TORONTO - Many Ontario patients aren't discharged from hospital on time and are still facing overcrowding and delays in emergency departments despite extra government cash, the province's financial watchdog said Monday.

More than 50,000 patients stayed in hospital longer than necessary last year because their ongoing care couldn't be arranged, auditor general Jim McCarter said in his annual report.

Those patients end up occupying much-needed beds that could help alleviate the long waits in hospital emergency departments, he said.

Most people have the wrong idea about why there's so much overcrowding and delays in ERs, the auditor said.

"A lot of people think it's because you've got a lot of people coming into emerg with minor ailments," McCarter said.

"What we actually found was that it was more a problem with the lack of in-patient beds."

About one in five patients require support when they leave the hospital, from home care to rehabilitation to nursing-home care, he said. That number is expected to climb dramatically as the population ages.

Currently, about half the patients who need home care have to wait in hospital an average of six extra days, while 90 per cent of those who need long-term care waited more than four months, the report found.

Meanwhile, emergency patients who needed a bed waited an average of 10 hours, while others waited 26 hours or more.

Often there were beds available, but they sat empty because they hadn't been identified or cleaned, the report found.

In one case, a cancer patient waited three days in an emergency department for a hospital bed. It was later discovered that the hospital had been holding 24 patients in the ER, even though there were 18 empty beds available.

About two-thirds of the hospitals McCarter surveyed didn't have the capacity or infrastructure to measure how long empty beds were unoccupied.

Work is already underway to unclog the province's ERs, said Health Minister Deb Matthews.

"It's right up there at the top of our priority list -- getting the emergency department wait times down and moving people who are in hospital beds who ought not be in hospital beds into an appropriate level of care in their community," she said.

McCarter acknowledged that there's been some improvement in wait times. But many ERs still aren't meeting provincial targets despite $200 million in extra funding over two years, he found.

He noted that patients with serious conditions sometimes had to wait 12 hours or more, exceeding the province's eight-hour target.

Some people also waited for more than an hour to be triaged, far longer than the recommended 10 to 15 minutes.

Hospitals were also spending extra money -- and risking staff burnout -- by having nurses work overtime, particularly during the nights, holidays and on weekends.

McCarter found that one nurse's overtime accounted for more than half her salary for nine years. The nurse took in $157,000 last year, $90,000 of which was overtime pay.

The level of home care services also varied widely across the province, with some patients waiting up to 15 months to be assessed, he found. About 10,000 people are still waiting for home-care services.

The auditor's findings show that Ontario's 14 local health integration units -- created by the Liberals to make local decisions and dole out public cash -- are a waste of money and should be shut down, said Opposition Leader Tim Hudak.

"Despite sinking hundreds of millions of dollars into the LHINs and the (aging at home) strategy, 50,000 people are sitting in hospitals across this province who shouldn't be there, who should be in a long-term care home or at home with family," said the Tory leader.

"(Premier) Dalton McGuinty has taken all of the money and basically flushed it down the drain."