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Feds 'Urgently' Need To Make Private Nursing Homes Public After COVID-19 Outbreaks

Experts and advocates say for-profit long-term care homes should be taken back into public hands.
Christine Collins’ brother Peter waves from his room at Carlingview Manor on April 30, 2020.
Courtesy of Christine Collins
Christine Collins’ brother Peter waves from his room at Carlingview Manor on April 30, 2020.

Christine Collins’ brother Peter tested positive for COVID-19 less than a month after he was transferred from a hospital to Carlingview Manor in Ottawa. He was supposed to be in isolation upon arriving at the long-term care home, but on the dementia floor where he lived, residents wandered around without distancing, she said.

The home, where 61 residents have died during the pandemic, was very short staffed, Collins added. She was told the shower room was closed during the outbreak because there were not enough staff members to sanitize it between uses.

She said she “completely blame[s]” the home for Peter testing positive. Now, months later, he still has symptoms like severe migraines and shortness of breath. Collins visits her brother once a week, outside, but doesn’t feel safe going inside the home.

“I’m not sure,” Collins said at a town hall this week, “but maybe you can imagine how very angry and horrified I am to find out that my pension that I paid into for 37 years, owns Carlingview Manor as part of the Revera chain.”

WATCH: Ford warns long-term care homes to let staff access PPE. Story continues below.

As the country barrels toward a second wave of COVID-19 and new outbreaks emerge in Ontario long-term care homes, experts and members of the Ottawa Health Coalition are calling for the federal government to immediately take action to take Revera Inc. public.

The Public Service Alliance of Canada (PSAC) has 140,000 members’ pensions invested with PSP Investments, a federal agency that manages pensions for federal employees, the RCMP and Canadian Armed Forces. PSP presently owns a 100 per cent stake Revera.

Next week, the PSAC will formally present a proposal to make Revera public when leaders from the PSP Investment board meet with pension advisory committees, it said in a press release.

The Ottawa Health Coalition held a town hall Wednesday night, where speakers urged the federal government to take action and make Revera, and other long-term care homes in the country, public.

“I would argue that the pandemic ... is the best argument for why this is now necessary”

- Kevin Skerrett

Revera is the second-largest long-term care provider in Canada. It currently faces several lawsuits for its response to the pandemic, including one that accuses the company of being “systemically negligent” in caring for residents, leading to COVID-19-related deaths.

Larry Roberts, a Revera spokesperson, said he could not comment on the lawsuits facing Revera as they are before the courts.

“The staff at Carlingview Manor have worked very hard, in conjunction with Ottawa Public Health and local hospitals, to provide safe, compassionate care to our residents throughout this unprecedented pandemic,” he said.

A spokesperson for PSP Investments said PSP and Revera are committed to engaging with all levels of government and other stakeholders regarding continual improvements in long-term care.

“We believe that by working together to positively influence the LTC sector for the benefit of seniors, we can be part of the solution,” the spokesperson said.

‘Nonsense’ to say government is powerless

Jean-Yves Duclos, president of the treasury board, said in May that PSP operates independently from the government.

To say the government is powerless is “nonsense,” said Kevin Skerrett, a senior research officer assigned to pensions at the Canadian Union of Public Employees (CUPE), at the town hall.

“If a federal government did decide that this is a problem, and that a change is necessary, it would be a very straightforward change to intervene,” he said, adding it would likely require a regulatory or legislative change.

“I would argue that the pandemic and the tragedy that we’ve just been through is the best argument for why this is now necessary and urgently required,” Skerrett said.

In May, the president of the PSAC wrote a letter to the pension plan’s CEO asking for his office to initiate consultations immediately to transition management of Revera operations to provincial health authorities.

The Ontario Health Coalition has found at least 21 legal actions relating to conditions in the province’s long-term care homes. Two class actions are directly against Revera, and one is specifically against Carlingview Manor, the Ottawa long-term care home owned by the company.

There’s legal precedence that plan fund managers must invest in the best interest of their members without undue risk, said James Infantino, the national pension and disability insurance officer for the PSAC.

“Who is Revera accountable to?”

- James Infantino

It could be argued, he said, that PSP Investments is breaching the fiduciary duty to manage investments in the best interest of its members. But he noted that PSP divesting from Revera, without any changes to make the company public, wouldn’t change the situation for residents in long-term care.

Infantino said the PSAC has raised concerns about Revera in the past, such as in 2018 when CTV ran an investigative broadcast focused on “horrendous neglect” in Revera homes.

“Who is Revera accountable to?” he asked. “They don’t have to file financial statements to anybody, and yet they operate in this manner, and yet they’re funded by our pension funds.”

Staffing concerns in for-profit homes

Data analysis by the Toronto Star found residents in for-profit facilities are about twice as likely to contract COVID-19 and die from it than residents in a nonprofit home.

There are “major problems” with work and care conditions in Canadian long-term care homes, and especially in for-profit homes, said Amanda Vyce, CUPE’s national health-care researcher.

For-profit operators minimize staffing costs by having fewer staff, paying lower wages, providing fewer benefits and offering less job security. They also have fewer staff with formal qualifications, Vyce said, which is associated with having a lower quality of care.

Low staffing levels can also mean high workloads which, paired with low wages, can cause staff turnover, she added.

“When revenues generated by for-profit homes are allocated to shareholder profits, rather than improvements to staffing levels, working conditions and therefore resident care, it is not surprising that quality of care suffers,” Vyce said.

Ontario’s long-term care staffing study, released in July, found 50 per cent of personal support workers (PSWs) stay in the health-care sector for fewer than five years, and 43 per cent leave because of the burnout from working in short-staffed facilities. The highest turnover in the sector is from part-time and casual workers, who are predominantly entry-level PSWs, the study states.

Anil Naidoo, the national representative at the National Union of Public and General Employees (NUPGE), called the situation in long-term care a “collective stain” on Canada.

He pointed to a NUPGE poll from May that suggested 86 per cent of Canadians are in favour of including long-term care facilities under the Canada Health Act and an Angus Reid survey that found two-thirds of Canadians want the government to take over long-term care facilities.

Naidoo emphasized that long-term care workers are also in an “impossible situation” trying to care for residents without support and, in some cases, without adequate personal protective equipment.

“Money is thrown at the problem, but really in effect, only ends up propping up the for-profit sector that should be … taken back into the public hands,” he said.

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