Building a better long-term care model

Reading this article about a woman who doesn't want to leave the hospital because there are no openings in her preferred nursing homes and she doesn't want to go to the first available nursing home, I've been thinking about how to improve the current system. Here's what I've come up with:

What if being transferred to a long-term care facility didn't ever have to be final?

You can make a list of the facilities you want and rank them in order. You're immediately put into the available facility on your list that you've given the highest ranking. If none of the facilities on your list are available, you're put into the first available bed.

HOWEVER: After you get put into the first available bed, you're still in line for the facilities on your list. When a bed becomes available in one of them, you get moved there. And even after you're placed in a facility on your list, you still get informed of openings in facilities that rank higher on your list with the option of transferring there. In other words, if your #3 facility has an opening first so you're placed there, but then your #1 facility subsequently has an opening, you get the option of transferring to your #1 facility.

You can put however many facilities you want on your list, and rank them however you want. You can have every facility in the province ranked in order of preference, or you can have 12 facilities ranked equally, or you can have 2 facilities in first place and 5 in second place, or whatever you want.

Possible variations:

- Patients who are currently placed in a facility that's not on their list have precedence over patients who are currently placed in a facility that is on their list. For example, if I'm currently in my #5 choice and you're currently in the first available bed in a facility that isn't on your list, and I'm ahead of you on the waiting list for a facility that's #1 on both our lists, you get admitted to that facility first.
- Exceptions can be made to the "first available" rule under specific circumstances (for example, if the first available facility has been found in violation of regulations, if the first available facility is inaccessible to the patient's support people, etc.)
- The patient (or, if the patient is not competent to make decisions for themselves, their representative) can veto any placement proposed under this system.
- Before the patient loses their faculties, they can include in their power of attorney guidelines dictating circumstances under which the representative may or may not change the patient's priority order. For example, the representative might be permitted to change the patient's priority order if a new facility is built that didn't exist back when the patient was still competent, but might not be permitted to make changes solely for financial reasons.

I have no idea how much of this is or isn't a good idea. It seems like it would get appropriate care to as many people as possible and preferred care to as many people as possible, but there could easily be flaws that I'm not seeing. It would be cool if they could do projections on this model and see if it would work.