As Ms. Vyce said earlier, it's hard to know across the country exactly how far off we are, given the way that staffing levels are collected and reported.
I can give you the example of B.C. We have a guideline of 3.26 hours per resident per day. On average, they're being funded for 3.25 in B.C. right now. When Ms. Vyce spoke about the 4.1 figure, I would point out that it was recommended by the most comprehensive study to date. It was a report to the U.S. Senate in 2001. The complexity levels of seniors have increased radically since 2001, so it needs to be updated. The study looked at over 5,000 facilities in the U.S. seeking Medicaid funding. It used regression analysis and extensive modelling, following care aides and staff to see what length of time...they're like time-motion studies. It used hundreds of key informant interviews, with directors of care, with heads of administration, with care aides. It's hard to replicate a study like that, so we do rely on that old figure, but the number needs to be revamped and undoubtedly it's going to be higher than 4.1 when we do that.
Right now in B.C., the 3.36 guideline obviously falls shy of that 4.1 figure. The 4.1 figure in that study refers to direct care hours: the nursing team, the care aide, the licensed practical nurse, the RN. In B.C. the 3.36 guideline includes allied health, including dietitians and occupational therapists, who are all essential, but in a way it's like padding the numbers. If you get down to the direct care hours, it's even lower than the 3.36. As I mentioned, we're not hitting it right now; the average is 3.25, so there's certainly a gap.