Three of the “independent experts” long-term care home operator Revera chose to contribute to its recently released pandemic report have prior ties to the company, raising questions from advocates and family who say the report is unobjective and doesn’t reflect what has really been happening in the company’s homes during the pandemic.
The report, written by a panel tasked by Revera with examining the impact of the first wave of COVID-19 on the company’s residents and staff, said there was a “series of systemic breakdowns that allowed the virus to flourish in long term care,” including a sector-wide shortage of personal protective equipment and a “woeful lack” of laboratory testing.
It also found there were “mixed messages” and inconsistent information about infection prevention and resident cohorting from government ministries, public health units, hospitals and other bodies involved during the pandemic’s first wave.
It does not mention, however, the affiliations Revera has with three of the experts on the panel, whom the company says “contributed their advice and recommendations on a voluntary basis.”
The report does acknowledge the 266 deaths related to COVID-19 in the company’s homes across the country in the first wave of the pandemic. To date, 279 more people have died in Revera’s Canadian homes in the second wave — since Sept. 1, 2020 — according to the company’s media releases.
Revera currently faces multiple proposed class action lawsuits, one of which alleges the company was “systemically negligent” during the pandemic.
Revera ‘hand picked’ external committee
Revera announced its “external advisory committee” in a July press release, saying the group’s goal was to build on the knowledge gained during the pandemic to develop best practices for long-term care and retirement homes.
One of those experts, Bob Bass, is a negotiator who has previously represented Revera in arbitration meetings with unions. Kevin Skerrett, a CUPE pensions researcher involved with the Ottawa Health Coalition, told HuffPost Canada that Bass is well-known in the labour relations community.
There’s “no question” Bass has been paid for his work for Revera, Skerrett said, adding that work has included arguing against wage and working condition improvements.
Another expert on the panel, Dr. Krystyna Ostrowska, has been “contracted” to sit on the company’s infection control and prevention committee, Revera’s chief medical officer of health told Ontario’s long-term care commission in October.
And a third expert, Santiago Kunzle, who is the director of Montgomery Sisam Architects Inc., lists Revera on his website as a company he has a “strong, ongoing working relationship” with. Also listed are Extendicare and Sienna Senior Living Inc., two other large, for-profit, long-term care operators. Kunzle’s firm worked on a Revera retirement residence in Barrie, Ont., according to his website.
Bass, Ostrowska and Kunzle did not respond to HuffPost’s requests for comment in time for publication.
The chair of the panel said there were no conflicts of interest with the experts who worked on the report — but others disagree.
Christine Collins, a member of the Ottawa Health Coalition whose 69-year-old brother is a resident at Revera’s Carlingview Manor in Ottawa, said she believes there were “really obvious” conflicts of interest with the report’s authors. Carlingview was one of Ontario’s hardest hit homes in the first wave.
She also questioned the individual Revera appointed as chair of the group — Dr. Bob Bell, a former deputy minister of health and long-term care in Ontario who worked under the previous Liberal government.
“He was deputy minister at a time when policy decisions were made in favour of for-profit long-term care homes,” Collins said.
She said although Revera said he was an independent part of the team handling the report, she believes the company “knew full well that he would give their message.”
WATCH: Singh calls on the federal government to end for-profit long-term care homes. Story continues below.
Collins’ concerns are echoed by Candace Rennick, Secretary-Treasurer of CUPE Ontario.
“There should definitely be an arm’s length, at least, between the for-profit industry and current and former government officials,” she told HuffPost. “It just doesn’t make sense, and we know that there has been a cosy relationship between the for-profit industry and the current government.”
Skerrett agreed Revera should make the panel members’ work with the company clear, saying although the report does raise some fair concerns, it’s “troubling” that it excludes issues such as concerns around for-profit ownership of long-term care homes.
“The company hand picked a group of individuals that they were comfortable with, and I would say that looks to me like they would be comfortable, they would get a report that … would not be a problem, would not have results or content that the company’s not comfortable with,” he said.
Susan Schutta, a spokesperson for Revera, said the majority of the people on the panel — including Bell — have never been paid by the company.
“A few of the people who worked on the report have existing professional or consulting relationships with Revera, given that they are the best at what they do,” she said, adding those people were paid for that work but were not compensated for working on the report.
Revera also engaged a “noted health journalist” to draft the report, she said.
“Suggesting that these experts did not provide credible analysis because they consult with our company on other matters is a regrettable mischaracterization of people who have consistently demonstrated excellence in their field and who are world-renown[ed] authorities.”
‘That is what experts do’
In a statement to HuffPost, Bell said he didn’t receive any compensation from Revera — nor would he accept any in the future — and he rejects any suggestion he had a conflict in interest when it came to chairing the panel or writing the report.
“I personally wrote, edited and finalized the report, using the original drafts contributed by the panel members to ensure scientific and clinical integrity was maintained while improving accessibility of the piece and unifying the voice of the various sections,” he said.
He noted he refused to accept edits outlined by Revera’s lawyers, which he understands they asked for because of the “litigious circumstances surrounding [long-term care] at present.”
Bell said there were no conflicts of interest with the report’s contributors and the panelists were not paid for their work.
“Why do it?” he asked. “Because we MUST make Long-term Care and seniors’ care in general higher quality and safer. I think this report is a contribution to that goal.”
The panelists were chosen through a “joint and collaborative effort” between him and Revera, he said, adding there was a “ton of unpaid work” involved — about 40 hours minimum for most people, and an excess of 150 hours for himself.
