“By any measure of morality and humanity, the situation in Ontario’s long term care sector has become intolerable.”

You might assume that quote stems from the tragic trail of devastation COVID-19 has left in our long-term care homes, where our parents and grandparents are dying without family by their side.

But in fact it’s from the conclusion of a January 2019 report from the Ontario Health Coalition, a highly respected patient advocacy group known for its comprehensive research.

Most long term care homes in Ontario were municipally-run or nonprofit until the 1990s, but that changed under the Progressive Conservative government of Mike Harris. Now 59 per cent of the province’s approximately 600 LTC homes are owned and operated by the private sector.

A few big chains control most of what is now the LTC “market” in Ontario, including the largest in Canada, Chartwell Retirement Residences, where Harris is chair of the board.

A Health Coalition study found residents in for-profit homes have a 10 per cent higher risk of mortality and a 25 per cent higher risk of hospitalization than those in nonprofits. It said for-profit homes spend 49 per cent of operating revenues on staffing while nonprofits spend 75 per cent, and called chain affiliated homes “the worst offenders” for low staffing levels.

The Ontario Nurses’ Association was forced to take court action to get some private homes to provide staff with personal protection equipment and to isolate residents who tested positive for COVID-19. Nurses had to go to court to get protective gear in a pandemic!

I don’t know how Justice Edward Morgan of the Ontario Superior Court of Justice didn’t laugh out loud in rejecting the employers’ claim that the nurses were looking out only for themselves while “the privately-owned LTC homes represent broad, community-based interests.”

The office of Ontario’s Patient Ombudsman said Monday it received “disturbing” complaints about LTC homes “severe staffing shortages, inadequate infection control measures, inability to meet the basic needs for some residents, and poor or no communication.”

Six privately-run LTC homes where 71 people died of COVID-19 as of last Friday are the target of a proposed class action suit filed in Superior Court alleging they failed to protect residents. Some families say they hadn’t even been told their loved one was ill.

LTC homes rely on part-time staff to avoid paying benefits, forcing many to work at two or three homes to make ends meet. We learned in 2003 that nurses working part-time at multiple hospitals became superspreaders during SARS, and implemented effective new staffing rules and infection control procedures, but not in LTC homes. Shame. Shame on all of us.

There’s a waiting list of at least 30,000 to get into long term care, chronic staff shortages, and an increasing numbers of patients with some form of dementia or other complex needs.

Ontario is second-last in Canada, behind only Newfoundland and Labrador, in the number of long-term care beds per capita, another shameful fact contributing to the lengthy wait list.

CBC News reported “comprehensive resident quality inspections” of LTC homes, done in each home annually until 2017, were reduced to about half the homes in 2018, and to just nine homes in 2019. Government excuses of a new complaints-based inspection process ring hollow.

A public inquiry into LTC, after the pandemic passes, should consider getting the private sector out of the “business” of caring for 80,000 of our most vulnerable family members and make the homes fully part of our public health care system. It wouldn’t be cheap.

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