Saturday, November 14, 2020

Coronavirus: Ontario’s worst hit nursing homes and who owns them 

“And so the bottom line is it is now irrefutable that the for-profit homes, the larger chains, in particular, have a strong correlation with the highest death rates of COVID-19 in our province.”

By Stewart Bell & Andrew Russell Global News
Posted June 16, 2020 


WATCH: 2 companies own nearly half of the Ontario LTC homes worst hit by COVID-19 – Jun 16, 2020 https://globalnews.ca/news/7059683/coronavirus-ontarios-worst-hit-nursing-homes/


Almost a third of the Ontario nursing home residents who have died of COVID-19 were living at facilities owned by just two corporate chains, according to a Global News analysis of government statistics.

Sienna Senior Living and Revera Inc. long-term care facilities have lost 525 residents altogether, according to the figures. The data also shows that more than half the deaths at all nursing homes in the province were at facilities owned by six companies.

The province puts the number of nursing home deaths related to COVID-19 at 1,786 as of June 12. The data is self-reported by the long-term care homes to the province.

Canada’s long-term care homes have borne the brunt of the pandemic. In Ontario, more than 7,000 residents and staff have become infected, and almost three-quarters of those who died were nursing homes residents.

While there were outbreaks at several hundred care homes, a much smaller number suffered large-scale deaths — and most were owned by a handful of private companies.


6 companies nearly 1,000 deaths




Using Ontario government figures on COVID-19 deaths in long-term care, Global News matched each home with an outbreak to its owner to see how they had fared during the pandemic.

The numbers only include deaths at homes that lost five or more residents, as the province does not release figures for care homes with fewer than five resident deaths.

As the largest owners, Sienna and Revera were particularly hard hit. Sienna homes have lost 295 residents to the pandemic, while Revera homes have seen 230 deaths. Many of their homes had no deaths or outbreaks.

Families react to allegations at 5 Ontario care homes – May 27, 2020
https://globalnews.ca/news/7059683/coronavirus-ontarios-worst-hit-nursing-homes/


Six Sienna homes experienced 20 or more deaths, compared with four Revera homes and four Rykka homes. Two Sienna homes had more than 50 deaths, as well as two Revera homes.

Of the 14 homes that lost more than a quarter of their residents, three were Sienna homes, two were Southbridge homes and one was a Rykka home. Three were non-profits. At four Revera homes, at least 20 per cent of residents died.


“We have a very serious problem with long-term care facilities, but it’s not a problem that started with COVID-19,” said professor Tamara Daly, a professor of health policy and director of York University’s Centre for Aging Research & Education who has been studying the issue for two decades.

Ontario has the highest number of for-profit care homes in Canada, with 57 per cent of the more than 600 facilities owned or managed by for-profits, according to Daly’s research. In B.C. and Alberta, roughly 44 per cent and 40 per cent are for-profits.
A closer look at Canada’s long-term care crisisA closer look at Canada’s long-term care crisis – Jun 16, 2020

Understaffing and reliance on part-time workers were key drivers in nursing home outbreaks, said Daly.

For-profit homes generally had more part-time and casual workers, which can lead to a greater spread of infection as staff employed at multiple facilities move between workplaces, she said.

Non-profit and municipal homes tended to have higher levels of full-time staff, meaning support workers had a better understanding of the needs of those they were caring for, Daly said.

“You have better care outcomes associated with more continuity. It’s really straightforward,” she said.
For-profit vs. non-profit
Why non-profit nursing homes provide better care for residents – Jun 16, 2020

But the debate over private versus public homes is far from settled.

According to SEIU Healthcare, the union representing thousands of the province’s long-term care workers, for-profit homes had 7.2 deaths per bed during the pandemic.

By contrast, homes operated by non-profit groups had 4.5 deaths per bed, while those owned by municipal governments fared best, with 2.4 deaths per bed, the union said.

Preliminary data from Ontario Long Term Care Association, however, said 85 per cent of privately-owned homes had no deaths as a result of COVID-19, compared to 82 per cent of not-for-profit homes.

A Sienna spokesperson said that while some of its homes were “hit by challenging outbreaks, the vast majority of our 70 residences across the country have experienced few, if any, cases of COVID-19.”

Natalie Gokchenian said in a statement that “having reviewed current information, I can confirm that the number of deaths as a percentage of outbreak beds is lower than that of other long-term care providers in the province.”

One of the country’s largest long-term care providers, Sienna operates homes in Ontario and British Columbia. The company reported profits of $7.5-million in 2019, down from $21.8-million in 2017.

