Long-Term Care Home Complaints

LTCH Experience Survey Announcement | Press Release (PDF)

FOR IMMEDIATE RELEASE

Ontario’s Patient Ombudsman wants to hear about your experience in long-term care during the first year of the COVID-19 pandemic

(Toronto, May 12th, 2021)

Patient Ombudsman is launching a province-wide COVID-19 experience survey for residents, caregivers and staff in Ontario’s long-term care homes (HYPERINK). The survey is anonymous and an opportunity for those who were affected by the crisis in long-term care to privately share their experiences.

Throughout the pandemic Patient Ombudsman responded to and resolved healthcare complaints from residents, caregivers and whistleblowers (staff who remain anonymous) who courageously shared their concerns during a very difficult and challenging time. During the first wave of the pandemic, Patient Ombudsman experienced a 300% increase in COVID-19 related complaints in long-term care.

“It is important to ask all members of the long-term care home community about how they were personally impacted by the pandemic. This time last year, long-term care was in crisis and the collective experiences from that critical moment in time have much to tell our office as we work to understand exactly what happened and why.”
Craig Thompson, Patient Ombudsman

This COVID-19 experience survey will inform Patient Ombudsman’s on-going investigation into long-term care homes with COVID-19 outbreaks. Survey results will be shared publicly later this year.

Key facts:

• In the fall of 2020, Patient Ombudsman issued a special report that included recommendations to the sector, such as a change in approach to visitation restrictions. Patient Ombudsman called out the restrictions to bar visitors from their loved ones as inhumane. (hyperlink)

• In June of 2020 Patient Ombudsman, launched an own motion investigation (OMI) on COVID-19 outbreaks in long-term care.

• To date, Patient Ombudsman’s investigative team has completed an analysis of thousands of documents and is now collecting additional evidence through interviews and witness impact statements.

Patient Ombudsman is a champion for fairness in healthcare. We facilitate resolutions and investigate complaints about patient care and healthcare experiences in long-term care homes, public hospitals and home and community care. We take the time to listen closely to all perspectives without taking sides. Our work aims to improve the system for everyone, by shining a light on issues of concern.

For media inquiries please contact: Jason Oliver, Senior Communications Specialist
M: 416-523-9356 E: Jason.Oliver@Patientombudsman.ca
 

LTCH COVID-19 Investigation Update (Spring 2021) | Press Release (PDF)

Patient Ombudsman Investigation Update

Investigating the experiences of residents and caregivers in Long-Term Care Homes that managed a COVID-19 Outbreak: Spring 2021 UPDATE

In response to the crisis in Ontario’s long-term care homes during the first wave of the COVID-19 pandemic Patient Ombudsman initiated an Own Motion Investigation.

Patient Ombudsman is reviewing the outbreak experience in a cluster of long-term care homes where we heard significant concerns during the first wave of the pandemic. Before engaging with these homes, careful consideration was given to the homes ability to respond to our enquiries while continuing to manage outbreaks and implement vaccine roll-out initiatives.

“We never want our activities to be disruptive to the operations of long-term care homes. The health and safety of residents, caregivers and staff is always paramount when undertaking document reviews, witness interviews and consultations with administrators.”
Craig Thompson, Patient Ombudsman

Patient Ombudsman’s investigation is reviewing:

• Visitation restrictions and protocols.

• Communications including the timing and type of information that was shared with residents and families.

• Staffing levels over the course of the outbreak.

• Infection Prevention and Control practices and protocols.

• Access to Personal Protective Equipment (PPE).

In parallel with the investigation, Patient Ombudsman is launching a province-wide experience survey targeting residents, families, caregivers and long-term care home staff. Hyperlink to this.

Investigation Milestones:

• Patient Ombudsman 1st wave of COVID-19 special report and recommendations to long-term care homes

• Formal notice of intent to investigate (NOI) to a short-list of long-term care homes.

• Completion of an evidentiary document review process that included thousands of pages of document (including but not limited to medical charts, written communications, policies, and procedures).

• Commencement of virtual interviews with residents, families and essentials caregivers and staff in selected long-term care homes.

• Collection of witness impact statements.

• Launch of provincial survey to seek the input of long-term care home residents, caregivers and staff.

