SGAP is concerned by the Ontario government’s proposal to restrict public on-line access to long-term care (LTC) home inspection reports to three years. These reports are important to hold nursing homes accountable to the public. The Ontario government’s rationale for this makes no sense.
The proposal was part of a bill tabled last week by the Minister of Red Tape Reduction, Andrea Khanjin. By definition “red tape” is a process that is excessively slow and/or expensive because of unnecessary bureaucracy. Yet, limiting the duration that these reports are online does nothing to reduce red tape.
To add insult to injury, Ontario government spokesperson, Mark Nesbitt, wrote in an email “By setting a three-year publication period for reports, the government is ensuring the public has access to relevant and accurate information that reflects each long-term care home’s current performance.” Does the Ontario government actually think the people cannot look at a publication date and determine relevance themselves?
The final kicker in that the Ontario government will make reports older than three years available to the public “upon request”. Currently, if you want to see a four-year-old or a 14 year-old inspection report for an Ontario nursing home, you can look that up in seconds on an online web site. If this bill becomes legislation, the requests for these older reports will be slower and more expensive because the “upon request” will be handled by an unnecessary bureaucracy. Ironically, the Protect Ontario by Cutting Red Tape bill is creating … more red-tape and less protection for Ontarians in nursing homes.
The only benefactor to this three-year limitation is the nursing homes with something to hide – nursing homes that the Ontario government’s own inspectors found serious problems with. Why is the Ontario government assisting such nursing homes with their cover-up? The government’s duty is to enforce their Long-Term Homes Care Act which should provide a standard of care to patients in LTCs and value to Ontario taxpayers who subsidize this cost.
SGAP is concerned by the Ontario government’s proposal to restrict public on-line access to long-term care (LTC) home inspection reports to three years. These reports are important to hold nursing homes accountable to the public. The Ontario government’s rationale for this makes no sense.
The proposal was part of a bill tabled last week by the Minister of Red Tape Reduction, Andrea Khanjin. By definition “red tape” is a process that is excessively slow and/or expensive because of unnecessary bureaucracy. Yet, limiting the duration that these reports are online does nothing to reduce red tape.
To add insult to injury, Ontario government spokesperson, Mark Nesbitt, wrote in an email “By setting a three-year publication period for reports, the government is ensuring the public has access to relevant and accurate information that reflects each long-term care home’s current performance.” Does the Ontario government actually think the people cannot look at a publication date and determine relevance themselves?
The final kicker in that the Ontario government will make reports older than three years available to the public “upon request”. Currently, if you want to see a four-year-old or a 14 year-old inspection report for an Ontario nursing home, you can look that up in seconds on an online web site. If this bill becomes legislation, the requests for these older reports will be slower and more expensive because the “upon request” will be handled by an unnecessary bureaucracy. Ironically, the Protect Ontario by Cutting Red Tape bill is creating … more red-tape and less protection for Ontarians in nursing homes.
The only benefactor to this three-year limitation is the nursing homes with something to hide – nursing homes that the Ontario government’s own inspectors found serious problems with. Why is the Ontario government assisting such nursing homes with their cover-up? The government’s duty is to enforce their Long-Term Homes Care Act which should provide a standard of care to patients in LTCs and value to Ontario taxpayers who subsidize this cost.
Senior’s Guardian Angels is extremely disappointed and concerned by Ontario’s Progressive Conservative government’s Bill 7 legislation passed yesterday. This legislation will force hospital patients into long-term care facilities (nursing homes) not of their choosing. This new legislation presents three serious problems.
First, the Ontario government is implying that this legislation will coerce patients by charging them a fee. It is concerning that the government will not specify what the consequences for non-compliance will be.
Second, the current waiting list in Ontario to get into long-term care is tens of thousands of elderlies and disabled who cannot look after themselves. This waiting list will only grow as the eldest of the baby-boomers now reach the geriatric age.
When a bed opens up in a long-term care facility, the Ontario government will prioritize getting a patient out of a hospital bed, which is more expensive for them, into a long-term care bed, which is a lower cost for the Ontario government. Once the government opens this pandora’s box, it will be unclosable. Hospital discharges will take priority over existing waiting-lists and hospital patients will disperse the elderly and disabled at long-term care facilities.
Third there is a correlation between the quality of care at nursing homes and the length of their waiting lists. Nursing homes that chronically have empty beds available tend to have earned their bad reputations though abysmal lack of quality. The Ontario government is responsible for monitoring and regulating long-term care quality, or lack thereof. It is reprehensible for the Ontario government to attempt to fill such beds by coercing patients into bad quality nursing homes. As the Ontario government both financially supports and regulates long term care facilities, they should simply enforce their own regulations – the Long-Term Care Homes Act. This will fix bad quality nursing homes at no additional cost to the Ontario taxpayers.