READ MORE: Inspection reports found mouse feces, neglect, abuse at Ontario long-term care homes before COVID-19

Sienna homes include Camilla Care Community, where 68 have died, and Madonna Care Community, with 46 deaths. The Canadian Forces was deployed to Sienna’s Altamont Care Community, which has had 53 deaths.

At Altamont, the military reported “significant staffing issues” and underfed residents. Most recently, troops were sent to Sienna’s Woodbridge Vista, where 62 residents and staff are infected, and 23 have died.

Sienna president and CEO Lois Cormack resigned for personal reasons, the company announced Friday.

“Since the beginning of the pandemic, we have worked closely with public health authorities and health-care partners to ensure all precautions, protocols and directives are in place and that we continue to have adequate supplies of personal protective equipment available for all team members,” Gokchenian said.

The company has launched a six-point plan that aims to improve operations and delivery of care, she said. “The action plan includes an immediate, company-wide review into our policies, practices and culture at Sienna led by former Deputy Attorney General of Ontario, Paul Boniferro.”



Revera Inc. owns and operates more than 500 seniors residences in North America and the United Kingdom. Its Ontario homes include Carlingview Manor in Ottawa, which has had 61 resident deaths, and Forest Heights in Kitchener, where 51 have died.


The company is owned by PSP Investments, a Crown corporation and the investment arm for federal public servant pensions. Revera is also facing two class-action lawsuits in Ontario and Alberta.

“Some Revera homes have suffered serious outbreaks, and the hearts of our entire organization go out to the families and friends of the people we have lost to this tragic pandemic and the staff who cared for them,” said company spokesperson Larry Roberts.

“There are many variables and factors that have played a part in why COVID-19 spread and affected some homes and not others, however objective data has not shown that ownership is one of them.”

Roberts said the company was “adapting and evolving our practices and protocols in accordance with the latest medical advice and public health directives.” He said Revera would respond to lawsuits against the company “in due course in the appropriate forum.”

READ MORE: How to make long-term care homes ‘good living’

Ontario Long Term Care Minister Merrilee Fullerton’s office said ward rooms and congestion had amplified the spread of COVID-19 at nursing homes.

“These are long-standing structural and capacity issues that, coupled with a severe staffing shortage that predates the virus, have led to the tragedy we have seen in our homes,” the statement said.

The union representing federal public servants wants PSP Investments to divest itself of Revera Inc. amid what it called “mounting and overwhelming evidence” of the “extremely disproportionate” rate of COVID-19 infection and death in long-term-care homes.


Homes run by Rykka, an operating partner of Responsive Management Inc., based in Markham, Ont., had 132 deaths at four facilities, the third-most in the province, the analysis of government data shows.

They include Hawthorne Place Care Centre and Eatonville Care Centre, where a military report said residents were left in soiled diapers and there was a “culture of fear” among workers worried about using supplies like wipes, gloves and dressing gowns.

Coronavirus outbreak: What Premier Ford has to say to families after ‘heart-breaking’ military report on some long-term care homes

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Responsive Management said the company was spending all the money it received from the government on staffing, support services, food and supplies like personal protective equipment.

“Most of our homes managed to keep COVID-19 at bay and the rest have turned the corner thanks to the dedicated efforts of our staff,” said Linda Calabrese, vice-president of operations.

“Many of our staff members have been able to come back to work and we are seeing residents recover fully. We are hopeful that we can declare the outbreak over in our homes soon,” she said.

READ MORE: Long-term care facilities are the only option for many. What happens when they fall short?

Ontario’s worst-hit home was Orchard Villa, with 70 deaths. The company that owns the facility, Southbridge, had a total of 126 COVID-19 deaths at five homes, according to the analysis of government data.

“While the majority of our homes had no or very few cases, COVID-19 presented Orchard Villa with some unique challenges as one of the homes that went into outbreak early,” company spokesperson Richard Franzke said.

“The guidance and recommendations from government and health authorities evolved since then, which ultimately enhanced the support for the sector. The home also experienced staffing shortages as a result of COVID-19. To address our staffing needs, we reached out for help early and often.”

“Nothing is more important to us than the residents in our care, and we want to ensure that we are always meeting or exceeding our commitment to providing the highest standard of care.”


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Sharleen Stewart, president of SEIU Healthcare, said private homes received the same provincial funding from the provincial government but also had to generate profits for shareholders, meaning there was less to spend on staff and supplies.

“Even before COVID we could see the difference from the staffing perspective,” Stewart said. “The workers were telling us how different it was in those homes, and as you know, they do work in more than one.”


“It’s pretty glaring that the for-profits have got a real problem.”

She said the union is calling for an inquiry into what happened.

“It’s not to point fingers. It’s to identify what didn’t work and what worked. I mean, look at the municipal homes and the not-for-profits, they have better outcomes, and they have the same issues.