Next steps:

• Analysis and synthesis of all witness interviews and related evidence.

• Report writing and issuing of recommendations.

• Opportunity for response from long-term care homes subject to the investigation.

• Report to government and public target date - early 2022

 

News Release of Long-term Care Home Investigation | Press Release (PDF)

FOR IMMEDIATE RELEASE

Patient Ombudsman launches systemic investigation into the resident and caregiver experience at Ontario’s Long-term Care Homes with outbreaks of COVID-19
(Toronto, June 2nd, 2020)

Patient Ombudsman began monitoring the impact of COVID-19 on the experiences of patients, residents and caregivers when the pandemic was first declared. Complaints from residents, family members and whistleblowers pointed to a crisis in Ontario’s long-term care homes.

On April 26th, 2020, Patient Ombudsman launched a public appeal for COVID-19 complaints in long-term care. Patient Ombudsman asked staff, family members, caregivers and residents to disclose situations where they felt the safety of residents and staff may be in significant jeopardy.

Since March, Patient Ombudsman received 150 complaints about long-term care homes.  That number continues to grow.

“Our office would like to thank every resident, caregiver and staff person of a long-term care home for having the courage to come forward with their complaints. We are committed to resolving these complaints and amplifying the voices of residents and caregivers as we learn from their experiences.

Patient Ombudsman acknowledges Ontario Ombudsman’s separate investigation of the oversight of the long-term care system by the province’s Ministry of Long-Term Care and Ministry of Health.

Our investigation is specific to the resident and caregiver experience at long-term care homes with outbreaks of COVID-19. We feel that this investigation will help long-term care homes prepare for future outbreaks of infectious diseases, including COVID-19.” (Craig Thompson, Executive Director, Patient Ombudsman)

Investigation focus

The investigation will focus on the experience of residents and caregivers in those long-term care homes that experienced an outbreak of COVID-19.
Some of the issues affecting the experience of residents and caregivers include:

• staffing levels;

• visitation restrictions;

• infection prevention and control procedures; and

• communication of information.

Patient Ombudsman is a champion for fairness in healthcare. We facilitate resolutions and investigate complaints about patient care and healthcare experiences with long-term care homes, public hospitals and home and community care coordinated through Local Health Integration Networks. We take the time to listen closely to all perspectives without taking sides. Our work aims to improve the system for everyone, by shining a light on issues of concern.

For media inquiries please contact: Jason Oliver, Senior Communications Specialist
M: 416-523-9356 E: Jason.Oliver@Patientombudsman.ca

Notice of Intention for Investigation | Press Release (PDF)

 

In accordance with s. 13.3 (6) of the Excellent Care for All Act, 2010, this notice is to advise licensees within the meaning of the Long-Term Care Homes Act, 2007 of Patient Ombudsman’s intent to initiate an investigation on our own-initiative. 

This investigation is being conducted pursuant to s. 13.3 (4) of the Excellent Care for All Act, 2010. The scope of our investigation will examine, but will not be limited to, the following issues:

1. How did the actions or inactions of individual long-term care homes (LTCH) in response to COVID-19 outbreaks affect the care and healthcare experience of residents?

2. What were the common system factors that influenced the actions or inactions of individual LTCHs that experienced outbreaks of COVID 19?

Please note, this Notice of Intent is general to all licensees within the meaning of the Long-Term Care Homes Act, 2007.Patient Ombudsman will look to contact individual licensees directly and provide them with specific Notices of Investigation in advance of specific investigative activities directed towards individual long-term care homes.

Subsections 13.3(9) through and including 13.3(24) of the Excellent Care for All Act, 2010 apply to this investigation, and the investigators have the powers set out in these provisions. A copy of these provisions is appended below. 

This investigation will be conducted in private.  Thank you in advance for your cooperation and that of your staff. 

Sincerely,

Craig Thompson
Executive Director, Patient Ombudsman

 

Excerpts from s. 13.3 of the Excellent Care for All Act, 2010

Investigation
13.3 (1) Where, after attempting to facilitate the resolution of a complaint under section 13.2, the patient ombudsman believes that the complaint should be investigated, the patient ombudsman may investigate the complaint. 2014, c. 13, Sched. 5, s. 4.

