Seniors pay more to live in long-term-care homes they find least desirable.

The price is supposed to be the same everywhere as it is set by the provincial government. But what you get for your money is wildly inconsistent. A room with two beds can cost nearly $250 less a month at newer homes than at older homes.

It's hard to swallow when seniors are being pushed into the first available long-term-care bed -- no matter what they think of the home -- by hospitals threatening to charge them $300 a day if they refuse.

"You're paying more and getting less," said Helen MacPherson, who felt strong-armed by a Hamilton hospital into putting her 82-year-old father into a home she didn't like. "We were in shock when this happened. But if we said no, we were up the creek (financially)."

She paid $57.76 a day for a semi-private room with a curtain separating the beds. If her father was in one of their top choices, it would have been $49.76 a day and there would be a wall between the beds.

It comes down to what each home considers to be a basic ward room. The province dictates a basic ward room costs $1,513.53 a month while semi-privates are $1,756.87. Private rooms are $2,061.03 monthly or $67.76 a day.

In older homes, ward rooms can have four beds. But in homes built in the past five years, they almost always have two beds. It's a big issue in Hamilton where only 42 per cent of the 3,900 long-term-care beds are in facilities built since 2002.

Families overwhelmingly pick newer homes so wait lists are up to three years. Waits for older homes can be as short as two months.

The disparity is causing major headaches for Hamilton hospitals, which have at least 120 of their beds taken by seniors waiting for long- term care. That's on top of 70 temporary beds opened at St. Joseph's Villa in Dundas earlier this year to give hospitals some relief.

Hospitals can't let them wait years for their top picks because these blocked beds cause overcrowding in emergency departments and lead to cancelled surgeries.

"It affects the whole organization," said Romeo Cercone, vice-president of long-term care at St. Joseph's Healthcare. "It's a huge impact that starts right at the emergency department."

Hospitals can't force seniors to take a bed they don't want so they offer impossible choices: pay $300 per day for the bed, return home or take the bed that's open.

It greatly concerns the Advocacy Centre for the Elderly in Toronto.

"We don't believe it's legal for any hospital to charge anything more than the same rate as a long-term- care home," said Jane Meadus, a lawyer for the centre. "We probably get a call once a day on this from somewhere in the province."

Hospital executives say legislation backs them up, and the tactic used across Ontario is endorsed by Health Minister George Smitherman.

"We have to be careful not to pretend that we're going to be in a situation at all times where your preference matches up right from Day 1," he said. "We really do require some flexibility."

The $300 fee is about one-third of the daily cost of a hospital bed. So far one patient has been charged and the hospital didn't collect.

"We're not interested in receiving the revenue," said Brenda Flaherty, executive vice-president of clinical operations at Hamilton Health Sciences. Hospitals aren't equipped for long-term care and beds there cost three times as much.

Meanwhile, patients pay the same fees as if they're in a home without any benefits of long-term care.

Even MacPherson acknowledges her dad did better in the home. But giving up that hospital bed is a gamble because it's tough to get out of a home you don't like. People in hospital and those in crisis in their own homes are a higher priority on the waiting list.

MacPherson's father is still nowhere near getting into one of their top three picks after a year-and-a-half. Meantime, he's been moved to a home the family finds more acceptable. He'll likely stay.

"I don't want to move him again," said MacPherson. "It's too much."

New long-term care legislation passed last month does nothing to fix the problem, and there are no plans to build new beds here.

The answer appears to be boosting home care. But that will take three to five years. "It's frustrating," said MacPherson. "They've worked hard all their lives and they're getting kind of shifted off."

jfrketich@thespec.com

905-526-3349