Ontario commits to keep funding for-profit long-term care despite pandemic findings

TORONTO — It's been over a year since Cathy Parkes' father died from COVID-19, but she's still paying close attention to inspection reports for the long-term care home where he breathed his last breath.

Her father was one of 70 residents who died at Orchard Villa, a home in Pickering, Ont., during the first wave of the COVID-19 pandemic in the spring of 2020.

As recently as June, the home was dinged for failing to follow infection prevention and control protocols. Now, Parkes and other relatives are rallying against a potential license renewal and expansion for the home's owner, Southbridge Care Homes.

"I am flabbergasted that it's even a question," Parkes said of the potential renewal. "It should be a pretty simple no, considering the history of home."

A scathing report by Canadian Armed Forces members who were called in to help long-term care homes overwhelmed by the pandemic found residents at Orchard Villa were suffering without proper nutrition or hydration.

Parkes said she wants the municipality to take over the home. Her position isn't uncommon among families, advocates and opposition politicians who argue Ontario should transition away from for-profit ownership of long-term care homes, a segment of the sector that saw the highest death toll among residents.

In Parkes' view, the process should begin by revoking licenses of companies that saw high numbers of deaths and a documented failure to follow protocols.

But the Progressive Conservative government's priority has been the construction of new long-term care beds and it's continuing to award contracts to private operators.

Of 220 planned long-term care development projects, 111 will be for-profit, said a spokesman for the Ministry of Long-Term Care. The government is currently taking bids for long-term care development as it aims to build 30,000 new beds over the next decade. Successful applicants are expected to be announced early next year.

More than 4,000 long-term care residents have died during the COVID-19 pandemic. For-profit homes had nearly twice as many residents infected with the virus and 78 per cent more deaths compared with non-profit homes, according to scientists advising the government on the pandemic.

The commission looking into how the pandemic played out in long-term care noted in its final report that "now is the time to revisit the business" of the sector. It recommended that the government follow a model that allows private funding for construction but have operators that aren't profit-motivated run the homes.

Vivian Stamatopoulos, a professor at Ontario Tech University who studies family caregiving, said the government's continued support of for-profit homes is "terrifying" during a "watershed moment" as the province prepares to dole out 30-year contracts for the next generation of homes.

"We are going against all of the evidence as to what we should be doing," she said in a recent interview. "We're not doing anything to change the system. We are literally reproducing it even worse."

Stamatopoulos, who testified at the Long-Term Care COVID-19 Commission, said the province should focus on accountability for bad actors during the pandemic with documented neglect, including taking back ownership.

Saskatchewan has taken some steps in that direction. It plans to end its contract with long-term care provider Extendicare -- which saw the province's deadliest COVID-19 outbreak in one of its homes -- and take over operations at the facilities.

Ontario's New Democrats have pledged that, if elected next June, they will phase out for-profit long-term care operators within eight years.

The Opposition party's plan for the sector also promises to stop issuing and renewing licenses to for-profit providers and fund other entities to take over homes. NDP Leader Andrea Horwath formally called on Ford's government in the legislature last month to place a moratorium on licenses for for-profit providers.

Liberal Leader Steven Del Duca said his party is still developing its election platform on long-term care, but noted that the pandemic has highlighted that profit and long-term care "don't mix well."

Long-Term Care Minister Rod Phillips has maintained that recent changes introduced by the Progressive Conservatives aimed at improving accountability and upping enforcement will improve the situation.

He's said that taking back licenses from for-profit homes isn't practical, arguing that approach would cost money and time that could be better spent expanding the sector.

"We would rather spend billions of dollars on building new homes," Phillips said in a recent interview.

There are approximately 38,000 people on waitlists for long-term care spaces in the province.

Non-profit, for-profit and municipal operators are encouraged to apply under the government's call for bids, but the report on the commission and a group representing not-for-profit operators have recommended policy changes that would make it easier for non-profit operators to successfully apply.

Parkes said she has a hard time trusting that the government's promises of greater accountability are more than pre-election talk.

"The military report comes out and Doug Ford says 'I'll hold these people accountable,' but instead they're giving them licenses," Parkes said. "It's a bit of a slap in the face."

This report by The Canadian Press was first published Nov. 2, 2021.