Ontario already had tools to penalize the worst long-term care companies, including nonprofits with persistent problems.
Doug Ford’s government said it had allocated hundreds of beds to Ontario’s five long-term care providers at the center of a military report that shocked the nation more than a year ago with details of the conditions and neglect.
Holland Christian Homes, which owns Grace Manor in Brampton, Ont., A long-term care home where 12 people have died from COVID-19, received public funds in July to build 40 new beds and redevelop 120 more. .
This is the final installment in a five-part series where CTV News Toronto examines the province’s decision to allocate new beds and potential funding to the five companies.
Click on the links to read Part 1 on Southbridge Care Homes, Part 2 on Sienna Senior Living, Part 3 on Rykka Care Centers, and Part 4 on GEM Health Care Group.
PART 5: HOLLAND CHRISTIAN HOMES
Grace Manor of Holland Christian Homes is the only non-profit home that received urgent support from the Canadian Armed Forces during the first wave of the COVID-19 pandemic.
Wendy Crane remembers standing in front of her mother’s window the day the military arrived at the house in late April 2020. She asked what was going on inside the house and an officer told her to not to worry, that the army was watching.
“He said it was all going to be written down, everything that we are witnessing,” Crane said. “I knew the house was still having problems. Before the pandemic, I used to go there daily, sometimes twice a day, to see my mom and make sure she was okay. I didn’t think she was safe.
A month after their mission, the military released a scathing report, written by Brigadier-General CJJ Mialkowski, detailing allegations regarding conditions inside Grace Manor and four other homes, confirming the worst fears of families whose relatives were dead within their walls.
The army’s one-page report on Grace Manor was shorter than what they wrote for the other four houses. It details serious infection, control and prevention issues, including the fact that employees do not wash their hands after interacting with a patient and wear the same pair of gloves for multiple tasks.
In his report, Mialkowski alleged that staff left food in a resident’s mouth while he was sleeping. He described the staff “aggressively repositioning a resident” and said they would not help residents during meals. “The staff would rather write that the resident refused to eat, rather than help them,” the report said.
Crane said she always wanted to move her mother out of Grace Manor. She said the house took so long to look after the exterior of the building and made sure flowers were planted in the summer. But inside, the house was filled with residents they “didn’t want to deal with.”
“I have pictures of my mom’s fingernails, of how they just let them grow, regardless,” she said. “I told the CEO if you take care of your residents, the way you take care of the land, they would be a lot happier.”
“I wanted to get her out of there… I quit my job to take care of her. I felt my mother was not safe there. There was nothing but negligence.
Crane’s mother passed away in September 2020. She survived the COVID-19 pandemic, but lost her life to cancer. She said she will never forget the day her mother passed away at home.
“I went to get the RN and she said, ‘Just a minute, I’m just cutting a burger for a resident,’” she said. “Do you tell someone when their mother has just breathed her last?”
INSPECTION REPORTS CONTINUE TO LOOK FOR PROBLEMS
A total of 40 people have died from COVID-19 at homes owned by Holland Christian Homes, with 12 deaths at Grace Manor and 28 at Faith Manor, also in Brampton.
In its most recent budget, the Ontario government promised to add 30,000 new long-term care beds over the next 10 years. It indicates that 20,161 other new beds and 15,918 refitted beds are in the “development project”.
After receiving the applications, the government has already granted licenses to some companies that have applied for the new and upgraded beds. Holland Christian Homes, for example, used all of their allowances to open a rebuilt Faith Manor in September. It also went from a 120-bed house to a 160-bed house.
Many critics and families say the government should not have given millions of taxpayer dollars to the company named in the military report.
A spokesperson for the Ontario Ministry of Long-Term Care told CTV News Toronto that the COVID-19 pandemic has exposed the need to update and modernize long-term care homes, which means that even for-profit households will get public funding to solve the problems. in their facilities and build new beds.
The ministry also told CTV News Toronto that the pandemic has shown the need to update homes in order to prevent the spread of outbreaks. A spokesperson said the province would add capacity in areas of Ontario with “significant demand.” “
In response to CTV News Toronto, a spokesperson for Holland Christian Homes said the issues highlighted in the military report were now resolved.
