Senior care homes, COVID-19: death and working conditions

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NDPP

'Now it's Happening Again...' (and vid)

https://twitter.com/AndreaHorwath/status/1328443611365707782

"During the first wave, Mr Ford promised an 'iron ring' around ltc homes. Instead he refused to spend the money to hire more PSWs to protect seniors, leaving thousands of families devastated. Now it's happening again and Mr Ford is gambling with people's lives."

And losing heavily.

[email protected]

NDPP

- 109 COVID-19 LTC outbreaks in Ontario

-   700 residents infected

-  11 new deaths

jerrym

Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO) says the Ontario Ford government is not doing enough to stop the large number of deaths in long term care homes. 

The Ontario government is failing to prevent deaths of vulnerable people in long-term care homes and needs to tighten restrictions in red-control zones now, says the head of a group that represents registered nurses.

Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO), called on the government to lock down the province immediately in the wake of seven deaths at a long-term care home in Scarborough.

"I have never seen such disregard for the lives of residents and their staff in long-term care, and by extension, the lives of families left in anguish," Grinspun said on Sunday.

Sienna Senior Living reported on Saturday that seven residents at Rockcliffe Care Community have died since a COVID-19 outbreak was declared at the home on Nov. 2. More than half of the residents at the home have become infected with the novel coronavirus.

A total of 136 residents and 66 staff members have tested positive for the virus. One resident case has been marked as resolved. Nineteen staff members have been cleared to return to work. The home, which has 204 beds, currently has 165 residents. ...

Grinspun was particularly critical of Merrilee Fullerton, minister of long-term care, saying Fullerton "ought to have known" that COVID-19 would begin to kill vulnerable people in long-term care homes during its second wave given that restrictions are not strict enough. Fullerton used to be a practising doctor.  "For most people, this is unbelievable. We predicted this scenario. The minister ought to have known that things would be this bad or worse going forward," Grinspun said on Sunday. "No one in government — the public, yes, but in government, no — should be surprised. We will see more outbreaks. We will see more tragedy," she added. ...

Grinspun said the association called on the government on Friday to implement an immediate 28-day lockdown of red-control zones in Ontario, with the exception of essential services and schools. The association also asked the government to make investments in staffing of registered nurses, nurse practitioners, registered practical nurses and personal support workers in all homes across Ontario. And it wants the government to keep "essential care partners" in the homes and to prevent crowding in homes where a number of people share one room.

"We are not acting soon enough," she said. "It's all empty words." Grinspun said if young men were dying, instead of elderly people, there would be protests in the streets — "no one would do that to them" — and the failure to act is clearly discrimination against older people. "It is ageism of major catastrophic proportions," she said.

https://www.cbc.ca/news/canada/toronto/rockcliffe-care-community-reactio...

jerrym

The Ontario NDP released a plan in October to move all long-term care facilities into the public sector following the disastrous performance of private sector LTC homes during Covid-19.

The Ontario New Democratic Party revealed an eight-year plan Friday to create a new long-term care system in the province — including transitioning all facilities to a public model, adding tens of thousands of new spaces for the elderly and eliminating the waiting list for long-term care if the party is elected in 2022. 

"The COVID-19 pandemic revealed a disaster hiding behind the walls of Ontario's long-term care homes," said NDP Leader Andrea Horwath in a news release. 

"We have to take action now to make sure people are safe in nursing homes and during home-care visits throughout the second wave," she said. 

The New Democrats released their plan one day after the office of the provincial Patient Ombudsman published a report that found complaints about long-term care homes increased over 370 per cent from March 1 to June 30 as the pandemic began sweeping through care facilities. As of Wednesday, the province was reporting that 1,952 residents in long-term care have died due to COVID-19, making up 65 per cent of COVID-19 deaths in Ontario. 

Cramped quarters and the neglect of residents, coupled with underpaid staff who sometimes worked at multiple homes were issues exacerbated by the pandemic and led to the death toll in long-term care facilities, experts told CBC News.   ...

