Results of an investigation led by Saskatchewan ombudsman Mary McFadyen shows Extendicare Parkside in Regina was unprepared to handle a COVID-19 outbreak.
The outbreak was declared on Nov. 20, 2020 when Extendicare Parkside learned of two positive cases involving an employee and a resident. The resident died.
Contact tracing later showed that 13 residents and 12 employees also contracted the virus and that number continued to grow.
“This was a tragedy. 194 out of 198 residents got COVID-19 and 39 of them died of it. Three others who got it died of other causes. 132 Parkside staff also got COVID-19. It is important for residents and their families to know what happened,” McFadyen said in her report, tabled by the Speaker of the legislative assembly Thursday.
McFadyen found that, as early as March 2020, both the Saskatchewan Health Authority and Extendicare Parkside knew they would be in “serious trouble” if a COVID-19 outbreak occurred.
“Instead of reducing Parkside’s population, so no more than two residents shared a room, the focus was on keeping a few rooms vacant to isolate COVID-19 positive residents. This was a mistake,” read McFadyen’s report, titled Caring in Crisis: An investigation into the response to the COVID-19 outbreak at Extendicare Parkside.
The investigation focused on five areas: physical layout and limitations, pandemic planning and management, the supply and use of procedure masks, limiting the spread of COVID-19 from resident to resident, and staff and staffing.
McFadyen said given its physical limitations, it was “vital” Extendicare Parkside prevent an outbreak, but it failed to do so.
The investigation found Extendicare Parkside “was not consistently screening staff for symptoms and failed to ensure staff were taking required precautions like social distancing and wearing masks during breaks.”
Instead of giving staff at least four masks per shift as per SHA guidelines, employees were provided with one mask along with a paper bag to store it while on breaks.
As part of Extendicare Parkside’s pandemic plan, COVID-19-positive residents were to be isolated in a hallway on the facility’s north wing.
“Instead, it isolated the first few positive residents in its main wing where they had been staying. By the time it decided to move positive residents as planned, it had so many cases it needed to convert its entire north wing into a COVID-19 wing,” the report read.
“Its staff were not equipped to safely move so many residents at once. Positive residents were moved simultaneously with non-positive residents. Not all of them were masked and rooms were not fully disinfected between moves.”
The report also showed Extendicare Parkside didn’t have an outbreak staff contingency plan to replace employees required to self-isolate.
“This created a staffing crisis within the first few days of the outbreak. Because it is not an Authority affiliate, it also could not directly access the Authority’s staff,” the report read. “This was one of the key reasons the Authority had to take over Parkside and manage the outbreak.”
In June 2020, Parkside Extendicare lobbied the Ministry of Health to implement rapid testing into the facility.
However, the ministry said it did not have enough supplies to do so and believed the measures in place were effective enough. The ministry didn’t know Extendicare Parkside wasn’t following those measures.
Rapid testing was implemented into the facility on Dec. 8, 2020, but McFadyen’s report indicates it was too late at that point.
On Nov. 6, 2020 a public health order was put in place that required long-term care residents to wear masks outside their rooms, unless eating or if they had a medical condition or cognitive impairment preventing them from doing so.
Extendicare Parkside and SHA officials were not aware of the public health order until December 2020.
“McFadyen also found that Extendicare has not done a critical incident review, which is required whenever there is a serious, adverse health event, including loss of life. The purpose of these reviews is to prevent similar errors in the future,” the report read.
Based on McFayden’s findings, she has a number of recommendations for Extendicare Parkside moving forward.
“Apologize to the families of the Parkside residents who passed away as a result of the outbreak, and to all the other residents whose lives were disrupted,” the report read.
“That it collaborate with the Authority to conduct a critical incident review of the outbreak at Parkside, that it ensure its administrators and staff comply with its own rules and the rules laid out by the Ministry of Health and the Authority.
“And that it ensure it has resources on site so its staff will be able to comply with all relevant infection prevention and control management.”
Extendicare Parkside told Global News in an emailed statement Thursday measures are in place to make things better.
“The pandemic has exposed weaknesses in our health-care system and, in particular, has made painfully clear the structural challenges that have burdened the long-term care sector for decades,” Extendicare Parkside said.
“At Extendicare, we are focused on learning from this unprecedented pandemic to build a better future for seniors’ care.
“We have taken action inside our own organization, with the launch of our Improving Care Plan, a multi-year national plan to improve care, every day, across every home we operate.”
Extendicare Parkside said it will carefully consider the findings and recommendations in McFayden’s report.
McFayden also had several recommendations for SHA, despite saying it did provide Extendicare Parkside reasonable support during the pandemic and outbreak.
“That the Saskatchewan Health Authority immediately stop allowing four-bed rooms in long-term care facilities, that it updates its agreement with long-term care home operators and ensure they comply with its care-related policies, standards and practices,” the report read.
“That it conduct detailed annual reviews of all long-term care homes to ensure they are following its care standards and report publicly on each home’s level of compliance.
“And that it also ensures its communicable disease prevention and control management standards and practices are being followed consistently, including completing inspections of all long-term care homes at least once a year.”
The province responded by saying it accepts its share of responsiblity and accepts McFayden’s recommendations.
“On behalf of the government and the SHA I want to apologize to the families and friends of all of those who died in Parkside as a result of COVID-19,” said Everett Hindley, Saskatchewan’s minister of seniors and rural and remote health.
“The government has accepted all of the ombudsman’s recommendations to ensure this can never happen again.”
Hindley said SHA has been appointed administrator over all five Extendicare long-term care facilities in Saskatchewan for a period of 30 days.
“At the end of 30 days, SHA will submit a report to the Ministry of Health regarding compliance with the ombudsman’s recommendations and the care requirements, as stipulated under the program guidelines for special care homes,” Hindley said.
“At that time, SHA will re-evaluate its ongoing relationship with Extendicare and Parkside and whether it should continue.”
No recommendations were made to the ministry due to the fact it’s positioned itself away from having any responsibility for long-term care home operations.
“We strongly encourage the Ministry to make meaningful and lasting systemic and structural improvements to Saskatchewan’s long-term care system so that something like this does not happen again,” McFayden said.
The Saskatchewan NDP weighed in and questioned not only the outbreak at Extendicare Parkside, but the province’s entire long-term care system.
“The ombudsman also makes it clear that the problems in long-term care go far beyond this one horrific outbreak when she calls on the government to ‘make meaningful and lasting systemic and structural improvements to Saskatchewan’s long-term care system,’” said Matt Love, NDP critic for seniors.
“The Saskatchewan NDP believes that should include the end to for-profit care in Saskatchewan.”
The full report can be found on the ombudsman Saskatchewan website.