Ontario investigating 2 long-term care homes following allegations residents died of neglect during pandemic

Ontario is investigating two Toronto long-term care homes where the Canadian military reported residents died of neglect, not COVID-19, during outbreaks last year.

Minister of Long-Term Care Merrilee Fullerton said multiple inspectors are working with the coroner's office at Downsview Long Term Care Centre and Hawthorne Place Care Centre, interviewing staff and medical directors to verify reports that residents died of dehydration and malnutrition.

Inspectors visited the homes on Monday, the ministry said. 

It will be up to the Coroner's Office to decide if there's enough evidence to call in police, Fullerton said Friday.

Toronto police said they have not yet received anything from the Coroner's Office related to deaths at Hawthorne Place or Downsview. 

Ontario Provincial Police told CBC News last week they're not aware of any ongoing investigations into deaths at nursing homes related to COVID-19, but are reviewing the long-term care commission's report released in April. 

The Canadian Armed Forces submitted reports about the two homes to the independent Long-Term Care COVID-19 Commission, which was tasked with examining the impact of the pandemic on Ontario's nursing home residents.

"We are trying to piece together what really happened and verify information," Fullerton told reporters. "We are reviewing where this information came from. What is the basis? What is is the source?

"There's no doubt there was deaths. We're looking at causes." 

To date, 3,778 residents died of COVID-19 in long-term care, according to the province. However, it does not track how many residents died from other causes during the pandemic.

The military reports, revealed this month, have fuelled calls for criminal charges to be laid against homes for failing to provide the necessities of life, said Vivian Stamatopoulos, an advocate for the families of long-term care residents.

"I don't think we've ever had a situation with such glaring evidence of widespread neglect contributing to death and yet nothing has been done," said Stamatopoulos, a professor at Ontario Tech University. 

"I think we have more than enough evidence to pursue charges. Why hasn't that very damning information that exists been handed over to local police departments?" 

Homes deny allegations

The military provided medical and humanitarian aid at Downsview, Hawthorne and five other homes as the system was overwhelmed by COVID-19 cases last spring.

At the Downsview home, where 65 residents died of COVID-19, 26 residents died of dehydration because there wasn't enough staff to care for them before troops arrived, the military alleged in a June 2020 report submitted to the commission. 

"They died when all they needed was 'water and a wipe down,'" said the report.

The military said there was a lack of management at the for-profit home and there did not appear to be "any noticeable plan in place" when the forces withdrew.

The company that owns Downsview, GEM Health Care Group, denied these allegations in a statement to CBC News.

The report consists of "unsubstantiated second-hand comments," said Chief Operating Officer James Balcom. 

"Based on the experience of our staff at Downsview, our own facility records and our co-operation with the Office of the Chief Coroner, it is false and misleading for anyone to claim that 26 deaths at Downsview Long Term Care Centre were due to dehydration."

Balcom said he's confident the province will reach the same findings in their investigation. 

At Hawthorne Place, also a for-profit home, the military reported when their civilian team arrived there was "feces and vomit on floors and on the walls" and residents had died of dehydration and malnourishment. Fifty-one residents died of COVID-19. 

Two residents had dried feces under their fingernails for a "prolonged" period of time," the military reported. Civilian staff said management "is non-existent."

Hawthorne Place told CBC News the Canadian Armed Forces never raised these issues with them during "extensive meetings" last year.

"At no time were issues raised relating to mold, fungus, dehydration, malnutrition or concerns related to the home's future management, or success," said spokesperson Nicola Major in a statement. "All concerns that were raised were addressed immediately."

She said management were at the home and worked collaboratively with health-care agencies to find personnel to fill in for the 100 Hawthorne employees unable to work due to COVID-19. 

"Throughout the entire outbreak, management provided oversight and engaged with our care support team providing direction and outlining protocols and changes to infection control directives as they were received," Major said.

'We need justice'

Neil Shukla is demanding answers after his 90-year-old grandfather Nemai Mallick died at Hawthorne Place on April 27, 2020 — days after the military was called in to assist the overburdened home grappling with a COVID-19 outbreak.

Shukla and his family had been concerned about Mallick's care before the pandemic. A few years ago, a family member noticed Mallick was dirty and his hands and fingernails crusted with what appeared to be dried feces, Shukla said. On another visit, they spent an hour imploring staff to address a blaring noise coming from a device on Mallick's wheelchair. 

"Nobody seemed interested in addressing this problem," Shukla told CBC News. "All I got was deflection of blame, a complete disconnect and lack of care." 

When Hawthorne Place went into lockdown last spring, the family tried to Skype with Mallick, who'd tested negative for COVID-19, but found him to be unresponsive, said Shukla. Later, they were told Mallick had regained consciousness.

Two days later Mallick passed away. Shukla said his death was listed as from natural causes.

"We were given a very vague description of his death. It was very confusing and sudden and we wanted to know what happened," Shukla said. "They couldn't give us a clear answer." 

The family asked for an autopsy, but according to Shukla that never happened. Now, the military's report has made the family wonder if Mallick's death was triggered by neglect. 

"He could've potentially died because he wasn't given water," Shukla said. "We need an explanation and we need justice."

Major, Hawthorne Place's spokesperson, said every death certificate in Ontario that lists cause of death is signed by an attending physician and none from the home cite neglect, dehydration or malnutrition. 

To protect residents' privacy she said she cannot comment on specific cases, but the decision to conduct an autopsy is made by the coroner based on their knowledge of the case and expertise. Any concerns a family has about the cause of death is shared with the coroner. 

"Our residents and their families are at the forefront of everything we do, and all resident deaths are responded to with the deepest of respect," Major said.

Military alleged abuse a year ago

A year ago, the military alleged horrific elder abuse at five homes, including Hawthorne Place, in a public report that sparked widespread outrage. At that time, the military said residents at Hawthorne Place were given food and water by force, causing "audible chocking" and had not been bathed for weeks.

Staff were not disinfecting equipment between using it for residents who'd tested positive for COVID-19 and those who'd tested negative, the report said. Fans were blowing in the hallways, even though that practice increases the virus's spread. The home had ant and cockroach infestations.

The Ministry of Long-Term Care initiated an inspection following these allegations, which was not able to substantiate many of the allegations, Major said.