Hello Mr. Ford,
I am amazed to have heard you say to the press that you knew nothing about the horrific conditions in many Ontario nursing homes. I described the concentration-camp like environment to you in a letter I sent you. (A copy is enclosed.) You acknowledged with a reply on February 28, 2019. (A copy is enclosed.)
The minister of Long-Term Care, Merrilee Fullerton, knew about this when I named her as the defendant in my Human Rights Tribunal complaint against the government of Ontario, which I announced at a Seniors Guardian Angels Program press conference in Queen’s Park – your government’s own headquarters. You can view this press conference at the link below.
You misrepresented the facts by stating you did not have any prior knowledge of the horrific conditions in some Ontario nursing homes. Are you sincere in wanting to fix this problem? If “the buck stops here” with you, the following are some efficient and cost-effective ways for you to proceed immediately;
ENFORCE YOUR OWN LEGISLATION
Ontario’s Long-Term Care Homes Act (LTCHA) is not being enforced in a meaningful way. As the Canadian Armed Forces’ horrific report has shown, this lack of compliance goes to the extent that some nursing homes are deliberately failing to provide the necessities of life for their patients as a way to make money. When your government “regulates” such bad-operators by doing no more than sending written reprimands, you are encouraging their despicable business model of profits-before-patients.
By stating that your government enforces regulations, you are misleading victims who put forth complaints into thinking that there will be meaningful enforcement, problems remediated, and their loved ones will receive the adequate care that they pay for as patients. As your government is doing nothing to fix this problem, I am glad to see so many victims’ families taking civil legal action against nursing homes as this is their only viable course of action.
For nursing homes that cannot or will not comply with the LTCHA, the government can invoke mandatory management orders (MMOs) that relieves such nursing home management of their duty and replaces them at the expense of the owners of these non-compliant nursing homes. Thus, the problem is solved without cost to the Ontario taxpayers. While I am pleased to see you invoked some MMOs recently, I am disappointed that the threshold for invoking such a measure is public outrage over the ‘body count’ inflicted by greedy and/or incompetent nursing home management. There are many additional nursing homes in Ontario that also need MMOs to be invoked on them.
The consequence of a MMO (and ultimately revoking their license) will motivate all nursing homes in Ontario to comply with the LTCHA. This can be done under the existing legislation immediately and will not cost anything. These consequences will encourage bad-operator nursing homes to comply with legislation.
The results of this compliance will be less complaints and shorter processing times for them. For me, it took a year for your government to process a serious complaint of abuse and neglect to issuing meaningless reprimands. Is the Ontario Government’s nursing home enforcement process designed to employ the greatest number of people in a way that achieves the least amount of compliance?
In addition to the LTCHA not being enforced in a meaningful way, the criminal code is not being enforced. If the heinous acts documented in the Canadian Armed Forces’ report were committed outside of nursing homes, there would be criminal charges for such things as murder, failing to provide the necessities of life, assault, and abuse. However, if such things happen in nursing homes, there are seldom criminal charges laid. If you are sincere about fixing this problem, there should be criminal charges against those responsible. Is your government strong enough to take this position? Or are you beholden to the big nursing home chains?
LETTING VISITORS IN
There was a growing trend in nursing (and retirement living) homes of banning visitors who complain. Wuhan flu has been a huge benefit to the nursing home industry as they now have an excuse to expand this ban to all visitors. This ban halts such complaints as advising nursing home staff of problems, reporting observed mistreatment to government, calling police for criminal offenses, and filing civil law suits. As the Ministry of Long-Term Care’s inspection process is now complaint driven, no visitation means there will be no inspections. No inspections mean that nursing home problems will get worse. (There are no surprise inspections to nursing homes – they know when these are coming.)
If you are sincere in fixing Ontario’s nursing home problem, you must mandate that nursing homes re-instate open-door policies for visitors to arrive unannounced. Nursing home patients are in the last stage of their lives. It is cruel to deprive them of visitation. It is also a violation under the Canadian Charter of Rights and Freedoms.
TRANSPARENCY IN REPORTING
The typical family evaluating nursing homes has limited information upon which to base their decision. Inspection reports on the Ontario government web site are outdated and difficult for the novice to comprehend. They can also disappear at the behest of nursing home management.
There is no way for families to tell if a nursing home is good or bad. Your refusal to publicly release the names of the nursing homes on the IMS Table “red list” indicates that your government’s secrecy will continue.
INQUIRY AND ACTION
After the horrific murders of eight patients in Ontario nursing homes by serial-killer Elizabeth Wettlaufer, the government of Ontario undertook a full public inquiry. This inquiry exposed many of the problems in nursing homes that led to the current crisis. Your government has either not acted on these recommendations or done the opposite of what this inquiry recommended. Your refusal to order a full public inquiry into the Wuhan flu related deaths of almost 1,700 patients in Ontario nursing homes (some amid squalid conditions) indicates you do not want to know the complete scope of this problem, much less implement a solution.
As an advocate who is knowledgeable about long term care and passionate about fixing it, I will make myself available to participate in your independent inquiry of Ontario nursing homes.
Seniors Guardian Angels Program
Doug Ford’s Reply to my letter
From: Doug Ford <firstname.lastname@example.org>
Sent: Thursday, February 28, 2019 09:54
Subject: An email from the Premier of Ontario
Dear Mr. Vice:
Thanks for your email about the long-term care home inspection and complaints process. I appreciate hearing your views and concerns, and I was sorry to learn of your mother-in-law’s situation.
As the issue you raised falls in the area of responsibility of the Honourable Christine Elliott, Minister of Health and Long-Term Care, I’ve forwarded your email to her. Minister Elliott or a ministry staff member will respond to you as soon as possible.
