B.C. is grappling with a shortage of care beds and growing waitlists at long-term care facilities
B.C. is seeing a shortage of long-term care beds even as a “silver tsunami” of aging baby boomers threatens to overwhelm an already strained system with monthslong waits.
Experts told BIV that provincial investment in long-term care infrastructure is inadequate, and that government policies are shunning the capital needed to right the ship.
About 35,000 seniors age 75 and older require the intensity of care that is provided in a long-term care home. That number is projected to reach 55,000 in the next decade, according to a July 2025 report by B.C.’s Office of the Seniors Advocate (OSA).
Despite rising demand, the availability of beds is falling.
The system has gone from 77 beds to 58 beds per 1,000 people 75 and older over the past decade, and this will drop to 41 beds by 2035 if beds are built and replaced at the current rate, said the report.
The waitlist for long-term care has ballooned as a result.
The number of people waiting to be admitted to long-term care rose from 2,381 to 7,212 between 2016 and 2025, an increase of 200 per cent, said the OSA report.
The provincial average wait time for a long-term care bed has grown by 98 per cent from 146 days in 2018 to 290 days — more than nine months — in 2024, said the report.
“We have simply seen an erosion of the number of beds available,” said B.C. Seniors Advocate Dan Levitt, who leads the OSA.
“We’ve shifted the responsibility, unfortunately, from government-funded beds to the family, who are really now trying to do their best. They’re not professionals or trained to provide long-term care, but they’re the ones who are really saddled with a responsibility.”
Of the nearly 30,000 publicly subsidized long-term care beds, roughly a third are owned and operated by non-profit organizations, a third are for-profit and a third are run by a health authority.
New supply won’t come cheap. The cost to create some new long-term care beds can run more than $1 million per bed with about $100,000 per year in operating costs, Levitt said.
The amount of money being invested in long-term care, regardless of who the operator is, hasn’t kept pace with the demand, he said.
“If it was a different model, I’m not sure if we’d be any better off. We really have to see much more infrastructure investment,” he said.
Financials are challenging
One private operator of long-term care beds said there are no dedicated capital grants or incentives in B.C. specifically designed to support net new capacity of long-term care beds.
“That is something that is really needed in order … for us to reach the goal, like to even actually make a dent in that goal,” said Natalie Ku, chief financial officer of Optima Seniors Management Inc., also known as Optima Living.
It’s challenging to make new long-term care projects financially viable given the high costs of land, construction and operating expenses in the province, she said.
B.C.-based Optima operates the full spectrum of senior housing ranging from non-funded independent living to funded long-term care beds. Ku said current government funding levels would result in negative returns on building new supply.
“The math just doesn’t math,” she said.
Projects can take five to seven years from land acquisition to opening, Ku said.
There are also steep barriers to enter the capital-intensive, highly regulated and operationally complex industry, she said.
The company has been growing more in Alberta due to a “more difficult” business environment in B.C., Ku said. Alberta recently announced $400 million in funding to all operators within the province prepared to build net new capacity.
“We absolutely need to build beds, and comparing to other provinces, B.C. is really behind the 8-ball,” Ku said.
Stable funding elusive
Private long-term care operators generally have subsidized long-term care beds as part of a larger portfolio that also includes assisted living. They go through a request-for-proposal system and enter into contracts with the government to deliver a certain number of beds at a certain cost.
Operators who have some government-funded beds are subsidizing that activity through what the private-pay beds are taking in, said Mary Polak, CEO of the BC Care Providers Association.
“There’s no way possible that government on its own can build the necessary units to respond to what’s going to be a crisis very, very soon,” said Polak, who briefly served as health minister under the BC Liberals in 2017.
This means non-government operators need to have a viable operation to justify building the units that are going to be needed, Polak said.
This requires stability in funding. The B.C. Ministry of Health had discussions with industry about putting together a stable funding formula, but “when the [2024 provincial] election happened, that stopped,” said Polak.
The ministry’s efforts to establish a new long-term care funding model are described in an internal briefing note that was provided to B.C. Health Minister Josie Osborne during a legislative debate.
The partially redacted document said the ministry’s efforts have included creating an advisory committee that includes industry, assembling working groups and awarding a contract to PricewaterhouseCoopers LLP for up to $1.5 million for project management and research support.
The document said goals include increasing funded direct care hours to achieve 3.36 hours per resident day.
This metric is used to determine the amount of money operators receive to care for people.
Mark Blandford, CEO of Providence Living, said it’s not enough.
The non-profit, which uses land and working capital from the Catholic Church, is taking a village-based approach derived from Europe that allows seniors to live in small-scale housing environments with more personalized care and autonomy.
“In order to deliver this model of care comprehensively, we need it to be at [four] care hours,” he said. “That’s policy issue number one.”
Ministry responds
The Ministry of Health said in a statement it recognizes how difficult it is for people and their loved ones to wait for placement in long-term care.
“Ensuring our seniors have the care they need, where and when they need it, is a priority of government,” the statement said, adding the government is committed to supporting seniors and “making up for years of funding neglect.”
The ministry said since 2017, it has announced the expansion and development of 36 long-term care homes, which will provide 5,588 new modern care home beds, including 3,320 net new publicly funded beds.
Of the 36 approved long-term care projects, 20 included redevelopment plans to replace many multi-bed rooms in outdated facilities, the ministry said.
Regarding waitlists, the ministry said the health authorities monitor individuals waiting for placement in long-term care and provide home support and community services to support individuals to remain in their own homes while they wait for a placement.
Clock ticking
A crisis is at B.C.’s doorstep, with funded beds already “extremely difficult” to find for senior parents who fall ill, said Optima’s Ku.
“We all heard about the ‘silver tsunami’ with the baby boomers reaching the age of needing senior homes,” she said. “It’s a very scary future for British Columbians.”
