In Ontario, over half of COVID-19 related deaths have been linked to long term care homes (nursing homes), which disproportionately impacts elderly Canadians, who are one of the most vulnerable groups in our society. Seniors who are receiving long term care usually have cognitive and physical impairments, as well as chronic health conditions that have affected their ability to be independent, while making them more susceptible to contagious diseases. Approximately 30% of seniors aged 85 years and older are living in long term care facilities, due to the need for comprehensive care that cannot be met at home or in the community.
The ownership of long term care homes are divided between a variety of actors, being for profits as the primary provider, followed by non-profits and municipalities, though they all receive funding from the Ontario government. All operators of long term care homes are regulated by the Ontario government, where they are mandated to meet the guidelines stipulated in the Long Term Care Homes Act, 2007. Long term care homes can be liable for negligence in relation to the care of their residents during the COVID-19 pandemic, as they owe a duty to exercise reasonable care with the hiring and supervision of employees, ensuring that conditions in the nursing home are safe, and not presenting conditions that create an unreasonable risk of harm.
The sustained underfunding and understaffing of long term care homes has contributed to widespread infections within the facilities, specifically through the need for health care workers to rotate between facilities to maintain employment. The lack of pay and availability of full time positions has caused long term care workers to seek part-time employment in multiple care homes to provide adequate income, which has been cited as a long standing problem by health care worker unions. Understaffing and rationing supplies are often used as a cost cutting strategy for privately owned long term care homes. According to Dr. Barbara Yaffe, who is Ontario’s associate chief medical officer of health, health care workers that are working in multiple long term care homes are contributing to the spread of COVID-19, where stopping this practice would significantly reduce transmission within facilities.
In 2018, the Ministry of Health and Long Term Care provided recommendations on how to control respiratory infection outbreaks in long term care homes, where they recommended that staff be allowed to work in multiple facilities if they are not symptomatic, wait one incubation period from the last day worked at an outbreak facility, and do not conflict with the policies of the receiving facility. The Ontario government has only recently ordered a stop to healthcare workers rotating between multiple facilitates, though this order does not come into effect until April 22nd, almost a month after a pandemic was declared.
Long term care homes in Ontario are becoming increasingly constrained, due to out of date infrastructure. Existing facilities were not designed and built to meet the needs of today’s seniors, while the majority have not been renovated to keep up with the changing demographics of an aging population. The layout of most long term care homes consist of three to four bedroom wards with shared washrooms and bathing areas, as well as crowded dining rooms, small hallways and nursing stations located in close proximity to resident rooms. The crowded living conditions and shared facilities increase the transmission of viruses such as COVID-19, especially in rooms with more than one resident. Colin Furness, who is an infection – control epidemiologist at the University of Toronto, suggested that housing multiple patients in a single room should be banned, in order to reduce the spread of infection.
The Long Term Care Homes Act mandates that every facility must create an infection and control program (ICAP), which is a comprehensive set of policies and procedures that target respiratory infection outbreaks. The ICAP must address respiratory disease surveillance, staff and resident education, use of antivirals, immunization requirements and exclusion policies. Respiratory disease surveillance is a critical component of ICAP, as it is used to detect and report a potential outbreak, so control measures can be implemented as soon as possible. Understaffing, lack of personal protective equipment (PPE) and poor training has created a situation where adequate surveillance cannot be conducted, ultimately making it difficult to identify and control outbreaks.
To address these shortfalls, the Ontario government released a COVID-19 action plan for long term care homes, which focuses on increasing capacity for testing, screening and surveilling potential outbreaks, while expanding resources to manage outbreaks and spread of the disease. The province plans to conduct testing on all symptomatic residents and staff, as well as asymptomatic contacts of confirmed cases. Screening for asymptomatic residents and staff will begin in select care homes, in order to provide insight on how the disease is spreading. Rapid deployment teams from local hospitals will be utilized to assist with infection prevention and control in affected facilities, while the relocation of residents could potentially be used to improve isolation capacity.
The Services Employees International Union (SEIU) has asked the provinces to take over operations at three long term care homes in Ontario, while a separate union has filed a court injunction against the same homes over their handling of COVID-19. A combined total of 55 residents have died from COVID-19 between the three care homes, where the unions cite “pure negligence” as the reason. Court documents allege that nurses did not have proper access to PPE, symptomatic patients were not being isolated, and a lack of communication with staff and families. As of April 19th, approximately 70% of residents at Anson Place in Haggersville had been infected by COVID-19, while 23 residents have died. At Eatonville Care Centre in Etobicoke, 31 residents have died, while over half are infected with a jump of 84 cases in one day. Hawthorne Place Care Centre in North York has reported 27 cases of COVID-19, with no deaths. Sharleen Stewart, who is the President of SEIU, has characterized the handling of the pandemic by some of the care homes as reckless and careless.
If your family member has been harmed at a Long Term Care Home (Nursing Home) or Retirement Home due to COVID-19 or other causes you may have legal recourse. You should certainly file a complaint with the Ministry of Health and Long Term Care. Take advantage of a free consultation with one of the lawyers at Kotak Personal Injury Law. Our experienced personal injury lawyers and staff work fervently to ensure that our clients receive the settlement and benefits they deserve and are owed. You will find that we are good listeners and can advise you on a strategy that best suits your individual circumstances. Contact Kotak Law office today for a no-obligation consultation.
National Institute on Ageing. (2019). Enabling the Future Provision of Long-Term Care in Canada. National Institute on Ageing White Paper. Retrieved from https://static1.squarespace.com/static/5c2fa7b03917eed9b5a436d8/t/5d9de15a38dca21e46009548/1570627931078/Enabling+the+Future+Provision+of+Long-Term+Care+in+Canada.pdf
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