New BrunswickHorizon Health says recent changes by the Holt government won’t be enough to deal with the crisis of seniors on nursing-home waitlists taking up valuable space in the province’s hospitals.Margaret Melanson tells MLAs she’d give up part of her budget if it meant better long-term care Jacques Poitras · CBC News · Posted: Oct 02, 2025 3:50 PM EDT | Last Updated: 2 hours agoHorizon CEO Margaret Melanson says a new change in the rules would not result in a large number of alternative-level-of-care patients leaving hospital beds. (Jacques Poitras/CBC)Horizon Health says recent changes by the Holt government won’t be enough to deal with the crisis of seniors on nursing-home waitlists taking up valuable space in the province’s hospitals.The Liberals announced last week that the government was changing the rules for seniors who refuse to accept the first available spot in a nursing home.Alternative-level-of-care, or ALC, patients in hospitals — people who don’t need hospital-level care but are waiting to enter a nursing home — will now face fewer consequences if they turn down the first available spot offered to them.Horizon CEO Margaret Melanson said any change is positive but the Sept. 26 announcement “unfortunately will not achieve a large number of medically discharged patients leaving our facilities.””We do not anticipate that to occur.”She called for the province to require ALC patients to accept the first available placement while they wait for a transfer to their preferred option.”The potential that patients can remain in hospital if they are refusing nursing home choices is not something that occurs in every province of Canada,” she said.”We’re hopeful that perhaps New Brunswick can eventually move to that particular policy.”Melanson told MLAs she’d even be willing to give up some of her budget to address the problem.”If long-term care could be provided, we would be happy to be removing some of that money from our budget because we know that these individuals would be cared for more efficiently and with a higher quality in the community,” she said.”So while I would say our money has always been well-spent, it should be, in some cases, redirected.” WATCH | Horizon CEO says spending on long-term care would ease pressure on health-care system: Seniors stuck in hospital cost Horizon $200M a year, network saysHorizon Health CEO Margart Melanson says the number of medically discharged seniors waiting for a placement in long-term care continues to grow — and this has implications for the health of New Brunswickers and provincial finances. The health authority was over budget by $55 million last year and Melanson told MLAs on the legislature’s public accounts committee that the shortfall was “predominantly” because of ALC patients in beds that Horizon does not have the budget for.Other patients staying in hallways, lounges and other spaces are also a factor, she added.About 40 per cent of acute care beds in Horizon’s regional hospitals are now taken up by seniors waiting for nursing home placements, the result of a July surge with “no known cause,” the CEO told reporters.Horizon said ALC patients cost the system $203 million per year.The changes announced last week say that a person who refuses a placement will no longer be moved to the bottom of the waitlist and will be able to wait for a second offer.If they refuse a second offer, they’ll be removed from the waitlist and can only apply to be put back on 12 weeks later.But ALC patients in hospitals who refuse won’t be removed from the waitlist or lose their spot on the list.”We were given the opportunity to provide some feedback, and the feedback we provided was, ‘This is a step hopefully in the right direction, however it is not taking us far enough,'” Melanson said.According to Horizon, a large number of beds being taken up by patients waiting to get into nursing homes remains a major challenge. (Shutterstock)She said Horizon told the government that a better option would be to require ALC patients to accept the first available nursing home spot within a 50-kilometre distance.”We were very clear about the recommendations we made about that more robust approach within a particular geography,” she said.An Ontario law passed in 2022 allows hospitals to charge ALC patients $400 a day if they refuse a placement in a nursing home not of their choosing.That law was challenged in court as unconstitutional, but a court upheld the legislation earlier this year.Melanson told reporters Horizon is also able to charge patients who turn down placements but said it’s impossible for the health authority to expel them if they refuse to pay.The CEO said the July increase in ALC patients is a problem now because Horizon expects more admissions in the fall as cases of respiratory infections increase.Without a change, the numbers “will continue to occur and accelerate.”Opposition MLAs called for the government to move faster.PC health critic Bill Hogan did not, however, offer any concrete suggestions, other than getting government departments and the two health authorities to work together on solutions.”It’s understandable that we want to be compassionate with the people in hospital. … It isn’t the best place for them. It’s not the best service that they get, and we need to look and see how we can do it. But we can’t build new spaces overnight.” He said the 50-km range for a mandatory placement is a reasonable travel distance for some families but “may be impossible” for others..Green Leader David Coon said the province should move on new legislation that would allow a more comprehensive approach to long-term care.”The sense of urgency to address this issue is just not there, so we’re seeing these Band-Aid approaches,” he said.Liberal government house leader Marco LeBlanc said he was confident that cabinet ministers “are looking at that file attentively and working hard on making sure we have solutions before that [fall infection] season comes.”The Department of Social Development, which has responsibility for long-term care, did not respond to a request for an interview with the minister, Cindy Miles, about Melanson’s comments.ABOUT THE AUTHORJacques Poitras has been CBC’s provincial affairs reporter in New Brunswick since 2000. He grew up in Moncton and covered Parliament in Ottawa for the New Brunswick Telegraph-Journal. He has reported on every New Brunswick election since 1995 and won awards from the Radio Television Digital News Association, the National Newspaper Awards and Amnesty International. He is also the author of five non-fiction books about New Brunswick politics and history.
Liberal change to nursing home placements falls short, Horizon CEO says