“All findings that were part of the Army’s final observation report on Grace Manor from May 2020 were treated with the care and attention they deserved and action was taken quickly to change practices and procedures. existing accordingly. All non-compliance issues have since been resolved, ”said Director of Communications Trish Krale.
“Continuous improvement is integral to Holland Christian Homes, as we put the health, safety and well-being of residents and staff at the forefront of our operations. “
Government inspection reports suggest the house still has ongoing issues. As late as March 2021, it was found that the home had failed to document fluid intake for three residents.
“A resident was transferred to hospital due to a change in his condition and died in hospital. A complaint alleged that the resident was dehydrated when he was transferred to hospital due to staff negligence, ”the report said. “Three residents were identified at risk for dehydration and required a specified amount of fluids per day.”
“The residents’ clinical records were reviewed and showed that their fluid intake was not documented on numerous dates and times.”
An inspection conducted between July 13 and August 4, 2021 revealed several problems at the house. Inspectors documented that Grace Manor “failed to ensure that the drugs were administered to twelve residents according to the directions specified by the prescriber.”
The summer report included issues with fall prevention interventions, failing to protect residents from abuse, and failing to “have a resident with impaired skin integrity assessed by registered staff ”.
These are all violations of the Long Term Care Homes Act. When a house breaks the Act, a number of actions can be taken, the most common being a “written notice” from an inspector, which means that a house is informed that it has done something wrong and that we ask him to repair it. Often, problems persist after sending a written notice because there is no guaranteed follow-up.
Inspectors can also issue a “voluntary remedial plan” that requires a licensee to develop a plan to resolve the problem, which inspectors can then choose to follow. The province can also implement compliance orders, which ensures a return visit from inspectors.
The most severe sentence that can be imposed on a long-term care home is a “director’s order,” which can result in a home being put under new management and its license revoked.
Grace Manor’s latest inspection left the home with seven written notices, six voluntary remedial plans and a compliance order.
Natalie Mehra, executive director of the Ontario Health Coalition, said many homes like Grace Manor have managed to get by without experiencing any real repercussions.
“I mean all these families are haunted, it makes me cry to think about it,” Mehra said. “It was devastating. They can’t believe there was no justice. They can’t believe it.
“They didn’t suffer any significant consequences at all. I mean being written in an inspection report that hardly anyone sees doesn’t matter.
“THEY COULD DO A LOT TO KEEP THEM ACCOUNTABLE”
Long-Term Care Minister Rod Phillips did not respond to CTV News Toronto when asked why the long-term care homes listed in the military report had not been penalized and instead received stipends for new beds.
The Ford government on Thursday proposed new legislation that, for the first time, would give it the power to impose fines on retirement homes and appoint a supervisor to take control of those in the worst conditions.
The new fines would range from $ 200,000 for an individual to $ 1 million for a corporation. The government has also pledged to spend billions of dollars to hire more workers, increase the number of inspectors and build new facilities.
The current Long-Term Care Homes Act does not contain any provision imposing fines on the operators of such homes. In 2017, the Liberal government introduced a bill that provided administrative penalties of $ 100,000 for infractions, but the Conservative government did not pass a law when it took office in 2018.
The new legislation would also allow the province to choose a supervisor to take over the management of a home. The government has never used its powers under existing legislation to replace the management of a home or to seize its license.
The province said Friday that Ontario long-term care providers who broke regulations during the pandemic will not be fined retroactively under new legislation introduced this week. No fines have so far been imposed by the Ministry of Long-Term Care since the onset of COVID-19.
Mehra said the government still had the power to penalize homes and hold them accountable, but chose not to act on those powers.
“There are all kinds of things in the law to hold homes accountable, if that was really the order of the day,” she said. “They could suspend the licenses; they can suspend admissions, which puts them in the wallet. They can revoke licenses. They could do so much to hold them accountable, but they didn’t.
“They had the tools to do it all this time. ”