Ostrowska was not compensated for the “considerable work” she did on the report, Bell said, noting several other panelists with experience in infectious disease “contributed to an even greater extent” than she did.
Bass, meanwhile, “does work for many, many clients in healthcare” and volunteered an “enormous” amount of analysis regarding staffing during the first wave, Bell said.
“I worked closely on his part of the report and I can guarantee that no one influenced what he determined nor what he recommended,” he said.
It was also clear that Kunzle “was independent,” Bell said, adding the architect director’s firm “might” do design work for Revera, as well as other private or non-profit facilities, in the future because “that is what experts do.”
HuffPost reached out to the report’s six other authors. One had no comment, one didn’t respond before deadline and three — Dr. Samir Sinha, Dr. Mark Loeb and Michael Nicin — said they found the report process to be fair and independent. Another, Dr. Allison McGeer, said there were a “range of opinons” voiced at meetings and drafts.
‘I am so upset ...’
Collins found herself getting emotional when she first first read through a copy of Revera’s pandemic report.
“I cried for 20 minutes when I read what they were saying about people with dementia,” she said.
The report quotes an anonymous Revera executive who said it was hard to get residents with dementia to wear masks, and, because some of these residents roam constantly, “to keep them isolated is next to impossible.”
It’s a concern Collins identified early in the pandemic. Her brother Peter is on one of Carlingview’s secure floors for residents who have dementia, and Collins worried in the spring that the other residents wandering in and out of his room — even when he was in isolation after moving into the home from an Ottawa hospital — could be spreading the virus.
“They told me it was my brother’s responsibility to tell [another resident] to get out of the room,” Collins said.
“I am so upset that they take no responsibility for not giving a damn about all of the people that are on the dementia floor. They did nothing, no measures at all.”
According to the report, Revera’s supervisors found it was “somewhat effective” to have staff members dedicated to helping residents in secure units with hygiene.
But Collins alleges the shower room was closed during the pandemic and that her brother never even received a sponge bath during that time. When she called to ask about this, she said she was told her brother had a bathtub in his room — but he’s disabled and can’t climb in and out of the tub on his own.
‘They’re not taking any responsibility’
In the fall, Collins said her brother, Peter, was moved to a new, dirty room when he started displaying COVID-19 symptoms. He didn’t get a change of clothes for the four days he was in the new room, and twice didn’t get a meal delivered, she said.
“They’re not taking any responsibility,” Collins said. “Everywhere I looked when I was looking [at the report] — I saw references to government, hospitals … everybody except themselves.”
“It’s their own lack of care they need to take responsibility for,” she said.
CUPE’s Rennick echoed concerns that Revera’s report is “not objective” and deflects from larger problems, including those with the company’s model.
“It really does overlook how their own for-profit model of ownership has contributed to the sad and deadly realities for people living in long-term care during the pandemic,” she said.
“Our pension plan as public service employees should not be making profits on the backs and deaths of those suffering ...”
- Christine Collins
Analysis by the Toronto Star in both waves of the pandemic has found residents in for-profit long-term care homes had worse outcomes than those in non-profit or municipal homes.
Collins worked for Transport Canada for 37 years. As a former public service employee, her pension plan is managed by the federal Public Sector Pension Investment Board — which owns a 100 per cent stake in Revera Inc.
“Our pension plan as public service employees should not be making profits on the backs and deaths of those suffering, like my brother, and those dying in Revera homes,” she said.
Revera spokesperson Larry Robertson previously told HuffPost the focus on ownership models “is becoming a distraction” from talking about the challenges and “real reform” needed in the long-term care sector.
He said Revera does not make a profit from the delivery of care.
Panel chair: ‘No editorial influence’
The Public Service Alliance of Canada (PSAC), which has 140,000 members’ pensions invested with PSP Investments, has been among the organizations calling for Revera to be taken public.
In an online post, PSAC President Chris Aylward called the company’s pandemic report “a slick corporate public relations exercise.”
The PSAC post points to a Canadian Medical Association Journal article that found for-profit homes had larger COVID-19 outbreaks, and more resident deaths, than non-profit or municipal homes.
“Given this, one would expect a report produced by ‘independent experts’ to devote at least a small section to examining these findings in greater detail,” the organization said. “Instead, the report is completely silent on this.”
Revera’s report says “critics allege” for-profit homes choose to employ part-time staff because of the lower cost, but says that’s not true. It states it is “more cost-effective” to hire full-time employees because there is less turnover and lower onboarding costs.
“We had the pen on writing this report.”
- Dr. Bob Bell
Schutta, the Revera spokesperson, said Revera is the only long-term care operator to “undertake this level of external scrutiny” and make public its findings.
Speaking on CBC’s The Current, panel chair Bell pushed back on criticism that the report doesn’t include information about outcomes in for-profit care homes. He said the funding provided to long-term care homes is “tightly regulated in Ontario” for both not-for-profit and for-profit providers.
“The panel did not comment on the issue of various models of [long-term care] ownership. We were reviewing data from Revera — not from all LTC providers,” he said in his statement to HuffPost.
He said the panel did study the impact of resident density and risks associated with multi-resident rooms, which he noted are mainly in Ontario homes owned by for-profit companies.
On the CBC, Bell also said Revera allowed the experts working on the report to see their data and ask questions.
“We had the pen on writing this report,” he said. “There was no editorial influence from Revera.”