While Seniors Guardian Angels was glad to see Ontario Long-term Care minister Merrillee Fullerton questioned by the LTC committee, we were disappointed by the implausibility of her answers. We thanks Sue-Ann Levy for this excellent article!
LEVY: LTC Minister grilled by commission following COVID deaths of 3,700 seniors
Although she was aware last February that personal support workers working in more than one location might spread the virulent COVID virus, Long-Term Care Minister Merrilee Fullerton says her ministry didn’t act right away over fears any action “would tip some homes into staffing collapse.”
Instead, it took from March 22 — when it really became apparent that part-time workers could and were taking the virus from home to home — to April 26 to mandate that personal support workers (PSWs) only attend one home, the LTC Commission heard late last week.
“Our problem at the time was the issue surrounding the precariousness of our staffing,” said Fullerton, who was surrounded by 13 government and outside counsel as she answered, often deferring to Deputy Minister Richard Steele, a career civil servant.
During five hours of often intense questioning, it quickly became apparent that the minister — a family physician — was in way over her head during COVID’s first and second waves.
It seems she didn’t trust her own medical instincts and didn’t speak up when she sensed illogical decisions were being made, often “putting a lot of priority” on listening to the experts, the province’s medical officer of health, and other advisors for guidance.
“I was concerned about asymptomatic spread by Feb. 5 (2020) and concerned about the vulnerability of long-term care residents while public health experts said the risk was low,” she said. “I did not want to overstep even though I’m a family doctor.”
While her testimony seemed to suggest that she truly cares about the crisis in LTC, she spent much of her time excusing the decisions made that cost the lives of more than 3,700 seniors to date.
She suggested, when questioned repeatedly about sick PSWs coming into homes for weeks on end, that “staff were bringing it (COVID) in unknowingly” from the community — even though there was anecdotal evidence from the first wave that some PSWs felt obliged to work while sick.
“Back in those days at the end of March there was so much going on,” added Fullerton. “We were working furiously… things were moving so rapidly.”
This caused commission co-lead counsel John Callaghan to become impatient with the waffling.
“You considered it … considered it … considered it and changed only at the very last minute on April 22 after so many people had been infected and died,” he said.
Fullerton repeatedly blamed the complex system and the newness of the LTC ministry — formed in 2019 after being separated from the health ministry — which was shown to be mired in red tape, inconsistent in its communications, and as slow-moving as a giant turtle even in the depths of the crisis.
Fullerton said she wasn’t aware the LTC ministry had a pandemic plan and there was lots to be done at the outset with only 611 new beds built since 2011 (during the years of a Liberal government) plus a staffing crisis.
We heard that in the midst of the uncontrolled outbreak at Orchard Villa, the local medical officer of health had to step in and arrange for hospital assistance because there was “no plan” from the ministry.
It also took 11 days to get the military into hard-hit Orchard Villa after she identified a need.
Last May, she said her belief that there was a role for essential family caregivers was nixed by Williams and other public health experts for fear of community spread.
Fullerton dismissed the idea that regular inspections of LTC homes would have prevented outbreaks, insisting the inspection system needs to be changed.
Perhaps proving that she had no clue about why the inspection process is such a mess, she told commissioners that inspectors sometimes issued compliance orders for residents being “served their dessert before dinner”– when maybe in a person’s last year of life they want dessert first.
“The compliance structure needs to be more meaningful… inspectors can support our homes so problems … are not going to get shoved under the rug,” she said.
Inspectors have repeatedly raised issues of neglect, negligence and abuse in homes.
Repeatedly, there is no follow-up and no enforcement.
Fullerton should know that.
SGAP was appalled to find out that the Ontario government has funded $41 million for the nursing homes in Ontario to have security guards at their entrances
The government’s claim is that the guards will be there to provide “third party oversight” is to ensure that visitors entering homes adhere to screening a testing requirements. Really?! Third party security guards are contracted by an organization to keep people out. The Government of Ontario has leveraged covid to “raise the bar” on the requirements to visiting residents in nursing homes to a nearly impossible level to meet. Conversely, the standard for nursing home staff to enter is much lower. The only logical explanation is the purpose of these measures is to deliberately keep visitors out of nursing homes so that they will not see and report problems to authorities and news media.
This is very disturbing based on the horrific problems that were exemplified by the Canadian Military report last summer.
Residents in Ontario nursing homes are now in a state of “house arrest” in a legal and practical sense. The only thing missing are the guards, which arrive next month. To keep Canadians imprisoned in their own homes (their legal residences) under such conditions is a violation of the Charter Of Rights And Freedoms in the Canadian Constitution!