The NDP says its plan will cost $750 million in capital investments per year over eight years starting in 2022 if the party comes to power, plus $3 billion in annual operating costs. It includes:

  • Overhauling home care to help people live at home longer.
  • Funding for more and better-paid full-time positions for personal support workers.
  • Funding for "culturally relevant care."
  • The creation of 50,000 new long-term care spaces for the elderly.
  • The eventual conversion of the long-term care sector to public ownership.

On Oct 1., the Ford government announced it would invest $461 million to temporarily raise hourly wages for close to 150,000 personal support workers.

But Horwath has been critical of Ford's decisions around long-term care throughout the pandemic, and the NDP's report claims Ford should have made changes more quickly to protect residents and staff working in the homes. ...

Horwath says an NDP government would build not-for-profit facilities that are "home-like" settings rather than "impersonal, institutional-like" care homes, and implement new standards to ensure new homes are built under the new model, while older homes are phased out. 

Along with those changes, Horwath says the NDP is "committed to creating full-time and well-paid jobs for personal support workers" to increase staff retention and make it a career more people consider.

Horwath is also committing to creating "culturally-responsive" care to make seniors feel "included" in homes regardless of background. 

https://www.cbc.ca/news/canada/toronto/ontario-ndp-plan-changes-to-long-...

jerrym

Another series of disasters in private sector long term care homes in Toronto: 

- Nearly half of all residents at a city-run long-term care home downtown have been infected with COVID-19 since a outbreak was declared at the facility last month.

The city has confirmed to CP24 that there have been 112 positive cases among residents at the 250-bed Fudger House since Oct. 2.

So far 74 of those residents have recovered from the virus and nine have died. The remaining 29 cases are still considered active. ...

The news of the dozens of positive cases at Fudger House comes as officials in Mississauga express concerns about another outbreak at a long-term care home in that facility.

There are now 90 positive cases among residents at the 151-bed Tyndall Nursing Home and another 65 among staff. “While our outbreak response team is working tirelessly with them to address infection control and outbreak interventions to bring this under control this is a dangerous sign,” Peel’s Medical Officer of Health Dr. Lawrence Loh said during a briefing, noting that it is the largest outbreak in any long-term care home in the region since the first wave of the pandemic.

There are currently 96 active outbreaks at Ontario long-term care homes.

The outbreak at Fudger House is among the biggest in Toronto but is not quite on the same scale as one at Rockcliffe Care Community in Scarborough, where 135 residents and 63 staff have tested positive.

https://toronto.ctvnews.ca/nearly-half-of-all-residents-at-toronto-long-...

 

NDPP

Blueprint for fixing our disastrous long-term care system

https://rabble.ca/news/2020/11/blueprint-fixing-our-disastrous-long-term...

"The COVID-19 crisis has exposed catastrophic weakness in Canada's patchwork system for housing and caring for the elderly and disabled. In this country, a huge proportion of the destruction the pandemic has wrought - the disease and death - has occurred in long term care facilities. Canada's record in this regard is one of the worst in the world..."

Time to make a big noise and demand  the lethal ltc system is fixed by the politicians that represent you baby boomers, before you find yourself crushed like so many others before in its deadly grip.

jerrym

The infection and death toll keeps mounting in long term care homes. Some people want to see rapid testing used to identify hot spots and possibly reduce the number of LTC home infections and deaths, but others note that it is not a panacea. 

 COVID-19 continues to devastate care homes in B.C., particularly in the Fraser Health region where there are currently four large outbreaks in seniors’ facilities.

In addition to Tabor Home in Abbotsford, where 16 residents have died and 136 residents and staff have tested positive, there are also large outbreaks at Fellburn Care Centre, Finnish Manor and White Rock Seniors Village.

According to Dr. Elizabeth Brodkin, the chief medical health officer for the region, 83 residents and staff have contracted the virus at Fellburn in Burnaby, and seven people have died. At Finish Manor, there have been 58 cases and seven deaths. White Rock Seniors Village has had three people die and a total of 50 people infected.

“It’s retraumatizing. It’s so sad to hear that so many of my colleagues are going through this. And the severity of some of these outbreaks, it’s heartbreaking, and I know what they’re gong through,” said Debra Hauptman. She runs Langley Lodge, which lost 26 residents to COVID-19 in the deadliest care home outbreak B.C. has seen. Hauptman wants Langley Lodge to be part of a pilot project to bring rapid testing to B.C. care homes. “It’s extremely critical that we have this option. We’re asking please, let us try it,” she said.

