Access to subsidized assisted living dropping as for-profit companies focus on more lucrative private-pay market: study

February 5, 2020

Vancouver — BC added a mere 105 units of publicly subsidized assisted living over nearly a decade (2010-17), despite a growing population of seniors. As a result, access to subsidized assisted living dropped, while the number of private-pay units grew by leaps and bounds over the same period, with 1,130 private-pay units added. 

These are among the key findings in a study released today by the Canadian Centre for Policy Alternatives, Assisted Living in British Columbia: Trends in access, affordability and ownership

Report author Andrew Longhurst notes that fees for private-pay assisted living come entirely out residents’ pockets and the provincial government does not limit how much operators can charge. Average annual rents range from just over $24,000 for an assisted living bachelor suite to more than $36,000 for a one bedroom, plus a myriad of additional fees for “extra” services and supplies not included in the basic monthly charge. The median (middle) income for a single senior in BC is $27,600. 

“Without access to subsidized assisted living, seniors who can’t afford to pay privately may go without care altogether or wait until their health deteriorates to the point of requiring a nursing home or hospitalization,” says Longhurst. “This situation does not serve seniors or our public health care system well at all.” 

Assisted living is a type of supportive housing for people with moderate levels of disability who can direct their own care but need daily personal assistance in order to live independently (such as help getting dressed and bathing or assistance taking medications). Residential long-term care (or nursing homes), in contrast, provides 24-hour nursing supervision and care for individuals with complex medical needs. 

Longhurst notes that access to subsidized assisted living dropped by 17 per cent province-wide between 2008 and 2017 (measured as the number of units per 1,000 seniors age 75-plus). Four of the five health authorities saw declines: Vancouver Coastal Health (-25 per cent), Fraser Health (-19 per cent), Vancouver Island Health (-17 per cent) and Interior Health (-11 per cent). Northern Health saw a marginal increase in access (5 per cent). Vancouver Coastal Health had the lowest level of access with just 10 units per 1,000 seniors 75 and older as of 2017. 

The study also raises concerns about the growing role of for-profit companies and corporate chains in the assisted living sector. For-profit corporations provide the vast majority of private-pay units, while non-profits provide the majority of publicly subsidized units. 

“The absence of public capital investments to enable health authorities and non-profits to develop new spaces means very few new publicly subsidized assisted living facilities are being built,” says Longhurst. “The private-pay market has benefited as a result.” 

Longhurst is troubled by the growing financialization of seniors’ care, where real estate assets are bought and sold on international markets. 

“Allowing assisted living facilities to be treated as financial commodities is at odds with the basic social purpose of providing care to vulnerable seniors,” he says. 

The study makes two key recommendations:

  • Create new capital and operating funding opportunities for non-profit organizations and health authorities to increase the supply of publicly subsidized assisted living units as part of a home and community care funding plan.
  • Require detailed disclosure and public reporting to improve transparency and accountability in both assisted living and long-term care. A large body of evidence demonstrates the importance of public disclosure and reporting of ownership, costs and quality of services to enhance accountability and transparency in the seniors’ care sector.

*Note: the original text — BC added a mere 105 units of publicly subsidized assisted living over nearly a decade (2008-17) should have read (2010-17) as now corrected above.

For more information and to arrange interviews, please contact Jean Kavanagh at 604-802-5729,
[email protected]