“Profit over people”: The business of Canada’s for-profit long-term care sector called into question
Posted: September 22, 2020
(September 21, 2020)
By: Stephanie Hughes, Yahoo News
Aaliyah* faced a lot of pressure and professional oversight working in an Extendicare long-term care home in the Toronto area over the past two years, but what she saw during the COVID-19 pandemic couldn’t compare. Amidst growing COVID-19 cases in April, she describes a lack of communication from management, inadequate training for frontline workers, some isolated patients missing meals, and slings being used across bedroom doors to prevent patients from wandering – there were even talks of sedating patients to control their movements.
One moment stood out to her as being particularly disturbing. “We were at our peak and didn’t want any more positive [COVID-19] results coming up, because once that positive comes up, you’re in outbreak for another two weeks,” Aaliyah told Yahoo Finance Canada. A doctor ordered a nurse to swab patients and send them to the lab. “But then the administrator found out and said, ‘don’t send them.’” Aaliyah warned the doctors that the administrative team was trying to stop the swabs from getting out. This eventually led to a back-and-forth argument between the doctor and administrative team until the doctor said “I’m ordering the swabs and I’m done”.
After the swabs were tested for COVID-19, Aaliyah says, one test came back positive.
The Long-Term Care Problem in Ontario
The COVID-19 pandemic called the state of for-profit long-term care homes in Canada into question. In Ontario, 57 per cent of nursing homes are for-profit, followed by private non-profits, which account for 26 per cent, and municipal homes which make up 16 per cent. As of late June, the private for-profit homes reported the highest mortality rate at nine per cent, versus non-profit homes (5.25 per cent) and publicly-operated municipal homes (3.62 per cent), according to the Ontario Health Coalition.
The higher mortality rate from patients who had tested positive for COVID-19 doesn’t surprise Amit Arya, a palliative care physician with a special interest in long-term care, holding joint faculty appointments in the Division of Palliative Care at McMaster University and the University of Toronto.
“It is about prioritizing profit over people. That’s the whole principle when we’re running any sector like a business,” he told Yahoo Finance Canada in an interview. “What will happen is that any extra money that’s in the system will not be reinvested into the care of the people, and also the well-being and safety of the health workers.”
Arya added that for-profit homes tend to lag non-profit and municipal homes in safety upgrades. Upgrading these homes, Arya says, would avoid crowding issues in senior homes where three or four residents can be assigned to a single room, increasing the likelihood of virus transmission.
From over-crowding to under-staffing and a lack of equipment, a report by the Canadian Armed Forces (CAF) regarding its intervention in care homes exposed many shortcomings. Among them was the Altamont Care Community owned by Sienna Senior Living, where families of residents launched a class action lawsuit against the company.