The pilot project is being proposed by the BC Care Providers Association, which wants to see how effective testing is at keeping the virus out of care homes.

“That way, not only can we ensure we don’t have these outbreaks affecting residents and staff, but we might be able to reunite families, especially as we approach Christmas. Because it’s been heartbreaking to see the separation of families,” said Terry Lake, CEO of the BCCPA. “I think if we had done more work sooner, we’d be in a better place today,” he added.

His association wants to partner with one of the health authorities for the pilot project, but says his organization will forge ahead on its own if necessary. Proactive testing is already being done in some care facilities in Ontario. Manitoba is also working on a plan. Lake said the testing in a pilot project would likely be done three times a week. ...

The chief medical health officer for Fraser Health said rapid testing in care homes is under consideration, but she has reservations. “It is not a perfect answer because it is only a point in time. So if you test someone on Monday and it’s negative, it tells you they don’t have virus on Monday but it doesn’t tell you they won’t have virus on Tuesday or Wednesday,” said Dr. Brodkin. She also said there are concerns that staff could become too reliant on the test. “I know there is some concern if these were introduced in long-term care facilities, they might back off on some of the other things they are doing, which would be a big mistake,” she said.

https://bc.ctvnews.ca/push-for-rapid-testing-as-b-c-care-homes-battle-4-...

NDPP

Exclusive: 96% of Residents at Sunnywood LTC in Whitby have Tested Positive. 19 have died. 67 staff are positive. An inspection done less than 2 weeks ago found 'widespread failures' caused 'actual harm to residents.' No one was screened upon entry, PPE improperly used.

https://twitter.com/acelawyers/status/1336477780507316225

"These numbers are reprehensible, horrific, deplorable and blameworthy..."

[email protected]

NDPP

Ontario LTC Home Logs Zero Cases of COVID-19 in First and Second Wave of Pandemic

https://toronto.ctvnews.ca/ontario-long-term-care-home-logs-zero-cases-o...

"As long term care homes continue to grapple with the second wave of covid-19, The Mariann Home in Richmond Hill, Ont has so far weathered the pandemic without a single case of covid-19, which families and staff attribute to a number of safety measures taken earlier this year..."

Why aren't similar measures taken elsewhere?

NDPP

Two Ontario LTC Operators Got $157 M in COVID-19 Aid. They Also Paid $74 M to Shareholders

https://www.cbc.ca/news/canada/toronto/big-spend-long-term-care-aid-divi...

"Two of the largest long-term care providers in the Toronto area have received more than $157 million in federal and provincial COVID-19 relief while also paying out tens of millions of dollars in dividends to their shareholders. Extendicare Inc and Sienna Senior Living Inc have paid a combined total of $74 million in dividends this year. Meanwhile, more than 480 residents and staff have died of COVID-19 at the companies' care homes in Ontario."

Obviously richly deserved. Think of all the pension money saved. Most Ontarians will tsk tsk a little, avert their eyes and just be glad it's not them inside these for profit death-houses for the aged. As a result, nothing will change. Why would it? This is Canada...

 

NDPP

Former Ontario premier Mike Harris is raking in profits from the long-term [couldn't care less] system he helped create

https://rabble.ca/blogs/bloggers/council-canadians-blog/2020/06/former-o...

"Flash forward 25 years, as successive Conservative and Liberal governments continue this privatization trend...'

No wonder Doug  won't fix it...

[email protected]

NDPP

The Invisible People of Society (radio)

https://www.cbc.ca/radio/ideas/ideas-2021-our-annual-new-year-s-levee-1....

"IDEAS contributor Mary Lynk's documentary focuses on elderly people's place in the common good, as she describes them as often being 'the invisible people of society.' 'A friend of mine said to me when I was telling her I was working on this piece, 'everybody wants to get old but nobody wants to be old. And that what we dread about age is ageism. And ageism is huge in Western culture.' Lynk's documentary was inspired by her 94-year-old father who now lives with her."