The Ontario Health Coalition said staffing was a key factor in the pandemic.

In April, the staffing crisis worsened when employees were banned from working at multiple locations in order to curb the spread of COVID-19, forcing them to choose a single home.

Many chose not to work at for-profit homes, which generally offered worse wages, benefits and working conditions than facilities operated by non-profits or municipalities, said executive director Natalie Mehra.

She said the coalition’s research had discounted factors such as the number of beds operated by owners and the acuity of the resident population as a measure of how homes had coped with the pandemic.

“And so the bottom line is it is now irrefutable that the for-profit homes, the larger chains, in particular, have a strong correlation with the highest death rates of COVID-19 in our province.”

Who owns the 5 Ontario long-term care homes cited by military for extreme neglect, abuse?
 
By Andrew Russell & Stewart Bell Global News
Posted May 29, 2020 

WATCH: Families react to allegations at 5 Ontario care homes – May 27, 2020
https://globalnews.ca/video/rd/32c1ec32-a079-11ea-a714-0242ac110002/?jwsource=cl

A searing report from Canada’s military into Ontario’s troubled long-term-care system where over 1,600 people have died from COVID-19 put a spotlight on the for-profit companies managing some of these facilities.

The Ontario government released the report on Tuesday after Global News published details of the findings, which revealed shocking allegations of neglect and abuse at five Ontario homes Prime Minister Justin Trudeau called “deeply disturbing.”

READ MORE: Military teams raise concerns about conditions at Ontario care homes

Ontario premier Doug Ford announced Wednesday the government is taking control of five long-term care homes, including four that the Canadian military says neglected and abused residents.

New data from the Ontario Health Coalition shows 1,629 residents have died at long-term care and retirement residences and 10 staff have died as of May 19.

Here is a closer look at the companies behind the five troubled facilities.
Altamont Care Community
4:34Coronavirus outbreak: Premier Ford announces Ontario to take over 5 more long-term care homes – May 27, 2020 https://globalnews.ca/news/6998665/long-term-care-homes-ownership-coronavirus/

Altamont Care Community, located in Scarborough, where 52 people have died from COVID-19, is owned by Sienna Senior Living, among the largest for-profit, long-term care providers in Canada.

The company owns 37 long-term care facilities and another 27 retirement residences in Ontario. It owns another 19 long-term care and retirement residences in British Columbia.

Sienna Living made a $7.5-million profit in 2019, down from a $21.8-million profit in 2017, according to the company’s financial records.

In a military report, Brig. Gen. Conrad Mialkowski alleged most residents at Altamont were not getting three meals a day due to “significant staffing issues” and that there was “poor nutritional status due to underfeeding.”




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Military personnel also reported that residents had pressure ulcers due to prolonged bed rest, in some cases for weeks.

“No evidence of residents being moved to wheelchair for parts of day, repositioned in bed, or washed properly,” the report read.

The company declined to answer questions about its financial reports but said it was working to make sure the issues identified by the Canadian Forces “are all dealt with immediately and permanently.”

“To deliver the level of care that our seniors deserve, the staffing challenges we face in the long-term care sector must be addressed,” the company said in a statement. “We are committed to working with the government, and our health system partners, to solve this urgent issue.

“As the report notes, we have already increased staffing levels and flattened the infection curve.”

Orchard Villa
Families are calling for an inquiry into Orchard VillaFamilies are calling for an inquiry into Orchard Villa – May 1, 2020

Orchard Villa, a 308-bed facility in Pickering, is owned by Southbridge Care Homes and has been clobbered by the pandemic, with 77 deaths and at least 96 staff and 225 residents testing positive for novel coronavirus.

Families have called for a police investigation into Orchard Villa, and have alleged neglect, malnourishment and failure to adhere to infection prevention protocols.

Southbridge owns 37 long-term care homes across the province, including Country Village Homes near Windsor, where there have been 18 deaths. Southbridge is a limited partnership and doesn’t disclose its financial reports.

Orchard Villa is managed by Extendicare, which owns or runs more than 110 homes and retirement residences across the country.

According to Extendicare’s financial reports, the company reported a profit of $28.6 million on revenue of $1.13 billion in 2019, compared with a profit of $31.7 million on revenue of $1.12 billion the year before.

READ MORE: Family surprised to find apparent details of mother’s death in military nursing home report

Southbridge and Extendicare did not respond to requests for comment.

A $40-million proposed class-action suit was filed against Orchard Villa this week alleging negligence. The home has not yet responded to the civil action, filed in the Ontario court.

Military personnel reported seeing “cockroaches and flies at the Pickering facility, while patients were “left in beds soiled in diapers.”

