Increasingly frustrated by the apparent reluctance of Alberta Health Services and the Alberta Government to enforce the Nursing Home Act and its required-staffing regulations, United Nurses of Alberta has taken the unusual step of going to court to force the province to enforce its own law.
UNA asked the Alberta Court of Queen’s Bench yesterday to issue a writ of mandamus in the case of a nursing home in the town of Athabasca.The writ would order the province to enforce the Nursing Home Act and its Regulations, which require the presence of a Registered Nurse in a facility legally defined as a nursing home
“For several years, some Alberta nursing home operators have been failing to ensure levels of staffing required by law in their facilities,” said UNA President Heather Smith.
“When UNA and its members brought these failures to the attention of Alberta Health Services and the government, they have appeared reluctant to enforce the law,” she said. “AHS and the government have responded to reports nursing homes are not obeying staffing regulations by saying they are looking into the problems andwill deal with them, but they have not followed up with timely action.”
“It now appears AHS and the government are prepared to ignore the government’s own laws and regulations,” Smith stated. “As a result, we believe we have no recourse but to seek relief from the courts in the form of anorder to the government to enforce the Nursing Home Act and the Nursing Homes Operation Regulation.”
At issue are three requirements in the Nursing Homes Operation Regulation:
That all nursing homes have on duty at all times a Registered Nurse, Certified Graduate Nurse or Registered Psychiatric Nurse
That all nursing homes have a Registered Nurse or Certified Graduate Nurse on call if the only nurse on duty is a Registered Psychiatric Nurse
That in the event an RN or Certified Graduate Nurse cannot be on site for a period of time, an RN or Certified Graduate Nurse is on call
In the case in question, a private, for-profit nursing home run by Extendicare Canada in Athabasca has beenrefusing since last fall to staff the site with RNs at any time.
In response to repeated queries from UNA and the union’s call for Extendicare to comply with the NursingHomes Operations Regulation, which was adopted by the Alberta Government in 1985, AHS has repeatedly told UNA it is looking into the problem and has not arrived at a final position.
This month, UNA was informed by a senior AHS official that Extendicare had implemented an “LPN model” of staffing due to difficulty recruiting RNs, and that the company is no longer recruiting RNs. UNA was informed the company on its own decided using only LPNs “has become an effective staffing model that is providing quality resident care.” She also AHS wanted more time to deal with the situation.
UNA’s position is that it has been clearly established Extendicare is operating in violation of the regulations andno more investigation is needed.
Smith and UNA Labour Relations Director David Harrigan said the union raised the matter in a meeting Jan. 13 with Health Minister Stephen Mandel. Since that meeting, UNA has not received a response from the minister, leaving no choice but to proceed with legal action.
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1985 – Alberta enacts Nursing Homes Operations Regulation.
February 2012 – UNA Labour Relations Director David Harrigan writes Alberta Health Services and Health Minister Fred Horne regarding failure of nursing homes in Grande Prairie, Medicine Hat, Edmonton and Hardisty to fully comply with RN staffing provisions of the Nursing Homes Operations Regulation.
March 2012 – Harrigan writes AHS and Health Minister Fred Horne about the ongoing situation in Grande Prairie, Medicine Hat, Edmonton and Hardisty.
March 2012 – Having received no reply, Harrigan writes a second time to AHS and Horne about the situation in Grande Prairie, Medicine Hat, Edmonton and Hardisty.
May 2012 – Horne responds, saying some sites are now in compliance and AHS is working with another site to ensure it will be.
October 2014 – Report of the Auditor General of Alberta agrees with UNA's position staffing as per the regulations is essential and that at least one RN must be on duty at all times or, in cases where an RPN is on duty, available on call. The AG also expresses concern about the level of AHS monitoring.
November 13, 2014 – Harrigan contacts AHS Chief Operating Officer Deb Gordon by email regarding the failureof a private facility in Athabasca to comply with the regulations and requests she require the facility to comply.
November 17, 2014 – Harrigan contacts Gordon to state UNA remains concerned by the situation and to notifyher of UNA’s intention to contact the minister.
November 22, 2014 – Gordon responds, saying AHS has investigated the matter and has learned the companyhas implemented an “LPN model” of staffing due to difficulty recruiting RNs, is no longer recruiting RNs, andwhen an RN is not on site to supervise LPNs, one is on call.
November 22, 2014 –Harrigan responds to Gordon, reminding her of Horne’s commitment to ensure the regu-lations are obeyed and stating that the company is in direct violation of the regulation.
November 22, 2014 – Gordon responds to that email, saying AHS is reviewing the situation and has not arrivedat a final conclusion.
November 22, 2014 – Harrigan responds to Gordon saying no further review is required as it is acknowledgedby all parties the company is operating in violation of the regulation.
December 4, 2014 – Harrigan writes Mandel to request Alberta take steps to ensure the regulation is enforced inall Alberta nursing homes, especially the Athabasca site.
December 19, 2014 – Harrigan writes again to Mandel noting UNA has not received a response and requestingenforcement of the regulation.
January 13, 2015 – Harrigan and UNA President Heather Smith raise the issue during a meeting on health care financing with Mandel. Mandel promises to look into the matter again.
March 9, 2015 – UNA seeks relief from the courts to force the government of Alberta to obey the law.