerned about working conditions for the staff,” he added. “At the end of the day, the big concern after that would be our fiduciary responsibility because we have to pay the bills. How do we balance all of those issues?
“You want to get past pointing fingers and move forward in the future, and how do we correct everything.”
“Resident care has to come first,” agreed Mayor Brown.
Prior to the March takeover, the ministry had put out a call for management proposals. In addition to Riverside, Extendicare and the Rainy River District Social Services Administration Board also had submitted proposals.
At the time, the Rainycrest board had chosen the DSSAB proposal as the best among the three and recommended it to the ministry.
However, there were mixed messages from district municipal councils—some of whom had expressed a preference for the DSSAB proposals while others favoured Riverside.
So instead, the ministry decided to take control of the home itself and appoint Riverside as interim administrator.
In the months leading up to this decision, the Rainycrest board also had considered hiring Extendicare to help run the home, but backed off after a public outcry over the privatization of its management.
While the company was hired in March to help the home reach compliance standards, their staff left over the summer as conditions improved.
“Extendicare is still under contract with the home in an advisory role,” Mayor Onichuk noted. Reeve Fortier, who chairs the DSSAB board, said is it unclear whether these two proposals are still on the table.
“We think there’s a lot of merit in considering that,” Mayor Brown, who also sits on the DSSAB board, said of its proposal. “Riverside has to be looked at, as well.”
“I don’t feel the DSSAB has the necessary expertise, either,” said Reeve Watson, who sits on both the boards for both Riverside and the DSSAB.
But at the last annual general meeting for the hospital board in June, she stepped back from the vice-chair position and has no involvement with the board’s Rainycrest ad hoc committee.
“I’m trying to do what is best for the residents of Rainycrest,” she stressed.
To further complicate the issue, Reeve Fortier noted the Ontario government is examining the possibility of provincial land tax reform, to be implemented as early as 2006.
“Under that scenario, the DSSAB would probably evolve to be an area services board [ASB],” he explained. “And under an area services board, one of the mandatory programs that has to be administered is homes for the aged.”
Should that happen, there would be no option but to have the DSSAB manage Rainycrest.
“The area services board could still contract Riverside, but under a different scenario. They’d be in control of the budget,” he noted.
“It’s very difficult to just come out and say, ‘This is the way we should go.’ There’s too many unknowns out there,” Reeve Fortier concluded.
Reeve Watson noted there was no First Nations representation at last Thursday’s meeting, and said she forwarded her concerns to the ministry.
“There are a lot of First Nations residents there. Who’s representing them?” she asked.
As well, a new administrator has been hired for the home, who will begin Dec. 1.
Mayor Brown said the ministry will do an operational and governance review of other homes for the aged in Northern Ontario to compare how they operate and to help find a solution for Rainycrest.
The ministry will meet again with the board and municipal reps once those reviews are complete, likely in the New Year.