Sun Parlor Home and Victoria Street Manor 2014 Budget

Health Care System Aging population; physical structures Complex needs – peritoneal dialysis; younger residents with mental, cognitive and neurological impairments Costs (transportation) are being reallocated to residents Two different budget years – MOHLTC and County

Priorities –Comply with legislation Resident Quality Inspection – 4 Compliance Orders and 15 Written Notifications Chief Fire Marshall –Partnerships –Maximize use of technology/enablers to achieve efficiencies –Health Quality Ontario – Quality Improvement Plan

Department Budgets

Sun Parlor Home - Overall 2013 Budget 2013 Actual 2014 Budget Expenditures20,997,07021,386,38022,104,530 Recoveries (14,384,790)(14,906,070)(14,868,200) Net Operations6,612,2806,480,3107,236,330 Contributions to (from) Reserves (15,440)235,910(274,530) County Responsibility 6,596,8406,716,2206,961,800

Overall Performance 2013 Province funded 2% Improved WSIB Wages and benefits - Unfavourable variances 2014 No staff increases ONA arbitration Sept/14 CUPE no contract April/13 Comply with regulations Mandatory staff training Pay Equity Plan 2013

Administration New Administrator, Medical Director and Attending Physician Retirements - 2 Accountable to three funding sources (MOHLTC, Residents, County of Essex)

Administration 2013 Budget 2013 Actual 2014 Budget Expenditures867,340952,580981,830 Recoveries (83,400)(112,950)(94,400) Net Operations783,940839,630887,430 Contributions to (from) Reserves16,000(850)(45,890) County Responsibility 799,940838,780841,540

Administration 2013 – budget variances –Legal, insurance, arbitration costs –Some strategic objectives not realized 2014 –“attempting to hold the line” expenses –Pay Equity, job evaluation and arbitrated settlements

Nursing Provides resident focused nursing and personal care to maximize each resident’s physical, social and emotional potential while respecting the uniqueness of each individual for their personal integrity, dignity, self esteem and freedom of choice.

Nursing 2013 Budget 2013 Actual 2014 Budget Expenditures11,496,44011,592,12011,764,850 Recoveries (7,198,140)(7,575,900)(7,418,840) Net Operations4,298,3004,016,2204,346,010 Contributions To Reserves025,0000 County Responsibility 4,298,3004,041,2204,346,010

Nursing 2013 Staffing Schedules High-low beds 2014 No staff enhancements Recovery ($60,000) towards electronic charting Changes to High Intensity Needs Funding

Enriches the quality of life by achieving residents’ optimum physical, mental, social and spiritual function Recreational and therapeutic programs meet individual needs including PT and OT Residents’ Council, Family Council, Auxiliary Volunteers, Pastoral Care, hairdressing services Life Enrichment (Activation)

2013 Budget 2013 Actual 2014 Budget Expenditures745,800838,930944,990 Recoveries (640,640)(722,870)(827,220) Net Operations105,160116,060117,770 Contributions from Reserves000 County Responsibility 105,160116,060117,770 Life Enrichment (Activation)

Life Enrichment 2013 Improved modified work allowed early returns Flexible scheduling Enhanced therapy programs 2014 Staffing levels – evenings, weekends and holidays Support staff education Support offered for increased care and assistance each resident now requires

Safe, nutritious and attractive meals and snacks With the assistance of Registered Dietitians, nutritional assessment, evaluating risk and development of an individualized nutritional care plan, counseling and quarterly review of all residents Dietary programs for increasingly complex needs Meals on Wheels community program FNS essential and integral part of resident life Food & Nutrition Services

2013 Budget 2013 Actual 2014 Budget Expenditures3,152,9403,266,8803,249,650 Recoveries (781,470)(780,980)(786,480) Net Operations2,371,4702,485,9002,463,170 Contributions from Reserves000 County Responsibility 2,371,4702,485,9002,463,170 Food & Nutrition Services

2013 Variance - orientation for new hires and STD Cost of increased Meals on Wheels offset by recoveries Support Ontariofresh.ca “buy local” 2014 No staff increases Anticipate 5% food prices Menu management system Partnerships - Meals on Wheels Support staff education

Clean, comfortable and safe environment Part of the resident care team Appearance of the Home and grounds is important to residents and visitors These departments are impacted by the increasingly complex medical condition of residents as well Housekeeping, Laundry, Maintenance

2013 Budget 2013 Actual 2014 Budget Housekeeping1,150,6401,218,3601,205,580 Laundry 872,860958,280910,300 Maintenance1,281,9201,375,1801,371,460 Net Operations3,305,4203,551,8203,487,340 Recoveries(49,360)(43,450)(44,200) County Responsibility 3,256,0603,508,7303,443,140 Housekeeping, Laundry, Maintenance

Housekeeping, Laundry, Maintenance 2013 Salaries and wages are over-budget due to replacement of staff for unavoidable, health- related issues More activity in support departments (eg. Room transfers) related to resident condition 2014 Wages include the implementation of CUPE pay equity, job evaluation and arbitrated settlements Expected rate increases for utilities causing a budget increase

Structural Capital Allocation 2013 Budget 2013 Actual 2014 Budget Expenditures425,000366,800304,200 Recoveries (225,560) Net Operations199,440141,24078,640 Contributions From Reserve(199,440)(141,240)(78,640) Reserve Balance, Beginning of Year 516,650556,690415,450 Reserve Balance, End of Year 317,210415,450336,810

Structural Capital Allocation high low beds -whirlpool tub/lift -compressors HVAC -hot water boiler -courtyard canopy -flooring and painting two whirlpool tubs - one 80 lb washing machine - ceiling lifts, patient lift slings - shower chairs - domestic water storage

Major Capital Expenditures 2013 Budget 2013 Actual 2014 Budget Expenditures402,000217,000770,000 From Reserves(342,000)(207,000)(710,000) To Capital Reserve (Amortization) 510,000560,000 County Responsibility 570, ,000

Major Capital Expenditures 2013 Kitchen freezer/flooring 2014 Nurse call system Resident wandering system Wireless connectivity Security Upgrades Resident room furnishings (Wehenkel) Dining room Elevators

Victoria Street Manor Amherstburg Residential housing and support to 14 frail, elderly residents To maintain their independent life styles

Victoria Street Manor 2013 Budget 2013 Actual 2014 Budget Expenditures602,130599,890601,670 Recoveries (426,140)(427,100)(432,060) Net Operations175,990172,790169,610 Contributions to Reserves000 County Responsibility 175,990172,790169,610

Victoria Street Manor 2013 Favorable variance - resident revenues Savings - Supervisor position not filled Numerous capital repairs concluded Improved resident assessment - IT project 2014 Pay Equity Negotiations/arbitration – uncertain Good reputation Assume full occupancy Physical attributes of the building

Pay Equity-known impact Negotiations/arbitrations - uncertain Despite economic and systemic challenges, the Homes anticipate continued success The Homes are confident that reputations for quality of care will be maintained Sun Parlor Home & Victoria Street Manor 2014 Budget Summary