Family of Hamilton man furious about $240,000 hospital bill

When Jon Suter was transferred from a local hospital to the alternate level of care (ALC) ward at St. Joseph's Villa last summer, his family worried.

The longtime diabetic was just nine months removed from an operation at St. Joseph's Healthcare Hamilton's Charlton campus that saw him undergo a second leg amputation in nearly as many years.

We didn't want him leaving the hospital," said Suter's sister and power of attorney, Susan. He had severe diabetes uncontrollable with insulin. He needed his doctors, and he clearly needed hospital-level care."

The family says the move was without choice.

Suter, 64, was one of thousands of ALC patients in Ontario that were transferred to long-term-care homes during the pandemic as hospitals looked to free up bed space for an expected surge in COVID-19 patients.

But as he waited for a permanent placement in a different long-term-care home - a placement that has yet to materialize - he quietly racked up a hefty hospital bill that has left his family utterly floored.

Suter is on the hook for nearly a quarter of a million dollars to St. Joseph's Healthcare Hamilton.

Since mid-July, the Hamilton native - whose only source of income is a monthly Ontario Disability Support Program (ODSP) cheque - has been charged around $1,034 a day for a bed at St. Joseph's Villa that his family said was never asked for.

A copy of his bill reviewed by The Spectator shows Suter owed the hospital $241,956 as of March 10.

It's astounding, it's appalling, it's reprehensible," said Susan. What really frightens me is that they're going to do this to other people."

St. Joseph's said in a statement it could not address the individual circumstances of a patient.

Patients are designated ALC once they are medically stable and have had their acute or post-acute needs resolved.

Many of them are bound for long-term-care homes, but - depending on whether their preferred home has space available - some can be transferred to hospital-run ALC beds in community locations, such as the Satellite Health Facility downtown or St. Joseph's Villa in Dundas.

Transferring patients from hospital to long-term care is considered only after all community supports are exhausted," Jane Loncke, director of continuing care, rehabilitation and therapeutics at St. Joe's, said in an emailed statement.

Susan believes her brother was caught in the shuffle of a hastily put together plan to transfer ALC patients to long-term-care homes in a provincewide bid to ease the load on hospitals amid the pandemic.

Indeed, the Ministry of Long-Term Care went back and forth on green-lighting the transfer of ALC patients in 2020: allowing it March, suspending it in April, then allowing it again in June.

This on-again, off-again type policy came under criticism from the Office of the Auditor General, who slammed the ministry in a recent report for packing ALC patients into crowded long-term-care homes that were already at 98 per cent capacity pre-COVID.

In July and August 2020, according to the report, ALC patients transferred out of hospitals to long-term-care homes spiked at 998 and 829, respectively.

That is a whopping 96 per cent and 63 per cent increase over the 2019 monthly average.

Suter was one of those ALC patients transferred in July.

Susan said that prior to her brother's move to St. Joseph's Villa, he was offered a placement at the Regina Gardens Long Term Care Residence on the west Mountain. The family rejected the offer.

When we looked at the home, not that it's not a lovely place for senior citizens, but I don't think there's a person there under the age of 75," she said. My brother is 64, and my and mother and I are in bad health.

He could outlive both of us. We want him to be in the right home with the right level of care so that, if and when we're gone, he is taken care of."

Susan said St. Joe's warned her prior to the transfer that there could be a discretionary fee" while Suter waited at St. Joseph's Villa for a different placement.

Not that there would be a fee, but that there could be," said Susan.

Susan got the first bill from St. Joe's on Oct. 29. It said she and Suter owed $97,196.

I called the financial (department) at St. Joe's and left a message," she said. They never got back to me. Then I mailed them the bill back and asked why we were being charged so much."

At her wits' end - and with monthly bills still arriving - she got in touch with Hamilton MPP Sandy Shaw, who raised the enormity of Suter's hospital bill during question period at Queen's Park last week.

Jane Meadus, a lawyer and institutional advocate at the Advocacy Centre for the Elderly, said ALC patients transferred to long-term-care homes while awaiting placement are generally charged a chronic care co-payment" that is aligned with the rate of a long-term-care bed.

That shakes out to a monthly maximum of $1,800 - a fraction of the roughly $31,000 uninsured rate Suter was charged per month.

To get to that amount, that's a pretty high number," said Meatus. That family should have known throughout how much they were getting billed and why."

St. Joseph's said in its statement that in the time an ALC patient is waiting for a bed to become available, chronic care co-payment aligned to long-term-care rates" apply.

But they also cited a section of the Public Hospitals Act which states that, if a patient is not prepared to leave hospital when supportive discharge options are available, then their ongoing stay would no longer be covered by OHIP.

Meadus said that is not always the case.

Hospitals will often say, If you don't go to this retirement home or take a transitional bed - if you refuse those - then we're just going to charge you the uninsured rate because you're not being co-operative.' And that is something they are not allowed to do," she said.

The uninsured rate generally applies to people who are from out of province, like Quebec, and not covered by OHIP."

It is unclear whether Suter was charged at an uninsured rate because his family declined placement at Regina Gardens.

Susan said she plans to dispute the bill. Her brother was hospitalized again last month after his health condition worsened. He is still without a scheduled placement for a permanent long-term-care bed.

I can't pay that bill and Jon certainly can't pay that bill because he's on ODSP," she said. We don't know what to do ... We don't want him going back to the Villa because we don't want to be charged."

Sebastian Bron is a Hamilton-based reporter at The Spectator. Reach him via email: sbron@thespec.com