Especially in Canada. It's probably why we accept the horrendous conditions in the ltc 'killing fields' with such relative equanimity.

Aristotleded24

Another home being protested:

Quote:

Scores of people protested outside a Scarborough long-term care home on Saturday to draw attention to conditions inside the facility where 60 residents have died of COVID-19.

Tendercare Living Centre, 1020 McNicoll Ave., has lost 60 residents to the novel coronavirus as of Saturday, according to North York General Hospital (NYGH). The provincial government asked NYGH on Dec. 25 to help the home manage its COVID-19 outbreak for 90 days.

Maureen McDermott, a protester whose mother is in River Glen Haven Nursing Home in Sutton, Ont., wondered aloud at the rally how many people have to die before Ontario Premier Doug Ford and Long-Term Care Minister Merrilee Fullerton bring in the Canadian Armed Forces.

"What's that number going to look like tomorrow and the next day? This is disgusting," McDermott told the gathering,

"My mother resides in long-term care and putting her into long-term care was the worst day of my life, handing that over. But I had to have faith. And I did have faith. Then COVID-19 happened," she said.

NDPP

There is no excuse for the suffering and death happening again in Ontario's long-term care

https://www.theglobeandmail.com/opinion/article-there-is-no-excuse-for-t...

"Ontario Premier Doug Ford promised to 'move heaven and earth' to protect seniors in long-term care. It would be too grandiose to say he has failed. More accurately, it seems he didn't even try. Indeed, the same horrifying scenes of disorder and neglect are playing out in residential care homes across Ontario, where the government has undeniably failed to deliver on its promise to protect those most vulnerable to this disease. There is no excuse for this calamity..."

 

'Save our Seniors!': Death Toll at Scarborough LTC Home Climbs to 60 (and vid)

https://twitter.com/CP24/status/1345723462896250880

"...Carrying signs that read 'save our seniors' and 'care over profits', demonstrators said the pandemic has shown that private nursing homes focus on profits instead of providing care to residents. They also want the Ford government to revisit legislation that they say makes it harder to hold private operators liable..."

WTF Ontario?! There are currently 207 Ontario LTC homes in outbreak - the worst since the pandemic began. Doug Ford's promise to build an 'iron ring' of protection around vulnerable seniors in ltc homes has turned out to be the promise of an iron ring of death from which there is no escape. This is a monstrous official dereliction of duty at best and at worst criminal negligence and manslaughter. Why has this unacceptable situation not been rectified? Why no charges? How shameful also that more Ontarians have not demanded immediate necessary corrective action to this ongoing extermination of our ltch elders. Some have been forced to call 911 because they are not  even receiving regular meals. Yet wealthy corporate shareholders have been paid dividends and bonuses.

[email protected]

 

jerrym

Once again the Ford government is facing a crisis in the long-term care homes with the situation so bad that CUPE is pushing the government to send the military back into the long-term care homes. It also called the Ford government's attempts at reforms in LTC 'lethargic and inadequate. 

It’s time for the Ontario government to send the military into long-term-care homes, the Canadian Union of Public Employees says.

With growing COVID-19 outbreaks in the province’s care homes, “We are tragically losing the battle to protect long-term care residents,” CUPE Ontario secretary-treasurer Candace Rennick said in a news release Saturday. “The homes and staff are on the verge of total crisis and collapse.”

The union is joining the Ontario Health Coalition in asking the Ford government to send the military into the hardest hit homes, as it did during the first wave of the virus.

On Wednesday, coalition executive director Natalie Mehra said it was clear the measures the province had taken since the second wave of COVID hit Ontario were insufficient. “What we’re seeing is worse than anything I have ever seen in the homes,” she said.

As of Jan. 1, Public Health Ontario reported 2,814 COVID deaths among residents of long-term-care homes and 11,217 total confirmed cases of the virus.

In its release, CUPE said there were 187 homes in outbreak with 1,186 positive residents and 1,050 positive staff, although those figures are likely a day out of date.

In a statement Wednesday night, the province insisted it is doing all it can to stem the second wave.

