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York Region medical officer of health steps in after COVID-19 outbreak at Villa Leonardo Gambin

Posted: January 2, 2021

(January 1, 2021)

By: Rosie DiManno, St. Catharines Standard

Paramedics take away an elderly patient at the Tendercare Living Centre, a long-term-care home that has been the hardest hit facility by the second wave of COVID-19 pandemic, on Wednesday.

The associate director of care at Villa Leonardo Gambin gets out a curt “no comment’’ and hangs up the phone.

The chief administrator at Villa Leonardo Gambin didn’t answer her phone — although she was definitely there on New Year’s Day — or respond to phone and email messages.

Their 168-bed nursing home in Woodbridge, meanwhile, has 26 coronavirus-positive residents and 12 deaths. That’s as of Dec. 31, because there were no updates Friday on the provincial COVID-19 website. The facility is facing its third (at least) outbreak since the pandemic began raging through long-term-care facilities late last winter. This one has been active since Nov. 20.

Villa Leonardo Gambin, an independent not-for-profit long-term-care home, is operated by Sienna Senior Living, which, according to its website, owns 37 LTCs in Ontario (and 27 retirement residences). It’s a huge player in an extremely profitable business.

Dec. 31 was also the day that Dr. Karim Kurji, medical officer of health for York Region, issued an order — complete with warning of a $5,000 per day fine for non-compliance — directing Sienna to “adhere to the directions of public health’’ after an inspection of the premises revealed that the institution:

  • “Has inadequate senior leadership (supervisory staff) presence on the institution’s units, at all times, to ensure appropriate adherence to IPAC’’ (infection prevention and control) measures and
  • “Has inadequate and/or insufficient IPAC knowledge and processes to protect resident needs, and requires assistance from York Region Public Health, Mackenzie Health Hospital, Public Health Ontario and the Local Health Integration Network to provide IPAC expertise to the institution to help contain and stop the COVID-19 at the institution.’’

So, 10 months into the pandemic and Villa Leonardo Gambin staff and administrators still remain so clueless about protocols for containing the virus — ensuring proper equipment, supplies and services, vigilant procedures, sufficient staffing and supervision, risk assessment, monitoring of essential care visitors, appropriate use of PPE, and immediately correcting errors — that Kurji (thankfully) has had to step in.

Unclear, from the way the order was written, is whether it’s a direct management order, compelling management takeover by Mackenzie Health Hospital, or what is known as a “voluntary management contract’’ that, upon consultation, establishes a management arrangement with a hospital.

“To confirm, Villa Leonardo Gambin received an order from the Medical Officer of Health for The Regional Municipality of York,’’ Sienna spokesperson Nadia Daniell-Colarossi tells the Star by email.

“There is no transfer of management to Mackenzie Health.’’

Adding: “We are working around the clock with our partners to care for residents and support team members at Villa Leonardo Gambin. Our resolve to fight COVID-19 is firm; however, it is incredibly challenging when the virus circulates a high levels in the community.’’

Daniell-Colarossi says Sienna has implemented a “robust’’ action plan that’s been approved by York Region Public Health and other authorities, and “have taken concrete steps to ensure additional advisory staff are on-site,’’ with further measures to “strength education and training around infection prevention and control.’’

Which is another way of saying that a robust action plan and concrete steps had been lacking before Kurji got on the case.

The provincial government does not post its orders online. But the Ontario Health Coalition, with its 400-member organizations, has done a good job of keeping track by cross-referencing data. In “A Call to Conscience,’’ a 68-page report issued Dec. 17 that documents in heartbreaking detail the inequities and shortfalls in institutional care for the elderly — outbreaks following the first wave of massive LTC contagion skyrocketed “with hair-raising speed’’ from 18 facilities, active, on Sept. 1 (only two had more than five cases) to 117 facilities, active, on Dec. 1 (and had reached 187 by Thursday) — lists eight institutions which have received management orders and 16 with “facilitated management agreements.’’

All but one are for-profit homes.

Sienna had been the recipient of one management order (Woodbridge Vista Care, management assumed by William Osler Health Centre) and three management agreements, with no data logged yet for December. Extendicare, the other big footprint LTC operator — more than 100 facilities under its leaky umbrella in Ontario — has been the subject of at least four management agreements.

Obviously, the more homes in a company’s portfolio, the greater likely number of outbreaks during a plague that has eaten long-term-care institutions alive. But one would think that having so much responsibility within the industry, outfits such as Sienna and Extendicare would also have a greater grasp of safety protocols, supervision and bottom-line standards. It can’t all be about squeezing a buck for profit.

A Star analysis published last week revealed that, through the first nine months of 2020, with COVID claiming hundreds upon hundreds of seniors’ lives in Ontario LTCs, the three largest publicly traded LTC operators in the province — Extendicare, Sienna and Chartwell Retirement Residences — paid out nearly $171 million to shareholders, at the same time they received $138.5 million through provincial pandemic pay for front line workers, the Canadian Emergency Wage subsidy program or other pandemic funding.

While our vulnerable, most fragile senior citizens are dying inside and dying to get outside. While our elderly only on Thursday began getting inoculated with the just-rolled out Moderna vaccine, but not, apparently, the earlier distributed Pfizer-BioNTech version because they weren’t at the front of the line and the Pfizer-BioNTech vaccine, which needs to be stored and cold temperatures, would have been too complicated for transporting into LTCs.

While, as well, the Doug Ford government has so sparingly used its powers — expanded in May under the Long-Term Care Homes Act — to bring LTCs under outbreak to management heel. Thus far, far as I can determine, no operator has had its licence revoked or even been fined for sloppy measures. Homes with scores of deaths haven’t been subjected to either management takeovers or facilitated agreements. Even as 2,749 residents have died.

Why the hell not?

“Accountability is still non-existent for homes that do not follow the Infection Protection and Control protections and other measures that are supposed to be in place,’’ says the Ontario Health Coalition report. “There remains no systematic intervention early enough to save lives and provide care in the homes that have outbreaks, and in some there is no evidence of intervention at all.

“There is no accountability for incompetent and negligent management.’’

Outbreaks should demand immediate intervention when they’re still potentially containable and controllable, with under five cases. Instead, institutions watch infection and fatality numbers escalate dramatically before either requesting help or having intervention imposed upon them. Understaffing — PSWs, nurses and doctors also contracting the virus and having to isolate — may be the leading culprit of careering outbreaks but, from the inspection reports I’ve read, staff woefully ill-educated in prevention and control are also to blame. Which might be through no fault of their own because many are new hires with zero experience.

North York General Hospital, which a fortnight ago took over management of the Tendercare Living Centre in Scarborough, has put out an SOS for medical volunteers to help stabilize the “dire’’ situation. I’m told that the home has reached out to 11 temp agencies in search of staffing recruits. But the virus has reached out too. Two other care facilities that share the building, McNicoll Manor and Moll Berczy Haus, on Thursday reported outbreaks as well: nine active resident cases at McNicoll, two at Molly Berczy, with two staff infections at each.

At Tendercare, where family members and seniors’ advocates protested last week, at least 52 residents have died in this outbreak, as reported Friday by The Canadian Press, with 78 active resident cases from among the 122 residents who had been sickened by the virus.

During a Town Hall virtual meeting on Wednesday, hosted by @NYGH_News, families were assured by Tendercare that dedicated staff would be provided to expedite family concerns with calls returned within 24 hours. But anxious relatives continue to complain that, despite constantly leaving messages, they’re not getting any callbacks.

Hello? Hello? Anybody there?

Minister Merrilee Fullerton?

Premier Ford?

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