The three-person audit team, which included two nursing professionals, is now analyzing resident charts and other data provided by the Sunnybrook Veterans Centre, home to about 500 Second World War and Korean War vets.
According to multiple sources, the auditors from Veterans Affairs Canada spent much of last week at the centre — its first inspection by any level of government in more than seven years.
Auditors interviewed or heard from more than 100 relatives or residents either privately or in groups.
"A significant part of this comprehensive audit is the specialized auditors' meeting with the families of veterans and veterans themselves," said Niklaus Schwenker, a spokesman for Veterans Affairs Minister Steven Blaney.
In a series of articles in recent weeks, The Canadian Press outlined numerous concerns raised by relatives of elderly vets who are, by and large, dependent on care.
The complaints include unexplained injuries, rough treatment, neglect of basic hygiene and infection-control procedures, delayed feedings, residents abandoned for hours on end or left languishing in bed for days, and a dearth of physiotherapy or rehabilitation opportunities.
The articles prompted Blaney to order a "comprehensive" audit of the centre, which receives about $26 million from the feds and another $29.2 million from Ontario for 310 of the beds that fall under provincial regulation.
The province, which at first indicated it would also pursue an audit, subsequently washed its hands of the complaints, saying now it sees no need to inspect the facility — something it routinely does with other long-term-care homes.
Instead, Ontario's Ministry of Health said it would defer to Sunnybrook, which says it is hiring an external reviewer to look into the complaints separate from the federal inspection.
"(The ministry) is confident that Sunnybrook is capable of undertaking a review of patient concerns to ensure quality and safety," said spokesman David Jensen.
Sunnybrook, which maintains its care is exemplary and blames complaints on a handful of malcontents, said it would have details of its proposed review in the new year.
In addition to helping look after their loved ones themselves, some relatives have hired caregivers at taxpayers' expense because of concerns about the living conditions in the veterans centre.
One such companion, who spoke to the auditors, said nurses were prepped ahead of the inspection about what to say — a suggestion Sunnybrook spokesman Craig DuHamel on Friday called "ridiculous" and "absolutely without merit."
The woman, who asked not to be named because she feared reprisals, said staff were told to say residents' diapers were changed "on a regular basis," which she said does not happen.
Residents are sometimes left to sit in their own urine and feces for as long as 10 hours, she said.
The companion said she saw improper handling of a resident that led to skin tear, requiring four nurses to stop the bleeding.
Staff, she said, decide all too quickly some residents are simply not worth offering therapy.
"There's a lot more family members that have complaints but they're too scared to even come forward," she said. "They're afraid of retaliation against their loved ones."
The flurry of activity that preceded the audit has subsided and residents are again being abandoned, especially in off-hours, she and other family members said.
In response, DuHamel said staffing levels "have remained constant throughout."
In his written submission to the auditors, John Marriott described how his largely immobile father-in-law was found with a tooth knocked out — apparently after somehow crawling out of bed and smashing his face on the floor — and died within days.
The man lived in fear of one nurse, Marriott said.
"I swear she will kill me if she gets a chance," he cited his relative as saying.
Sunnybrook, which has said it can't discuss individual complaints because of privacy concerns, points to surveys of residents and family members as indicative of the superior care it offers. It has also said it welcomed the audit.
The auditors — watched by two senior representatives of the veterans ombudsman — also observed various shift rotations, feedings and other practices, both during the day and in the evening.
The team is now poring over 100 patient files — with the permission of the residents or their legal representatives — as well as other documentation from the hospital.
Once the data analysis is over — likely by the end of next month — the auditors will generate a report that will initially be circulated internally before being posted publicly.
"We look forward to the results of the audit when fully complete,” Schwenker said.
Schwenker and veterans ombudsman Guy Parent, who was debriefed this week on the site audit, said it would be premature to comment on any findings.