Thanks again for contacting me.
Premier of Ontario
c: The Honourable Christine Elliott
My letter to Doug Ford
February 25, 2019
Office of the Premier
Toronto ON M7A 1A1
Dear Mr. Ford;
An area that requires the Ontario government’s critical attention is the lack of supervision of private nursing homes – long-term care (LTC) facilities. There is a fundamental lack of oversight that has resulted in, at best, an abysmal level of care at some LTCs. At worst, patients in such LTCs are being murdered – the Ontario Health Coalition reported that there were 29 homicides in Ontario LTCs in the past six years (which doesn’t include the eight murders committed by Elizabeth Wettlaufer). The LTC industry is getting away with murder – literally. Police are unable to deal with such crimes in LTCs as they generally lack guidelines and protocols for their already limited resources.
Calling the Ontario Ministry of Health (MOH) hotline to report a serious issue at an LTC takes months for them to investigate. For example, my wife reported the physical assault of an LTC patient (her own mother) last September. This has neither been investigated nor has a MOH inspector gotten back to my wife. The complaint, a physical assault, has been in que for months! After an investigation, several more months pass before the MOH presents the offending LTC with no more than a written report. There are neither fines nor criminal charges to the offending LTCs. As a result, some LTCs operate in total contempt of the Long-Term Care Homes Act (LTCHA) that is supposed to govern them.
My experience in dealing with MOH inspectors for LTCs is horrific. I augmented one complaint (of many) with a video from a hidden camera showing my mother-in-law being mistreated. A guideline for such video evidence is that the perpetrator of the mistreatment must admit that it is herself/himself in the video. Thus, the perpetrator was exonerated by saying “that is not me”. So much for zero-tolerance! This LTC then attempted to have me arrested by claiming that my video was illegal – the police determined it was not. Then this LTC went to the privacy commission – who found no violations of privacy. During this, the LTC’s lawyer sent several ‘nastygrams’. So much for the ‘whistle blower’ protection provision of the LTCHA!
My mom-in-law has been totally incapacitated by a stroke; she can neither move nor communicate. Thus, she is an easy target for the LTC where she is a patient. She cannot communicate when she has been abused, mistreated, and neglected. As a result, they frequently neither feed her, bath her, nor change her adult-diaper in a timely manner. This LTC frequently sites that they do not have the labour to do this. Thus, they “cut corners” from their legal compliance to reduce their expenses in the hopes that no one notices. You can appreciate that the LTC’s customers do not necessarily get value for their money. “Customers” include all Ontario taxpayers (who pay $4.2 billion a year for LTC) as well as the direct payments by Ontario’s 70,000 LTC patients and their families.
You must have encountered this phenomenon in transitioning from being a successful businessman to becoming a successful politician. That is, you encountered civil-service bureaucrats, at the city of Toronto and the government of Ontario, who have no idea what they are doing but are strangely adept in covering their tracks. This is the type of LTC management and labour that the current system is producing and supporting.
For many candidates to be LTC patients, there is simply no choice. One is deemed admissible to a LTC when one is physically unable to look after oneself. The offer by the MOH for a bed in an LTC facility cannot be denied by most.
In contrast, my own mother was in a LTC for the last decade of her life where I visited her every day. The quality of care she received was excellent; I could not find a single fault. When I commended the facility manager on this, she pointed out that providing quality care was simply the most cost-effective way for a LTC to operate.
Therefore, Ontario had two-tiered LTCs;
- The good-operators who provide excellent care and service through adherence to the LTCHA through sound management and quality control principles
- The bad-operators who provide a low to abysmal levels of care through poor management and/or who ignore the LTCHA
As there is a bed shortage amongst LTCs, the admission system is geared around the urgency of admitting the neediest. A transfer of an existing LTC patient is, understandably, a low priority. Therefore, patients that end up in a LTC that provides abysmal care and has contempt of the law are trapped there. As there is no way for the consumer to gauge the quality of an LTC, such a transfer could be to an even worse LTC – ‘out of the frying pan and into the fire’.
The entire procedure to report problems is broken. The MOH requires the following procedure;
- Report a problem to the facility manager. My experience is that the facility manager feigns concern, says he/she will fix the problem, and then does nothing and/or tries to camouflage the problem’s visible signs
- The LTC submits a critical incident report to the MOH. My experience is that the LTC will, at best, not do this. At worst, the LTC says the will do so and then does not. This keeps the offending LTC ‘off the radar’ of the MOH and any prospective patients who look up this information
- To contact the MoH directly – a message is left and MONTHS later, an inspector calls
- The MOH does an onsite inspection MONTHS after #3
- A report is written MONTHS after #4 – by this time there is a staff turn-over of front-line workers and management
It is no surprise that the same bad-operator LTCs keep getting ‘written up’ for the same issues repeatedly. They have absolutely no incentive to change.
What is desperately needed to remedy this situation is;
- Standards of service for timelines must be established and enforced. From the time a complaint is reported to the time it is responded to, investigated, and charges are laid.
- The MOH LTC call in hot-line must be live answered 24/7 (or else be re-named)
- When the hot-line receives a call that is a criminal offense (instead of or in addition to being a LTCHA offence), the MOH hot-line operator has a duty to notify police immediately.
- Financial penalties to LTC operators who do not comply with the LTCHA. (This was recommended by the Auditor General in her 2015 annual report.)
- More frequent use of the offending LTCs management being replaced by a MoH designate
- The self-regulating paradigm of the LTCHA does not work for LTCs who have contempt of the law
This is a safe political issue. The optics are you and the PC government making Ontario safer for one of the population’s most vulnerable population segments while getting better value for the taxpayer by fixing another problem you inherited from the previous government while paving the way to make public-private sector endevours more effective.