Long-term care homes in Canada are facing an unprecedented health care challenge. The highly contagious Covid-19 pandemic has drastically compromised the safety of the elderly, who are among the most vulnerable to the virus. It is no surprise that a significant percentage of the Covid-19 related deaths across Canada have occurred in long-term care facilities.
The Residence Herron in Montreal is the most glaring example of this with an alarming thirty-one deaths since March 13, 2020. Health care officials have confirmed that many of the staff had deserted the facility, with reports of residents found lying in soiled beds, abandoned, hungry and thirsty. Sadly, the Pinecrest Nursing Home in Bobcaygeon, Ontario has also confirmed nearly thirty deaths since March 20, 2020. Despite being highly contagious with airborne and droplet transmission, many of the residents were not appropriately distanced from each other to mitigate the spread of the infection. Similarly, Eatonville Care Centre, a long-term care home in Etobicoke, Ontario has also reported that thirty-one residents infected with the virus have now died.
While these are extraordinary times, the news media has shed a spotlight on the systemic problems concerning long-term care facilities. In particular health, safety and sanitary problems have long plagued nursing homes. Among these downfalls include the paucity of specialized personnel, chronic staff shortages, heavy workload and low salaries, placing the residents of these facilities chronically at risk.
Long term care homes are regulated by the Long-Term Care Homes Act ("LTCHA"), S.O. 2007, c. 8 and Ontario Regulation 79/10 made under the LTCHA. The LTCHA is designed to help ensure that residents of long-term care homes receive safe, consistent, high-quality, resident-centered care. Long-term care homes may be legally responsible for the injury or death that occurs following neglect, abuse or improper care, and may be liable to provide financial compensation to cover medical bills and pain and suffering stemming from the incident. Long term care homes can be found liable when management or staff members neglect to take some action to prevent the incident from occurring.
As the pandemic rages on, the Government of Ontario has implemented Emergency Orders that have allowed for greater flexibility to the LTCHA. During the declared emergency, long term care homes are authorized to fill any staff position with a person who, in the long-term care home licensees opinion, has adequate skills, training and knowledge to perform the duties required for the position. Additionally, pursuant to the Emergency Order, long term care homes are not required to:
- Ensure that the minimum number of staffing as set out in the LTCHA are met for a position, provided that all of the care requirements associated with that position are met;
- Comply with training and orientation requirements provided that staff and volunteers take measures to ensure resident care and safety;
- Comply with prescribed screening measures provided that they adopt other measures that ensure resident care and safety;
- Document information unless it involves an incident of a "significant nature" or is required to ensure the proper care and safety of a resident;
- Immediately document changes to a resident's plan of care unless they involve changes of a "significant nature" or of which staff members and others need to be immediately aware;
- Use flexible processes for the admission, transfer and discharge of residents.
The goal of these emergency measures is to give long term care homes flexibility to respond to the pandemic. However, there is cause for concern that there may be an increased rate of incidents of negligence. For instance, there may be unqualified staff that lacks the expertise or credentials to work with the elderly, causing more harm to such a vulnerable population. Poorly trained employees may not be adequately trained in infection control. Also, loosening the requirements of documentation, such as incident reporting, can further increase the risk to seniors who experience negligence or abuse. There can be a lack of transparency in reporting, hindering accountability. It is important that we remain vigilant about protecting our most vulnerable population during the pandemic. Long term care homes must continue to ensure a safe and secure environment for residents.
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