May decide not to investigate
(2) Without limiting the generality of the powers conferred on the patient ombudsman by this Act, the patient ombudsman may in his or her discretion decide not to investigate, or, as the case may require, not to further investigate any complaint for any reason for which the patient ombudsman could have determined not to attempt to facilitate the resolution of the complaint under section 13.2. 2014, c. 13, Sched. 5, s. 4.

Patient to be informed
(3) In any case where the patient ombudsman makes a determination not to investigate or further investigate a complaint, the patient ombudsman shall inform the patient, former patient, caregiver or other prescribed person in writing of that decision and state the reasons for that decision. 2014, c. 13, Sched. 5, s. 4.

Investigations on own initiative
(4) The patient ombudsman may also commence an investigation of the actions or inactions of one or more health sector organizations that relate to the patient care or health care experience provided by the organization or organizations in any case where the patient ombudsman believes that the matter should be investigated. 2014, c. 13, Sched. 5, s. 4.

Restriction
(5) Despite subsection (4), the patient ombudsman shall not commence an investigation under that subsection in connection with a matter that is within the jurisdiction of another person or body or is the subject of a proceeding. 2014, c. 13, Sched. 5, s. 4.

Organization and patient to be informed
(6) Before investigating any matter, the patient ombudsman shall inform the relevant health sector organization and the patient,  former patient, caregiver or other prescribed person, if any, who made the complaint that led to the investigation of his or her intention to make the investigation. 2014, c. 13, Sched. 5, s. 4.

Investigations are private
(7) Every investigation by the patient ombudsman shall be conducted in private. 2014, c. 13, Sched. 5, s. 4.

Exception, other persons and bodies
(8) Despite subsection (7), where the patient ombudsman obtains information in the course of an investigation that relates to a matter within the jurisdiction of another person or body, the patient ombudsman may provide that information to the other person or body. 2014, c. 13, Sched. 5, s. 4.
 

Obtaining information, etc.
13.3 (9) The patient ombudsman may hear or obtain information from any persons he or she thinks fit, and may make any inquiries he or she thinks fit. 2014, c. 13, Sched. 5, s. 4.

Opportunity to be heard
(10) The patient ombudsman is not required to hold any hearing and no person is entitled as of right to be heard by the patient ombudsman, but, if at any time during the course of an investigation, it appears to the patient ombudsman that there may be sufficient grounds for him or her to make any report or recommendation that may adversely affect any person or entity, the patient ombudsman shall give to that person or entity an opportunity to make representations respecting the adverse report or recommendation, either personally or by counsel. 2014, c. 13, Sched. 5, s. 4.

Requiring information
(11) The patient ombudsman may from time to time require any officer, employee, director, shareholder or member of any health sector organization, or any other person who provides services through or on behalf of a health sector organization, who, in his or her opinion, is able to give any information relating to any matter that is being investigated by the patient ombudsman,

1. (a) to furnish to him or her with the information; and

2. (b) to produce any documents or things that in the patient ombudsman’s opinion relate to the matter and that may be in the person’s possession or under the person’s control. 2014, c. 13, Sched. 5, s. 4.

Examination under oath
(12) The patient ombudsman may summon before him or her and examine under oath,

1. (a) any patient, former patient, caregiver or other prescribed person who has made a complaint under this Act; or

2. (b) any person who is mentioned in subsection (11). 2014, c. 13, Sched. 5, s. 4.

Certain other Acts
(13) A person who is subject to the Freedom of Information and Protection of Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act, 2004 is not prevented by any provisions in those Acts from providing personal information or personal health information to the patient ombudsman, when the patient ombudsman requires the person to provide the information under this section. 2014, c. 13, Sched. 5, s. 4.

Privilege preserved
(14) Every person to whom this section applies has the same privileges in relation to the giving of information, the answering of questions, and the production of documents and things as witnesses have in any court. 2014, c. 13, Sched. 5, s. 4.

Statements not admissible
(15) Except on the trial of any person for an offence in respect of the person’s sworn testimony, no statement made or answer given by that or any other person in the course of any investigation by the patient ombudsman is admissible in evidence against any person in any court or at any inquiry or in any other proceedings, and no evidence in respect of proceedings before the patient ombudsman shall be given against any person. 2014, c. 13, Sched. 5, s. 4.

