Public health issues orders against 4 homes

Same issues found that caused wildfire spread of COVID-19 at Rosslyn

Hamilton Public Health has issued orders against four more retirement homes associated with Rosslyn Retirement Residence in the wake of a disastrous COVID-19 outbreak that saw the facility evacuated and temporarily shut down.

Infection control issues that led to the wildfire spread in the Rosslyn were also found at Montgomery Lodge on Main

Street East, Dundas Retirement Place, Cathmar Manor on Catharine Street North and Northview Seniors Residence in east Hamilton.

The four homes are considered high risk for COVID-19 outbreaks and public health has already started to test all staff and residents there.

The facilities are all associated with the families of Aldo Martino and the late John Martino, who owned the Royal Crest Lifecare chain of nursing homes until they went bankrupt in 2003.

At the same time, nine recommendations were made public Friday — including stronger oversight of retirement homes — in the wake of a resident being left behind during the evacuation of the Rosslyn on May 15. The senior with COVID-19 was left without care for18 hours before family alerted St. Joseph’s Healthcare.

The debriefing revealed no one was in charge of the evacuation that involved

St. Joseph’s, Hamilton Health Sciences (HHS), public health, LHIN home and community care, Hamilton Paramedic Service, Hamilton Police Service and the operators of the home itself.

“We think the city is in the best position to co-ordinate these kinds of operations going forward,” said Rob MacIsaac, CEO of HHS and a member of the Ontario West command table.

The orders issued to the four other homes Friday include inadequate

screening of residents, staff and visitors, which was also a problem at the Rosslyn and contributed to 64 of the 66 residents and 20 staff being infected in a matter of days, creating a crisis at the retirement home on King Street East.

“The severity of the situation at the Rosslyn Retirement Residence can not be overstated,” said MacIsaac. “At the end the of day, decanting that home was critical for the well-being of the residents who lived there and immediate action had to be taken.”

Public health also found inadequate staffing contingency plans at the four homes, which was one of the main reasons the Rosslyn had to be evacuated.

“At the end of the day, all of the staff that were working at the Rosslyn were testing positive for COVID, so we were left in a situation where there was no sustainable staffing model to continue on,” said Paul Johnson, director of Hamilton’s

Emergency Operations Centre. “Basic care issues for residents at the Rosslyn were becoming harder and harder to manage through decreasing numbers of staff.”

In addition, the homes have inadequate outbreak response plans, hand hygiene and use of personal protective equipment (PPE) education. Johnson talked about these same issues in the outbreak at the Rosslyn.

“There did seem to be a lack of true understanding, training and knowledge around how important infection prevention and control is,” he said. “Processes like how to screen people in and out simply were not happening. That encourages spread within a home.”

He said conflicting information was provided around whether there was enough PPE for staff during the outbreak.

“It also appeared PPE was not always being used in the most appropriate way within the home,” he said.

Johnson called it a “chaotic scene” when the evacuation took place from 4:45 p.m. on May 15 to 12:50 a.m. on May 16.

“There was not good census information about how many people were there, who the people were, who had been hospitalized already and who was still needing to be transferred,” said Johnson.

He said checks were done before St. Joseph’s staff left at around 1:30 a.m., but so far no one has been able to explain how the resident wasn’t found. Some of the organizations involved have pointed fingers at the Rosslyn owners.

“At no time did we take over the facility,” said Johnson. “It was not our job to secure the building. That facility was always the Rosslyn’s to own, operate and manage.”

Some of the nine recommendations to come out of the problematic evacuation will be put in place locally immediately while all have gone to the Ontario West division of the superagency Ontario Health.

Two of the recommendations involve assessing all high-risk congregate settings, as well as testing residents and workers.

Next is identifying somewhere other than the hospitals to evacuate residents. The Rosslyn’s crisis led to 64 hospitalizations, including two people who don’t have the virus. Two others, who are infected, chose to make other arrangements and are being monitored by public health.

“Frankly, we would rather not fill up our hospitals with all of these folks,” said MacIsaac. “I don’t think it’s any secret that as we were preparing for the pandemic, we had looked at some alternative health-care facilities within the city, so I think we need to get back onto those efforts.”

The fourth recommendation is clearer accountability roles and responsibilities for those who manage and work in congregate settings. The fifth is basic standards and requirements for physicians providing care there.

Next was creating a command management structure for evacuations that puts the city in charge.

The seventh was setting up dedicated resources in hospitals to aid congregate living during the pandemic.

“This is not something we can continue to do off the side of our desk,” said MacIsaac. “People can’t have dual roles. We need to have people dedicated to this if we are to sustain this for any period of time.”

The last two are the acknowledgement of the limitations of hospitals to address these issues and the need for stronger regulatory oversight of retirement homes.

“This really highlights the lack of fundamental responsibility,” said Mayor Fred Eisenberger. “Everyone has a little piece of it, but no one has the ultimate authority to take direct action to protect these residents in these retirement homes ... I certainly call on the province to put more teeth into the regulatory regimes so that these things can be prevented well in advance of getting to this point.”

Hamilton has 613 confirmed and probable cases of COVID-19 as of Friday compared to 605 the day before.

Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com