CUPE said the PC government’s efforts to reform long-term care were “lethargic and inadequate.” And it also called military intervention “a temporary solution to the worsening crisis caused by the government’s failure to implement immediate and meaningful reforms needed months ago. This kind of crisis cannot continue to be met with half measures by the province.”

https://www.thestar.com/news/ontario/2021/01/02/send-in-the-military-pub...

Aristotleded24

Meanwhile in Regjna:

Quote:

The Saskatchewan government says it's aware of 65 deaths among long-term care or personal care home residents who were infected with COVID-19 since the pandemic arrived in the province last March.

One home run by a private company under a contract with the Saskatchewan Health Authority (SHA) has accounted for nearly two-thirds of those deaths.

In Saskatchewan, special care homes are statistically classified as long-term care homes. In some cases, special care homes are operated by a company that has a contract with the SHA, which inspects and monitors the homes. 

Extendicare's Parkside facility in Regina is one such care home.

As of Monday afternoon, 40 of Parkside's approximately 200 original inhabitants had died after becoming infected with COVID-19, including three who had been moved to a separate Regina seniors complex. The outbreak began in late November and has proved the most deadly in any Saskatchewan nursing home, although no new cases among residents were recorded as of late last week.

jerrym

In an interview on Power and Politics on January 4, 2021, Ontario NDP Opposition Leader Andrea Horwath discussed the utter failure of the Ford government to deal with Covid-19, where cases are skyrocketing, the disaster in LTC homes escalates, and a vaccination program that has the lowest vacination rate in the country is far from working well.

During the Power and Politics interview Horwath noted that over 200 long-term care (LTC) homes in Ontario have Covid outbreaks with 2,843 dead there already in these homes. Pointing out that there are reports of LTC residents begging for food and water to survive, in addition to the failure to get support in dealing with Covid, she demanded immediate action. Horwath sees the situation as so desperate that Ford needs to call in the Red Cross and  army to deal with the the long-term care problems. She also pushed for experts to be sent into each of the LTC homes to design Covid-19 containment plans to save as many residents as possible. Despite the enormous problems in the homes she pointed out that Ford has no plans to increase staffing in the homes until 2025. 

Many of the homes where things are completely out-of-hand are run by the private sector. Horwath earlier had called for making the private sector LTCs part of the public sector. "The Ontario New Democratic Party revealed an eight-year plan Friday to create a new long-term care system in the province — including transitioning all facilities to a public sector model". (https://www.cbc.ca/news/canada/toronto/ontario-ndp-plan-changes-to-long-...)  

Despite the Ford government getting 100 billion in funds from the federal government to deal with the problem that it has not utilized $12 billion according to the auditor general. "The Ontario government was sitting on $12 billion in COVID-19 contingency funding around the same time the second wave of COVID-19 began, the province’s financial watchdog said Tuesday." (https://toronto.ctvnews.ca/ontario-sitting-on-12b-in-unspent-covid-19-co...) It looks like the money it is not spending is going to be used to reduce the budget deficit so the Cons can proclaim they are great budget managers. How sick.

The video of Horwath's comments in the Power and Politics interview can be seen at the url below, starting at 19:35 minutes. 

https://gem.cbc.ca/media/power-politics/provincial-ministers-resign-foll...

jerrym

Even within the same senior care home, there is some questionable choices being made about who does and does not get a vaccination. 

Families have learned that where their loved ones live in the Copernicus Lodge seniors' home will determine whether or not they're eligible to receive the COVID-19 vaccine right now.

Residents in one of the home's senior apartment units, Tony Morawski, 101, and his 92-year-old wife, Jean, have lived at the facility for three years and have managed to fend off COVID-19 so far. 

Desperate to keep it that way, their family was holding out hope that they would be vaccinated as soon as possible in the home, located in the Roncesvalles neighbourhood in Toronto's west end.

But now they've learned those living in the home's apartment units will not get the shot at the same time as residents living in the long-term care facilities located in the same building. 

'Sitting ducks'

"We know that those residents are sitting ducks," said Dr. Samir Sinha, director of geriatrics at Mount Sinai Health told CBC News.