Right to object to self-incrimination
(16) A person giving a statement or answer in the course of any investigation before the patient ombudsman shall be informed by the patient ombudsman of the right to object to answer any question under section 5 of the Canada Evidence Act. 2014, c. 13, Sched. 5, s. 4.

Protection from liability
(17) No person is liable to prosecution for an offence against any Act, by reason of his or her compliance with any requirement of the patient ombudsman under this section. 2014, c. 13, Sched. 5, s. 4.

Fees, allowances, etc.
(18) Where any person is required by the patient ombudsman to attend before him or her for the purposes of this section, the person is entitled to the same fees, allowances and expenses as if he or she were a witness in the Superior Court of Justice, and the provisions of any relevant Act, regulation or rule apply accordingly, with necessary modification. 2014, c. 13, Sched. 5, s. 4.

Compliance
(19) Every person who is summoned by the patient ombudsman under this section, or is required to furnish or produce documents or information, shall comply with the summons or furnish or produce the documents or information, as the case may be. 2014, c. 13, Sched. 5, s. 4.

Entry
(20) For the purposes of an investigation under this section, the patient ombudsman may at any time enter upon any premises of a health sector organization and inspect the premises. 2014, c. 13, Sched. 5, s. 4.

Restriction
(21) Despite subsection (20), the patient ombudsman shall not enter any premises of a health sector organization, except with the consent of the health sector organization or under the authority of a warrant issued under subsection (23). 2014, c. 13, Sched. 5, s. 4.

Private dwellings
(22) Despite subsection (20), the patient ombudsman shall not enter any premises that is being used as a dwelling, except with the consent of the occupier or under the authority of a warrant issued under subsection (23). 2014, c. 13, Sched. 5, s. 4.

Warrant
(23) A justice of the peace may issue a warrant authorizing the patient ombudsman or another person to enter any premises of a health sector organization if the justice is satisfied, on evidence under oath or affirmation, that there are reasonable grounds to believe that it is necessary to enter the premises for the purposes of an investigation under this section. 2014, c. 13, Sched. 5, s. 4.

Obstruction forbidden
(24) No person shall, without lawful justification or excuse, wilfully obstruct, hinder or resist the patient ombudsman or a delegate of the patient ombudsman in the performance of his or her functions under this Act.

 

Call for complaints | Press Release (PDF)

FOR IMMEDIATE RELEASE

Patient Ombudsman seeks complaints about COVID-19 in Ontario’s Long-Term Care Homes

(Toronto, 2020-04-27)  Whistleblower complaints from staff and complaints from concerned family members reveal a crisis in many Ontario long-term care homes.

Patient Ombudsman is learning of significant safety concerns in long-term care homes including:

• Severe staffing shortages;

• Inadequate infection control and prevention measures;

• Inability to meet the basic care needs for some residents; and

• Poor or no communication.

Patent Ombudsman is asking staff, family members, caregivers and residents to disclose situations where they feel the safety of long-term care home residents and staff may be in significant jeopardy.

These complaints will help inform our response to support the care of vulnerable long-term care home residents, including potential investigations. We are proactively sharing information that comes to our office with the Ministry of Health, Ministry of Long-Term Care and Ontario Health.  

“This is a frightening time for many patients, residents, families and caregivers. Our goal is to learn as much as we can about how COVID-19 is affecting residents and staff in long-term care homes. Our hope is to help long-term care homes with future pandemic planning – including additional and potential new waves of COVID-19” (Craig Thompson, Executive Director, Patient Ombudsman)

Anyone with relevant information about COVID-19 issues in Ontario’s long-term care homes is encouraged to make a complaint or call 1-888-321-0339.

Patient Ombudsman is a champion for fairness in healthcare. We facilitate resolutions and investigate complaints about patient care and healthcare experiences with long-term care homes, public hospitals and home and community care coordinated through Local Health Integration Networks. We take the time to listen closely to all perspectives without taking sides. Our work aims to improve the system for everyone, by shining a light on issues of concern.

For media inquiries please contact:  Jason Oliver, Senior Communications Specialist

M: 416-523-9356        
E: Jason.Oliver@Patientombudsman.ca