Military report details 'disturbing' issues in Ontario long-term care homes

TORONTO — A military report on five Ontario long-term care homes released Tuesday details "horrific" allegations of insect infestations, aggressive resident feeding that caused choking, bleeding infections, and residents crying for help for hours.

TORONTO — A military report on five Ontario long-term care homes released Tuesday details "horrific" allegations of insect infestations, aggressive resident feeding that caused choking, bleeding infections, and residents crying for help for hours.

Ontario Premier Doug Ford called it "the most heart-wrenching report" he's ever read in his life.

"The reports they provided us were heartbreaking, they were horrific," he said. "It's shocking that this can happen here in Canada. It's gut-wrenching."

Ford called in military assistance last month for five long-term care homes dealing with COVID-19 outbreaks. After reading the report, Ford said it's clear the system is broken. He said he is now not ruling out a public inquiry, which he had previously declined.

Ontario has launched a "full investigation" into the allegations and will share the results with police so they can look into any possible criminal charges, Ford said.

Four of the five homes are private, but Ford said there are 626 long-term care homes in the province and they shouldn't all be painted with a broad brush. He suggested creating a fully public system wouldn't be feasible without help from Ottawa.

"We financially wouldn't be able to sustain that," Ford said. "Now, if the federal government comes in to support us, that would make it more sustainable."

Prime Minister Justin Trudeau, who has also seen the military report, called it "deeply disturbing."

"I was sad, I was shocked, I was disappointed, I was angry. I believe that we're talking about a situation that clearly is a reality associated with COVID-19, but has also existed for quite some time now," Trudeau said.

The allegations detailed by Canadian Armed Forces members also included failure to isolate COVID-19-positive patients and allowing them to wander outside of their rooms.

Hygiene issues were flagged at several of the homes, including stage four pressure ulcers (in which the damage can extend down to bone), reusing a catheter that had been on the floor for an unknown length of time, leaving another catheter in three weeks beyond the scheduled change date, and patients being left in soiled diapers.

Many feeding concerns were reported, including staff writing that a resident refused to eat rather than helping them, leaving food in a resident's mouth while they were sleeping, leaving food out of reach so residents end up missing meals, forceful feeding that led to choking or aspiration, and feeding them while they are lying down.

One such incident "appears to have contributed" to a patient death, the report said.

At one home, the military reported "significant" fecal contamination in resident rooms, cockroach infestations, residents not being bathed for weeks, and some crying out for help for more than two hours.

Residents at another home were bed-bound for weeks, with a "significant" number having pressure ulcers. Due to severe staffing issues, "most" residents were not receiving three meals a day, the report alleged.

At many of the homes, the military reported both severe understaffing as well as a lack of supplies. At one there was a "general culture of fear to use supplies because they cost money," the report said, and at another there was no crash cart available for cardiac arrest.

Since members of the military began providing operational assistance in Ontario, 15 of them have become infected with COVID-19.

Trudeau said there is no doubt that more needs to be done for seniors in long-term care, and Ottawa will help.

The military has been assisting at Orchard Villa in Pickering, Altamont Care Community in Toronto, Eatonville Care Centre in Toronto, Hawthorne Place in Toronto and Holland Christian Homes' Grace Manor in Brampton.

Orchard Villa, Altamont and Eatonville had all seen dozens of COVID-19 deaths each when the Canadian Armed Forces were called in, and a personal support worker from Altamont also died.

Orchard Villa has now recorded 69 COVID-19 deaths, while Altamont has recorded 52 and Eatonville 42. Hawthorne Place has seen 39 residents die — roughly double the number of fatalities at the time military help was requested. Eleven residents have died at Grace Manor.

Eatonville Health responded to the report by saying the severity of the COVID-19 pandemic has presented unique challenges to its health system, its home, and its staff.

It noted that to date, 104 COVID-19 cases have been confirmed among its employees.

"In addition to these team members self-isolating safely away from the home, some staff did not come to work due to personal health reasons, and those who remained were overwhelmed by the pressures brought on by COVID-19," Evelyn MacDonald, Eatonville's executive director, said in a release.

"We are committed to work alongside the Government of Ontario to find solutions to the ongoing challenges within our long-term care system that have been further exacerbated by the COVID-19 pandemic."

Sienna Senior Living said it has already made improvements at Altamont Care Community with the support of the Canadian Armed Forces.

Natalie Gokchenian, a spokeswoman for Sienna, said improving staffing will be key.

"COVID-19 has had a severe impact on an already lean staffing complement at Altamont, which will only continue as we deal with this virus over the coming year or more,"  she said in an email.

"To deliver the level of care that our seniors deserve, the staffing challenges we face in the long-term care sector must be addressed. We are committed to working with the government, and our health system partners, to solve this urgent issue."

Lakeridge Health said Orchard Villa had been managing a COVID-19 outbreak for almost two weeks before a team from Lakeridge Health was brought in to support them.

Lakeridge said it added dozens of frontline staff to support care to residents including deep cleaning, infection prevention and training staff on the use of PPE.

Donna Duncan, CEO of the Ontario Long Term Care Association, thanked the military for their assistance.

"Ontario's long-term care homes have been clear about the dire situation on the frontlines of this unprecedented fight against COVID-19," she wrote.

"The virus has exacerbated systemic issues, like the long-standing staffing challenges, as it impacts homes in varying degrees."

The province will inspect each of those homes, and has referred one death at Orchard Villa to the coroner's office, though officials did not provide details.

Ford has asked for the military mission to be extended another 30 days.

Ontario has seen more than 1,500 residents of long-term care facilities die in COVID-19 outbreaks, along with six staff members.

The province has also appointed hospitals to take over the management of two long-term care homes that have been unable to contain COVID-19.

The government has already said it will be launching an independent commission into the province's long-term care system.

The number of seniors homes experiencing an outbreak had grown to 190 when that announcement was made last week, but it has since dropped to 150.

The Ontario Long-Term Care Association, opposition parties and the health-care union SEIU have all called for a full public inquiry into the sector. But Ford has said that would take too long.

Provincewide, Ontario reported 287 new COVID-19 cases Tuesday, and 21 more deaths. It's the first time in more than two weeks that the number of new cases has been lower than 300. The previous five days had each seen more than 400 new cases.

There have now been 26,191 total cases in Ontario, a 1.1 per cent increase over the previous day, which is the lowest growth rate since early March.

Testing levels remain relatively low, with 9,875 tests completed during the previous day, despite a provincial capacity of nearly 25,000.

The numbers of people in hospital with COVID-19, in intensive care, and on ventilators all decreased.

This report by The Canadian Press was first published on May 26, 2020.

Allison Jones and Shawn Jeffords, The Canadian Press