Private CHSLDs Say Left Alone During Pandemic

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Quebec’s private long-term care facilities were forced to fend for themselves during the pandemic, the general manager of an industry association said Wednesday in a forensic investigation into the deaths of older people in CHSLD.

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“We called our suppliers of personal protective equipment, who told us’ we cannot supply it, it is reserved for health care personnel, it is not on the list,” said Annick Lavoie, general manager of the Association des établissements privés conventionnés (AEPC ).

In the absence of supplies, the Quebec health minister created a system of priorities. The private CHSLDs “were Priority 3, at the same level as the GPs,” while the public CHSLDs were at a higher level.

So the team would “gradually come” from regional health authorities, where “we would get maybe 50 percent of what we asked for,” Lavoie said. Sometimes “we had to travel several kilometers to get it because the CISSS or CIUSSS didn’t deliver it.”

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Lavoie said it was also difficult to get screened for COVID-19 because “our employees were not considered part of the health network.”

Unsubsidized private long-term care homes also struggled to obtain equipment, tests and information on infection control, said Paul Arbec, president of the Association des estabments de long-duration privé du Québec.

Communications with the government were also a major problem, Lavoie said.

The ever-changing directives from the Health Ministry, he said, “took three to five days to get to the front.”

Private establishments were often not invited to the meetings of the regional health authorities where information was distributed, and had to wait for the documents to make their way through the bureaucracy.

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Lavoie said he tried to alert the government to this problem several times, often without receiving a response.

In the future, he said that a representative of the AEPC should be included “in the different tables of the ministry” and the government should “send directly a clear interpretation of the guidelines” to the organization, which can then distribute it to the members.

“There is no real recognition by the CISSS and CIUSSS of the non-subsidized private CHSLDs as partners,” Arbec said. He blamed the 2003 and 2015 health reforms, saying before the mergers, “we were very involved at the regional level … with the mergers, we were excluded from the discussions.”

The coroner’s investigation is investigating the deaths of the elderly and vulnerable during the first wave of the COVID-19 pandemic. From February 25 to July 11, 2020, Quebecers aged 70 and over accounted for 92 percent of deaths from COVID-19, according to data from the Institut national de santé publique du Québec. The investigation is not designed to determine guilt, but to offer recommendations to prevent future tragedies.

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The research examined a sample of one death from each of the six CHSLDs and one private nursing home. This week, the coroner focuses on the provincial management of the crisis.

This story was produced with financial assistance from Facebook and the Canadian Press News Fellowship.

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