Ontario’s for-profit nursing homes have 78% more COVID-19 deaths than non-profits, report finds

Their report paints an alarming picture of for-profit nursing homes in the pandemic, particularly those owned and operated by chains — which were not mentioned by name.

“The most important risk factors for the magnitude of an outbreak and the number of resulting resident deaths are older design, chain ownership and crowding,” says the document released Wednesday as the province revealed another 60 deaths in long-term care and 137 residents testing positive over the previous 24 hours.

“Homes with for-profit status had outbreaks with nearly twice as many residents infected ... and 78 per cent more resident deaths ... compared with non-profit homes,” adds the report from the science table, which includes geriatrician Dr. Nathan Stall of Mount Sinai Hospital.

The findings are certain to increase pressure on Ford’s Progressive Conservative government, which is already facing calls to crack down on for-profit nursing homes or eliminate that ownership option so that profits can be poured back into improved care of residents.

About 58 per cent of Ontario’s nursing homes are privately owned, with 24 per cent operated by non-profit organizations or charities and 16 per cent by municipalities.

“The higher intensity of outbreaks in privately operated homes can be explained by the older age and design of these homes,” said Donna Duncan, chief executive of the Ontario Long-Term Care Association, which represents operators of all ownership types.

“Once COVID-19 enters a home, it is difficult to contain, especially in older long-term care homes with three- and four-person rooms and higher levels of crowdedness.”

As the Star reported in December, the three largest publicly traded long-term care operators paid nearly $171 million in dividends to shareholders in the first three quarters of 2020 while receiving $138.5 million in provincial pandemic pay for front-line staff, the Canada Emergency Wage Subsidy and other pandemic funding.

Those companies were Extendicare, Sienna Senior Living and Chartwell Retirement Residences. They have said pandemic funding was not used to pay dividends.

“The time has come to put the needs of seniors ahead of profit for big chain shareholders,” said New Democrat Leader Andrea Horwath.

She said the recommendations are similar to what caregiver advocates, families with loved ones in long-term care and front-line staff have been saying throughout the pandemic, which has killed more than 3,200 residents.

“Long-term-care homes with underpaid temporary staff and residents crammed three and four to a room are leaving seniors vulnerable, and are resulting in more devastating illness and tragic death,” Horwath said.

She called for permanent pay hikes for personal support workers who help residents with bathing, dressing, feeding and toileting, and form almost 60 per cent of nursing home staff, along with a hiring blitz to increase staffing levels. She also wants a ban on putting three or four residents in larger ward rooms, to help limit the spread of COVID-19.

A spokeswoman for Long-Term Care Minister Merrilee Fullerton said new admissions and readmissions to three- and four-bed rooms have been blocked since last June. Hospitals have sent staff to shore up a number of long-term-care homes, Krystle Caputo said, and 40 per cent of homes have had the opportunity for a first round of vaccinations, with the rest slated to be completed by mid-February.

“We are working to get vaccines into the arms of our most vulnerable seniors as quickly as possible,” said Caputo.

A $3 hourly wage top-up from the province for nursing home personal support workers is slated to expire at the end of March. Ford has pledged to improve the standard of daily, hands-on care for nursing-home residents to four hours from the current 2.7 hours by 2025, which critics have said is too slow given that the average life expectancy for long-term-care residents is 18 months after admission.

The report also found about half of Ontario’s nursing homes are considered crowded and have a 9.7 per cent incidence of COVID-19 infection, almost double the 4.5 per cent in less crowded facilities. Mortality rates were also double, at 2.7 per cent to 1.3 per cent.

Women residents of long-term care were less likely to be sent to hospital for COVID-19 than men.

The report also flagged the increased use of “psychoactive drugs” on residents, who have seen visitors severely restricted since COVID-19 arrived. About 90 per cent of residents have some form of cognitive impairment.