Copernicus Lodge, located in Toronto's Roncesvalles neighbourhood, offers a long-term care or nursing home setting along with senior apartments. The nursing-home side is facing an outbreak of the novel coronavirus, with 47 residents infected.

But senior apartments that share the same space as long-term care facilities often share staff as well, Sinha points out. Plus, many residents of those apartments, like Morawski and his wife, are at advanced ages, meaning they face a heightened threat of catching and dying of COVID-19.

"We have enough vaccine to get all these people done. Why we're actually picking and choosing and putting people at risk doesn't make any sense to me," Sinha said, adding it's unacceptable that those living in seniors' apartments are being forced to wait for the vaccine.

https://www.cbc.ca/news/canada/toronto/he-s-101-she-s-92-but-this-couple...

eastnoireast

i wonder how much money flowed out canadian for-profit ltc facilities since this all started,  how much flows out monthly. 

it should be garnesheed, retroactively, directly towards improving conditions.

even if it impacts investor confidence.

jerrym

In Ontario, the situation in long-term care homes is in full crisis as Ford admits his willingness to accept Trudeau's offer of military help and the PC government fails to offer a clear description of what its plan is. 

At a news conference Wednesday, Premier Doug Ford was asked about the "iron ring" the province had said it planned to secure around Ontario's long-term care homes. In response, Ford pleaded with front-line health-care workers to get tested for COVID-19.

"It's not coming in through the walls and the ceiling ... inadvertently though our great health-care workers, it's coming in," Ford said.

The premier also said at the news conference it's possible Canadian Forces soldiers will be called in again to help at some hard-hit homes, although he provided no specifics. 

However, a senior official in the Ford government later told CBC News that the province does not believe that any long-term care homes are currently in need of assistance from the military. The Red Cross is already assisting in homes, and no facilities have such a staffing crisis that military support is warranted at this time, said the official.

https://www.cbc.ca/news/canada/toronto/covid-19-ontario-january-13-2021-...

NDPP

Extendicare now hit with $200 million class-action lawsuit over ltc deaths

https://twitter.com/CP24/status/1349444212459233282

 

Hospital takes over management at Roncesvalles ltc home with COVID-19 outbreak

https://twitter.com/CP24/status/1349453707142979591

 

CBC: Ontario LTC Homes in Crisis

https://youtu.be/3RpdECwpVHg

"Rising LTC outbreaks in Ontario raise questions..."

jerrym

More evidence of the crisis created by private sector long-term care and the need for its removal during the Covid Crisis. 

The long-term care (LTC) home crisis in Ontario is a case study in the perils of treating healthcare as a vehicle for profit.

A recent report from the Canadian Medical Association (CMA) on the risks of COVID-related deaths in Ontario residences found significantly worse outcomes in for-profit and non-profit homes than in publicly run homes – outbreaks were far more likely in both for-profit and non-profit facilities and the death rate was nearly double that of the public sector.

As an overwhelming majority of Ontario’s 623 residences are run by chain companies –  57.7 per cent for profit, 26 per cent non-profit and 16.2 per cent municipal –  the necessity of including long-term care in a truly universal, publicly funded and accessible healthcare system has never been clearer.

Those in power have ignored strong criticisms of the living and labour conditions in Canada’s LTC system for decades. But the research is unambiguous: for-profit facilities offer comparatively substandard care. In fact, the CMA recommended a transition away from private facilities as far back as 1984. It should come as no surprise that LTC homes were woefully unprepared to survive the impact of the virus. ...

The poor living and labour conditions in LTC facilities have made them petri dishes for rapid contagion. Across Canada, 80 per cent of COVID-related fatalities have occurred in LTC facilities – double the average of other OECD countries. Ontario itself is struggling to cope with an embarrassing 70 per cent of its total deaths in LTCs. What’s worse, mismanagement and neglect within Ontario’s long-term residential homes are disturbingly widespread. Reports of LTC misconduct reveal that an alarming number of those who died from COVID-19 were already suffering in environments marred by gross indignity and, in some cases, abuse.

Military intervention during the first wave of the pandemic attracted significant media attention across Canada. The struggles of care workers and residents – long hidden from sight – finally came into public view. The military personnel sent to five homes in the Greater Toronto Area – four run by for-profit firms and one non-profit – were asked to compile an official report based on their observations.