Last week, the Ford government released a memorandum to nursing homes in Ontario titles “Enhancing the Protection for LTC-Homes” ( https://fco.ngo/files/Memorandum-Enhaning-the-Protection-for-LTC-Homes-February-4.pdf ) It leaves these basic questions unanswered;
- Why are nursing home staff (who interact with many residents) covid tested WEEKLY while a visitor (who only interacts with one resident) is tested DAILY? **
- Why are nursing home staff able to start interacting with many residents as soon as they arrive for work. That is, BEFORE the results of their covid tests are determined? *
- Why must a nursing home visitor, who only interacts with one resident, wait outside of the building for his/her covid test result to be determined? *
- Why does the timeline for adopting Rapid Antigen testing have visitors starting three weeks before nursing home staff? (p.4)
* “For staff, … Antigen Tests should be performed as soon as practically possible once a shift has started. … For …visitors… , the Antigen Test should be performed before contact with residents.” (p. 1)
** ” Staff … who enter LTC homes two or more days in a 7-day period undergo Antigen Tests on non-consecutive days up to 3 times in the period … visitors undergo an Antigen Test on the “day of” regardless of how many times they attend to a home (p.2 )
John & Betty talk about current issues in nursing homes with Kathleen & Peter on their podcast “The Yakking Show”.
This was a letter to the editor of the Globe & Mail in regards to their stories on long-term care published on 21 Nov 2020 and linked below;
***
Your cover-stories on long-term care on Sat 21 Nov are so one-sided that they are propaganda! The story “No One Should Die Alone”, failed to mention that the government of Ontario relieved the Forest Heights nursing home (FHNH) management of their duty two months after the outbreak of covid as there were 51 deaths; 21% of this 236-bed facility. This begs the question, how many of these 51 deaths were a symptom of the greater problem of the FHNH management not being able to or not wanting to look after their patients?
I examined the reports of the inspections conducted by the government of Ontario at FHNH. Some of the serious problems that have been re-occurring there since 2014 include issues around falls prevention, skin and wound care practices, failure to protect residents from harm, failure to update care plans, failure to do proper assessments on admission. ( https://publicreporting.ltchomes.net/en-ca/homeprofile.aspx?Home=2707&tab=1 ) Most of the non-compliances are Written Notifications and Voluntary Plans of Correction that never get followed up on.
In the companions nursing home story ( “In COVID-19′s second wave, Canada’s long-term care homes aim for a better balance of safety and community”), there seems to be a horrific underlying theme to this article that nursing home residents’ visits from loved ones are going to be replaced by iPads and staff who do not have time to feed them much less provide companionship.
Yours Truly;
John Vice
Media Relations
Seniors Guardian Angels Program
Headlines this month stated that Doug Ford’s Ontario provincial government is acting on one of the key recommendations of Ontario’s Long-Term Care COVID-19 Commission — a mandated four hours of daily care per patient. SGAP was initially thrilled by this news as we have been advocating this for at least a decade.
However, the Ford government’s timeline for implementing this is 2024-2025 – well after the next Ontario provincial election in 2022. The Ford government is abandoning the long-term care crisis for the next provincial government to deal with.
This has been SGAP’s experience with the Ford government from the beginning. Before the Ford government took office, every minister responsible for long-term care in Ontario for the last two decades met with SGAP to hear our concerns. Conversely, the two ministers in the Ford government responsible for long-term care (Merilee Fullerton and Christine Elliott) have ignored all communication from SGAP. As they did not want to hear what the problems are, it is no surprise to us that they will not fix them.
In contrast, SGAP, was grateful to receive an unsolicited invitation to meet with Teresa Armstrong, MPP, the NDP LTC critic. We commend the NDP in their role as official opposition to hold the Ford government accountable for their mishandling of long-term care in Ontario.
(L-R) Teresa Armstrong, MPP-NDP, Crtitic for LTC, meets with John and Betty from the SGAP
The Government Of Ontario has the gall to state in their legal defense that they do not take responsibility for the province’s long-term care system. (“Ontario government does not guarantee the health or safety of residents in long-term care homes, legal document says” – Tuesday, September 1, 2020
The Government Of Ontario’s authority is evidenced by their own legislation – the Long-Term Care Homes Act (LTCHA). It is also evidenced by their process of taking complaints of LTCHA violations, inspecting them, and “enforcing” them. (I put “enforcement” in quotes because the Government Of Ontario does no more than write written reprimands that nursing homes ignore.)
The Government Of Ontario will neither enforce the LTCHA nor take responsibility for nursing homes being under their regulation. Law suits against nursing homes and the Government Of Ontario, like Koskie Minsky’s class-action, are the only way to force responsibility on those with authority.
SGAP is extremely disappointed that the Ontario government is not doing a
full and independent public inquiry into the handling of the covid crisis at
Ontario nursing homes. The sheer number of deaths in Ontario nursing homes
– over 1,700 should, in and of itself, merit an independent public inquiry.
This number of deaths is augmented by the concentration-camp conditions that
the Canadian Armed Forces encountered when they were deployed in six nursing
homes. Under such circumstances, the scope of the private inquiry is too
limited in for the gravity of this problem. We can only conclude from this
that the ford government has no interest in knowing the complete nature of
the nursing home problem much less implementing a solution.