River Glen Haven is region’s worst long-term care COVID-19 outbreak: York Region Public Health

By: Mike Anderson

Monday’s announcement by the province that Southlake Regional Health Centre will take over management of River Glen Haven is a hopeful sign that the COVID-19 outbreak may soon be resolved.

But the bad news keeps coming for the embattled nursing home in Sutton, Ontario.

According to York Region Public Health, the 119-bed nursing home is now the worst active long-term care COVID-19 outbreak in York Region, with 84 residents and 31 staff testing positive for the virus since the outbreak was reported on April 27.

That’s an increase of 21 resident cases – more than 30 per cent, since May 22, less than a week ago, when 63 positive cases were reported.

On May 27, York Region Public Health also reported two more deaths at the home, bringing total confirmed deaths due to COVID-19 to 25 — nearly a 30 per cent mortality rate for residents infected with the virus.

However, just one day after the province issued the mandatory management order on May 25, RGH administration sent a decidedly upbeat email to family members in which it claims there are now just 16 active cases at the home, with 30 residents recovered.

At present, it is not possible to confirm these numbers, as public health only reports cumulative positive cases and doesn’t report the number of long-term care residents who recover from the virus.

The email from RGH administration sent on May 26, also made the following assertions:

“Our management and staff have and continue to work tirelessly to ensure resident care needs are met, and to mitigate the spread of COVID19 in our home. These are unprecedented times, and our commitment is and has always been the health and safety of our residents and staff. We will always be accepting of any assistance that furthers this effort in achieving our commitments.”

These statements seem to conflict with allegations made by the Ministry of Long-Term Care in its mandatory management order.

Specifically, the order was issued because RGH administration did not take “urgent action,” and there was a “lack of clinical and administrative leadership” to stop the spread of COVID-19.

According to the order, three primary factors contributed to RGH’s inability to contain the spread of the virus.

The first was insufficient staffing, including critical staffing shortages on some shifts. For example, on May 5, less than 50 per cent of staff reported for work at the home.

“The management team of the LTC has been unable to ensure a consistent and sustained staffing schedule which ensures that staff are consistently available to attend the LTC home,” reads the order.

Secondly, infection prevention and control measures were not implemented to contain the spread. Thirdly, staff were not provided with PPE.

In fact, Central LHIN, concerned about the lack of IPAC training at the home, filed a report with the Ministry of Labour:

“The Central LHIN has reported they filed a report to the Ministry of Labour related to their concerns of staff at the LTC home not wearing PPE appropriately, not following PPE instructions and lacking in clinical skills.”

When the outbreak began, some family members reported that negative cases were not being separated from positive cases; this allegation has been confirmed by the order.

Based on assessments conducted by Southlake and York Region Public Health, RGH had “poor IPAC interventions in place, thereby failing to limit the spread of the disease.”

“The LTC home was unable to cohort residents with COVID-19 from those residents who did not have COVID-19. There were also no clean areas within the LTC home that could be identified for donning and doffing of PPE safely,” the order reads.

The order also states that RGH administration failed to provide accurate reporting during the outbreak:

“The LTC home’s management team has not been able to accurately track numbers related to residents and staff who have been confirmed to have COVID-19. Without accurate and timely information of the number of cases and who is infected with the virus, containment cannot occur.”

There were also allegations from Central LHIN that RGH administration did not attend mandatory meetings or provide status updates during the outbreak.

While Southlake will manage the RGH for 90 days, the period can be extended by Stacey Colameco, Director, Long-Term Care Inspections, for the Ontario Ministry of Long-Term Care.

According to the order, ATK Care Inc, the home’s owner and licensee, is required to pay “any and all costs” during the management period, including costs borne by Southlake and the ministry.

RGH is also prevented from taking any actions that “undermine or jeopardize the ability for Southlake to manage the LTC home to its full extent.”