The findings are as heartbreaking as they are horrifying. They include numerous instances of elder abuse, physical violence, forced feeding (“audible choking”) and a liberal use of chemical restraints. Staff were seen ripping out catheters, leaving wounds and infections untreated and using unsterile equipment. Residents often waited for assistance while in soiled diapers. ...

An investigation by the CBC revealed that 85 per cent of LTC homes in Ontario have routinely violated healthcare standards for decades with near-total impunity. One family featured in the investigation grew suspicious after witnessing a significant decline in their mother’s wellbeing shortly after moving into a private nursing home. They decided to hide a camera in her room. The footage has been described as akin to “watching a horror film.” ...

The LTC crisis is a result of decades of welfare-state retrenchment and the general weakness of Canada’s pension-plan model. In 1995, Ottawa dramatically overhauled the system of federal transfer payments to the provinces. These transfer payments had previously funded the bulk of Canadian healthcare, education and social services. Over the course of this transition, governments quietly cut billions of dollars from these essential programs. This downloading of costs from federal to provincial governments was a trend from the late 1980s to mid-90s as all levels of government moved toward fiscal conservatism and privatization.

With far fewer revenue-generating mechanisms for the provinces, the programs now faced significant funding challenges. Partnering with the private sector became an increasingly attractive proposition for cash-strapped local governments.

These revenue constraints contributed to the development of Ontario’s patchwork LTC system. The history of LTC in the province is one of path dependency and neglect. The core of the problem is that the present LTC system, as Richard O’Donnell, former president of the for-profit Ontario Nursing Home Association puts it, “was never planned; it has simply evolved.” ...

Because LTC facilities service an aging population – what’s known as a “guaranteed consumer-base” – they are understood to provide lucrative opportunities for private profiteering. The introduction of debt-financing for private operators has ensured corporate hegemony over LTC provision. And the entry of real-estate investment trusts (REITs) – companies that own or finance income-producing real estate assets – into LTC investment has accelerated the financialization of the sector. This, in turn, has attracted the interest of private equity firms.

Over the past two decades, REITs, international investors and private equity firms have acquired control of 17 per cent of all LTCs and 38 per cent of retirement homes across Canada. ...

Both the privatization and financialization of long-term care are consistent trends across Canada. But Ontario has the highest proportionof for-profit LTC homes in the country. Some scholars estimate that, compared to all other provincial healthcare systems, Ontario’s delivery and management of LTCs is Canada’s most commercialized area of healthcare “with the possible exception of pharmaceutical manufacturing.” Study after study finds that for-profit facilities offer lower quality carelower staffing levels and engage in egregious labour practices.

Despite lower death rates and flattening the curve far more effectively than the for-profit and non-profit sectors, inadequate funding from all levels of government has taken a toll on the public system as well. city-run facility in Ottawa recently made headlines for much the same reasons as private LTC homes: inadequate infection control, repeated medication errors, poor skin and wound care and accounts of abuse. ...

The overwhelming majority of expenditures for LTC homes are labour costs. Keeping these costs low is key if LTC businesses want to maintain their profits. According to the latest available data on staffing in Ontario’s LTCs, personal support workers (PSWs), registered nurses (RNs) and nurse practitioners (NPs) in for-profit homes are paid less than those in public ones. An overwhelming number of staff in private homes –­ 48 per cent of PSWs and 30 per cent of nurses – work part-time across multiple facilities and hold two or more jobs to stay afloat. Workers in public facilities have more job security, higher wages and dramatically higher rates of unionization compared to both the for-profit and non-profit sectors. ...

In its report, the Canadian military noted a “culture of fear” among exhausted and poorly paid workers who are afraid to speak out or question employer practices. ...

The absence of any political will to address long-standing issues of neglect in LTC facilities impacts residents and workers alike. The exploitative labour practices in most LTC facilities have taken a huge toll on a predominantly female and racialized workforce. ...

