These questions included:
A perception that operators today are seeing higher resident acuity in long-term care settings – ever since Alberta initiated a separate care stream (designated supportive living) for lower acuity residents.
A sense that staff were struggling to meet the care needs of residents within the funded staffing hours.
Concerns about the funding model’s ability to support different facility types and the upkeep of aging buildings and care homes.
We found that an acuity-based model is still optimal for funding contracted operators and AHS to deliver care.
We also recommended some adjustments to PCBF – to better reflect today’s care environment and emerging changes in the populations we serve. Many of CHAA’s recommendations were well articulated in the province’s 2021 Facility-Based Continuing Care Review, and are now being evaluated in a thorough provincial review of the PCBF model.
Three years of the COVID-19 pandemic have also generated new insights across Canada regarding how care homes across the country are funded, staffed and supported. These learnings, which were captured in a provincial audit (COVID-19 in Continuing Care Facilities), are also being incorporated into Alberta’s funding model review.
To answer these questions, CHAA commissioned a year-long study and economic analysis on the first decade of PCBF in Alberta. The study looked at:
The accuracy of PCBF’s inputs and assessment tools in measuring resident health needs and acuity levels.
The extent to which PCBF appropriately funds staffing hours and labour costs to meet care needs.
The ability of PCBF to accommodate a variety of care models and facility types/sizes, particularly for resident populations with dementia.
Our study involved analyzing a decade's worth of funding advice from across 19 not-for-profit care homes, representing nearly 3,000 long-term care spaces. We also analyzed collective agreements over the same period to assess how well funding aligns with actual labour costs.
CHAA's research shows the premise of PCBF is sound, but the inputs and assumptions may need to be adjusted via an overall funding model review.
YES - The inputs and assessment tools are still a good foundation for measuring resident health needs and acuity levels.
NO - The model’s 3.02 hours of care (on average) per day, per resident, don’t always give staff enough time with residents. This conclusion has also been drawn by other studies within Canada, and is currently under review in Alberta.
NO - While PCBF can work well in some larger facilities, it was never designed to fit small care homes and buildings. A similar conclusion was drawn by Alberta’s excellent Facility-Based Continuing Care Review in 2021.