“Respecting dignity of patients not always a priority. Caregiver burnout noted among staff,” said the report, which also ranked infection prevention practices as “poor.”


READ MORE: Ontario NDP leader calls for long-term care minister’s resignation after disturbing report

June Bendell died at Orchard Villa three weeks ago, after she choked while she was being fed a nutritional drink.

Her children were told the death was deemed accidental, but said they were surprised to hear what appeared to be a different version of events from the Canadian Armed Forces.

“Now we heard she was lying on her back, and they recognized it as being an issue. And it is an issue,” Fred Bendell told Global News in an interview.

“She was handled poorly.”


June Bendell (right) and her husband Harry would visit nursing homes every Christmas dressed as Mr. and Mrs. Claus. Family Handout

Military personnel sent to Orchard Villa to control a COVID-19 outbreak had found that staff were not always sitting residents upright before feeding them, according to the military report released Tuesday.

The report also alleged the high-risk practice may have contributed to the death of a resident who had choked when a nursing home worker fed her “while supine.”
Eatonville and Hawthorne Place
Coronavirus outbreak: Ford calls military report on Ontario long-term care homes “gut-wrenching” – May 26, 2020

North York’s Hawthorne Place Care Centre, the scene of 46 deaths, and Eatonville Care Centre in Etobicoke, where 42 people died, are operated by Rykka Care Centres, an operating partner of Responsive Management Inc., based in Markham, Ont.

The company is privately held doesn’t publicly report its financial returns.

The company also runs Anson Place Care Centre in Hagersville, which has recorded 27 deaths so far.

At Hawthorne nursing home, the military alleged numerous instances of apparent patient neglect and that “little to no disinfection” had been conducted amid the COVID-19 pandemic.

CAF members noted an infestation of ants and cockroaches and that some staff “delayed changing soiled residents leading to skin breakdown.” Workers were also “afraid for their jobs” and there was not enough personal protective equipment to keep staff safe, the report said.

READ MORE: Ontario Superior Court orders 4 long-term care homes to equip nurses with protective equipment

Meanwhile, at Eatonville Care Centre in Etobicoke, the military said residents who tested positive for COVID-19 were allowed to wander the facility, putting everyone “at risk of being exposed” and passing the virus “throughout the home.”

The report said there was a “general culture of fear” at the home among personal support workers who were worried about using costly supplies like wipes, gloves and dressing gowns.

There were also allegations about the reuse of hypodermoclysis supplies, including catheters, even after their sterility had been compromised, the report said.

“Generally very poor peri-catheterization reported. Example: retracting penis foreskin to clean isn’t happening on a widespread level,” the report said, noting the CAF members found nearly a dozen cases of bleeding fungal infections.

The company said in a statement that it was working to address the issues raised by the military and is “initiating a third-party independent review of all the CAF’s findings”

“Most of the homes that we manage have been successful at keeping COVID-19 at bay,” said Linda Calabrese, vice-president of operations with Responsive Management Inc.

“We will not rest until our residents and their families have confidence that residents are getting the best care possible. When complete, we will share this review with the Government of Ontario, the Government and Canada and the Canadian Armed Forces.”
Holland Christian Homes
Coronavirus: Military personnel raise concerns over conditions at Ontario long-term care homes – May 26, 2020

Holland Christian Homes, which runs Grace Manor where 11 people have died, is the only not-for-profit home amongst the five listed in the report

The military alleged staff there moved from a COVID-19-positive unit to other units without changing protective gear, wearing the same pairs of gloves as they moved between patients and not washing their hands often enough.

They also flagged leaving food in a patient’s mouth while the person was sleeping, “aggressively repositioning a resident,” and not assisting residents during meals, noting that in some cases, staff would rather write that the resident had refused the meal than help them eat.

READ MORE: What’s Canada’s true coronavirus death toll? Here’s why it’s hard to say

Ken Rawlins, CEO of Holland Christian, said the situation at the home has stabilized and the military feels it can redeploy elsewhere.

“Like others, including our political leaders, we were shocked and dismayed at some of the conditions identified in this report,” he said.

“It is our goal, as it is of all involved, to ensure the highest standards of care and treatment of all residents entrusted to our care by their families.”

Ontario Premier Doug Ford said Holland Christian has since made changes and will not be taken over following the release of the military report, but will still receive provincial inspections.

Ford said the province is dispatching six teams of two inspectors to each of the five homes.

“We need boots on the ground. I want eyes and ears in the homes that we’re most worried about keeping close watch,” he said.

“We are fully prepared to take over more homes if necessary. We are fully prepared to pull licences, to shut down facilities, if it is necessary. We will do whatever it takes for as long as it takes.”


Stewart.Bell@globalnews.ca
Andrew.Russell@globalnews.ca


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