Ontario Premier Doug Ford has come to the swift defense of the for-profit LTC sector, introducing a bill to extend liability insurance to businesses, workers and non-profits. The government has given assurance that the law will not absolve healthcare providers of responsibility in the face of “gross negligence.” But personal injury lawyers and the New Democratic Party have slammed the bill as dangerous on the grounds that it will make the definition of “negligence” open to debate.

https://healthydebate.ca/opinions/crisis-privatized-care-in-ontario

jerrym

Linda McQuaig has also provided more evidence for the failure of private sector long term care during the Covid crisis, discussing how evidence financialized firms in charge of LTC homes do an even worse job than other private sector firms, which, in turn, do worse than non-profit and public sector LTC homes. 

When it became clear last fall that Ontario's long-term care (LTC) homes were about to be engulfed by the second wave of the pandemic, the Ford government swung into action.

Wasting no time, it promptly introduced legislation -- legislation that gave the corporate owners of long-term care homes extra protection from lawsuits that were accumulating against them.

Tragically, the province has shown no such speed or dedication to the task of providing extra protection -- or much protection at all -- to the elderly people who live in these homes and who, unlike the corporate owners, really are helpless to defend themselves.

It's striking that Premier Doug Ford has given priority to the interests of these corporate owners even as the coronavirus has swept through LTC homes, turning them into gruesome death traps and claiming the lives of almost 3,000 residents.

Investigations, including those done by Toronto Star reporters, have found that the coronavirus death rate has been significantly higher in for-profit homes than in not-for-profit homes.

Dramatic as this finding is, it may only hint at the extent of the problem resulting from allowing the for-profit sector to operate in the long-term care industry.

Indeed, the greatest danger may be posed by the emergence in the industry of "financialized" enterprises -- firms that operate according to a more bare-knuckle type of capitalism, associated with the financial industry, that focuses relentlessly on cost-cutting to drive ever-higher profit margins.

These financialized firms -- which include private equity funds and real estate investment trusts (REIT) -- have become a major presence in the seniors housing industry. They operate large chains and now control just over 30 per cent of government-funded LTC homes in Ontario.

Perhaps not surprisingly, LTC homes controlled by these financialized firms have experienced even higher coronavirus death rates than LTC homes controlled by other for-profit operators, according to Martine August, assistant professor at the University of Waterloo's School of Planning.

So if there are concerns about permitting profit-making in homes caring for the elderly -- and there should be -- these financialized firms should be particularly setting off alarms.

The financialized firms are "like private ownership on steroids," August says.

One concern is the impact on labour, the biggest cost driver in LTC homes. Unions representing LTC workers charge that for-profit homes generally pay very low wages and offer mostly part-time and casual work -- reducing the chance of meaningful relationships developing between staff and residents.

As for financialized LTCs specifically, there's little Canadian research but international studies show they tend to have fewer staff hours and lower-quality care, allowing them to increase shareholder dividends and raise executive pay, says August.

All this cries out for more public ownership and control over long-term care homes.

But, in recent decades, Ontario has gone in the opposite direction, encouraging private ownership in the industry. Roughly 57 per cent of the province's LTCs are now privately owned, with two U.S.-based REITs, Ventas and Welltower, among the biggest players in the industry.

The move toward privatization got started under then-Conservative premier Mike Harris, whose government made long-term care more attractive to private business by removing minimum staffing levels in the homes, making them ripe for profit-making. ...

From his vantage point as premier, with projections showing a coming explosion in the demand for seniors housing, Harris had little trouble spotting the lucrative potential for financialized firms in the industry. After retiring as premier in 2002, he quickly became chairman of a newly formed REIT called Chartwell Retirement Residences, which operates both publicly funded LTC homes and privately paid retirement homes. Over the past decade, Chartwell has distributed $798 million to shareholders and paid its executives $47.3 million, including an annual salary of $229,500 for the former premier's part-time chairmanship, which he still holds.

Mike Harris' involvement in the dubious rise of privatization -- and financialization -- in the long-term care industry makes it all the more outrageous that the Ford government recently awarded him the Order of Ontario, even as the pandemic continues its relentless slaughter of helpless LTC residents.

https://rabble.ca/columnists/2021/01/rise-private-ownership-steroids-fue...

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