Ontario hospital patient fined $28,600 for refusing to go to long-term care home

EDITOR’S NOTE: This article originally appeared on The Trillium, a Village Media website devoted to covering provincial politics at Queen’s Park.

An Ontario woman says her mother was fined more than $28,000 for refusing a long-term care home placement not of her choosing. 

Under the Ford government's Bill 7, the More Beds, Better Care Act, hospitals can charge a fee of $400 per day to patients who decline to move to long-term care homes chosen for them. The homes can be up to 70 kilometres away in southern Ontario or 150 kilometres away in the north.

Five patients were fined between September 2022, when the law took effect, and April 15, 2024, for stays between 13 to 93 days, according to the Ministry of Health.

The new data came from a freedom-of-information request filed by The Trillium for the total dollar amount levied under the legislation. As it has in the past, the province refused to divulge that figure.

Previously, the government said seven people had been fined under the More Beds, Better Care Act. That was a counting error, the ministry said — the real number is five.

Michele Campeau said her mother, Ruth Poupard, was hit with the 93-day fine. 

Poupard, who is 83 and has dementia, went to Hôtel-Dieu Grace Healthcare in Windsor after breaking her hip. When a hospital deems that a patient's status is no longer acute, they can be charged as an "alternate level of care" (ALC) patient at the rate of a basic long-term care room.

In Poupard's case, this cost about $2,600 for 28 days, according to receipts Campeau showed The Trillium.

Once a patient is designated as ALC, hospital placement coordinators can choose a nursing home for an ALC patient, send personal health information to the home, and authorize their admission, without the patient's consent.

Once Campeau refused the hospital's proposed home, the higher fines kicked in. For about the next two months, Poupard was charged $400 per day, Campeau said.

Her final bill: $28,640.02.

Eventually, Campeau was able to get her mother into her number 1 long-term care home choice — right in the middle of all her kids, so they can visit her easily. 

"She's very well taken care of. This home is one of the best I've ever experienced," she said.

Still, the fine remains. Campeau said she doesn't plan to pay it.

"They're never getting a dime," she said. "I will fight it to the end."

"This is intimidation. This is — I don't even know what you call it, besides elder abuse and extortion," she said.

Ford government defends law advocates call 'ageist'

Health Minister Sylvia Jones' office said Bill 7 has worked. The number of patients being discharged from "alternate level of care" stays has increased 34 per cent, and the length of the average ALC stay has reached an all-time low — nearly half as long as it was in 2019.

The law "ensures Ontarians are receiving the care they need, in a setting that is right for them," spokesperson Hannah Jensen said in a statement.

It's "ageism," said Vivian Stamatopoulos, a long-term care researcher and advocate at Ontario Tech University. She blamed the Ford government for failing to adequately fund hospitals.

"And then who suffers the most? It ends up being the seniors who are deemed disposable in this process," she said. "Why save their life, when we can try to save the younger person?"

Natalie Mehra, the executive director of the Ontario Health Coalition, said she's spoken to numerous families that have been pressured out of hospitals into inappropriate care spaces.

"Routinely, this is what it looks like," she said. An elderly man has a fall. He goes to the hospital. When his acute care is done, "he can't go home anymore. That's the end of the line for him," she said. 

The hospital will then "pour on the pressure to get him out, to anywhere," including making promises of home care or the quality of a long-term care home that may not be true, Mehra said. "It doesn't matter whether the care is appropriate or not. It doesn't matter. They just want the bed."

“I just think it’s reprehensible. It’s inhumane. It’s awful," she said.

CanAge CEO Laura Tamblyn Watts said eroding medical consent is a "slippery slope."

"It's a fundamental question of government taking away the right to consent, and that's something everyone should be very worried about," she said.

The law is the subject of a charter challenge, which will be heard later this month.

As for the bill, Campeau said no one has contacted her about it.

"They don't know what to do," she said.

It's unclear if any of the five patients' fines were ongoing, or if any had been collected, as of the ministry's response.

Campeau said she had some advice for Jones: "Take care of our seniors, because they probably voted you guys in in the first place," she said. "Let's not forget them."