The southwestern Ontario nursing home where serial killer Elizabeth Wettlaufer murdered seven residents is still under an order from the province not to accept new admissions six months after it was issued.

Caressant Care Woodstock has been under scrutiny since Wettlaufer's crimes came to light last fall. The registered nurse admitted to overdosing residents with insulin in order to kill them and was sentenced last month to life behind bars. She killed an eighth resident at another nursing home after she was fired from Caressant Care in 2014.

The Ministry of Long-term Care took the step of blocking admissions to Caressant Care Woodstock on Jan. 25, after multiple inspections found violations of the Long-Term Care Homes Act.

The violations included failing to properly report suspected mistreatment of a resident, failing to provide proper hygiene, problems administering medication and several other issues. 

"The ceasing of admissions has been directed based on my belief that there is a risk of harm to the health or well-being of residents in the home or persons who might be admitted as residents," Karen Simpson, the ministry's director of inspections, wrote in the order.

But Caressant Care Woodstock isn't the only nursing home struggling to comply with regulations. Inspectors are kept busy investigating complaints across the province and conducting annual inspections of 627 licensed homes.

Trout Creek home's licence revoked

Three other homes in Ontario are under cease of admissions orders, including Lady Isabelle Nursing Home in Trout Creek, which was ordered to stop accepting new residents back in April 2016. Last week, the ministry took the extreme step of revoking the home's licence because it had repeatedly failed to fix a variety of problems in areas including infection control, resident safety, safe storage of medications and program delivery. 

Now its residents will be forced to relocate to other homes, which could be a challenge given that Trout Creek is a small town near North Bay and beds could prove hard to find.

Bella Senior Care Residence in Niagara Falls was ordered to stop accepting new admissions in November 2016, as was Cedarwood Lodge in Sault Ste. Marie back in March.

Sault Interim Care Home 20170618

Family members of residents at Cedarwood Lodge long-term care home in Sault Ste. Marie, Ont., have alleged neglect and substandard care. It is under an order from the province not to accept new residents. (Kenneth Armstrong/Canadian Press)

Jane Meadus, a lawyer with the Advocacy Centre for the Elderly, said the ministry doesn't take issuing cease admissions orders or licence revocations lightly. So, when it does issue them, it raises a lot of questions and concerns, she said.

"Why are these facilities unable to meet the needs of the person, even with a great deal of oversight from the ministry? What is it that's happening?" Meadus said. "That's often unclear in these cases."

Caressant Care declined interview requests to explain why its order remains in place and what steps it has taken to get it lifted.

Lee Griffi, manager of corporate communications for Caressant Care Nursing and Retirement Homes, instead emailed a copy of the statement the company issued in January. It said the order would enable the home to focus on addressing the ministry's concerns on an "urgent basis" and that "immediate changes" would be made.

What concerns were addressed urgently and which ones are outstanding isn't clear.

'Microscope' on Caressant Care

Ministry spokesperson David Jensen said the home was required to submit a plan outlining how it would rectify the non-compliance issues and it did meet that requirement.

"The ministry continues to monitor the compliance situation at the home through ongoing inspections and ongoing contact with the home's senior management and the licensee's representatives," Jensen said in an email.

Inspectors most recently visited on May 12.

Meadus said the home has a "microscope on them."

"Obviously the ministry is being ultra-cautious with that home and they are in there all the time, versus some other homes that maybe are just going under the radar," the lawyer said.

Nursing Home Probe 20161025

Caressant Care is the nursing home in Woodstock, Ont., where serial killer Elizabeth Wettlaufer committed seven of eight murders. (Dave Chidley/Canadian Press)

Ministry inspectors have also spent a lot of time at Bella Senior Care Residence, which has a lengthy record of non-compliance. Last year, inspectors found evidence of emotional and physical abuse of residents. Some of those details were contained in a 106-page report posted on the ministry's website on Nov. 24, the day before it ordered a halt to admissions.

Eight months later, the order is still in place. Michael Bausch, the home's administrator, told CBC it's taking so long because the problems "were fairly extensive."

Bausch, who took over in December, said he's made changes in education, culture, policies and procedures and is confident the concerns raised by the ministry have now been addressed.

Orders an 'eye-opener'

It's a safe place for the 122 residents, Bausch said. "I have every confidence it is."

The home is waiting for ministry inspectors to visit and Bausch believes it will then get the all-clear.

Cedarwood Lodge declined an interview but said in a statement that the ministry has made suggestions and directives "to help us improve and those are things we are currently reviewing with our team and the ministry." The statement said the issues centred on "gaps in internal communications and how that affected the following of policies and procedures."

Inspection records show that not having a registered nurse on duty around the clock and other staffing issues were flagged as problems at Cedarwood Lodge, as was the facility's failure to protect residents from abuse and neglect.

Inspection reports for these and all homes in Ontario are publicly available on the ministry's website, but Anthony Quinn, director of public affairs for CARP, an advocacy group for older Canadians, said it takes too much digging online to find information about a licence being revoked or cease of admissions orders.

"It's an eye-opener, I think, for families who have loved ones in long-term care and it's something that should be more transparent," he said.

His group has been pushing the government to expand the scope of the public inquiry it called into the Wettlaufer case to look at long-term care homes in general. That would help get at the reasons why some homes are consistently violating provincial regulations, he said.

"I don't think Ontarians can be proud of the long-term care system as they see it today," he said. "We all, I think, have been holding our nose at what the system has become over the years."