Manitoba·CBC Investigates

For-profit care homes have higher COVID-19 death rates among Winnipeg nursing homes

Manitobans died from COVID-19 outbreaks in for-profit personal care homes at a rate higher than in those run by the province or not-for-profit organizations, a CBC News analysis revealed.

Biggest for-profit company says death rates are not about profit or non-profit, but community spread

Frances Rowlin, seen here with her goddaughter in 2011. Rowlin died at the age of 77 after contracting COVID-19 at Charleswood Care Centre. (Submitted by Dorothy Young)

Manitobans died from COVID-19 outbreaks in for-profit personal care homes at a rate higher than in those run by the province or not-for-profit organizations, a CBC News analysis reveals.

While for-profit care homes have only one quarter of the nursing home beds in the province, they account for 44 per cent of care home deaths.

Charleswood Care Centre, a 155-bed nursing home owned by Revera Inc., had the highest death rate of all Winnipeg-based nursing homes. 

Dorothy Young's best friend of more than 60 years, Frances Rowlin, was one of those residents who died after contracting COVID-19 at the for-profit home.

"It's not right," Young said.  "We're losing people that we shouldn't have to lose so early in their lives."

Dorothy Young lost her best friend, Frances Rowlin, to the COVID-19 outbreak at Charleswood Care Centre. (Darin Morash/CBC)

Since the beginning of the pandemic, Charleswood has reported 45 deaths related to outbreaks at the home, according to figures provided by the provincial government.

Young was around 12 years old when she met Rowlin at Girl Guide camp. They were later roommates for 15 years and Rowlin was her daughter's godmother.

Rowlin, 77, was in an assisted living facility before moving to Charleswood. She had Parkinson's and Lewy body dementia and was prone to wandering. She needed 24-hour care.

Young says Rowlin wanted to go to Golden West Lodge, but the wait list was at least a year long, so she went to Charleswood on Sept. 11, 2020, to wait until a bed opened up. 

Rowlin tested positive for COVID-19 on Dec. 12, 2020, and died two days later.

Frances Rowlin's best friend, Dorothy Young, questions the care that Rowlin received before she died at Charleswood Care Centre. (Submitted by Dorothy Young)

Before Rowlin died, Young said a retired nurse friend came into the home twice a day to make sure Rowlin was getting properly fed and given enough water.

Young wants to know why Charleswood wasn't better prepared for a possible COVID-19 outbreak, especially since the facility's owners, Revera, had seen the devastating effects at Maples Long Term Care Home and Parkview Place.

"You mean the head office didn't know what was happening in the Maples? And, you know, the other place, it was so bad here and they couldn't have said, this is what you need to do?" she said.

"Why weren't they learning from that?" 

Young wants to see the federal and provincial governments put an end to for-profit care homes in Manitoba.

"Their motive is money, make money, their motive isn't to give the best care for the money we charge. I don't believe that, not from what I saw," she said.

CBC analysis compares numbers of beds to number of deaths

 A CBC analysis compared how many beds were at each facility to how many residents died from complications related to coronavirus to come up with the number of residents who died per hundred beds in the facility.

The analysis looked at death and infection rates that occurred from the beginning of the pandemic to March 2.

March 17 marks one year since health officials first called for the immediate suspension of visits to seniors' homes. This began a seismic shift in how often and in what manner families were able to interact with their loved ones in long term care.

Maples Long Term Care Home, which gained widespread attention and a government-ordered external review in November, had the second-highest death rate in Winnipeg after 56 residents died in its 200-bed facility.

(CBC News)

Revera, which also owns the Maples care home, said in a prepared statement that "it is unfortunate that a more meaningful statistical analysis has not been undertaken for Manitoba, as was done at the request of the Ontario Long-Term Care COVID-19 Commission by Dr. John Hirdes."

Hirdes found that the there was not a "significant" distinction between the for-profit and non-profit homes. He argued the biggest variable is staffing issues at the commission hearing.   

Revera spokesperson Larry Roberts pointed out that of the 34 Manitoba PCHs which had at least one resident die during the pandemic, 19 are not-for-profit homes, nine are privately-owned, and six are publicly-owned.

He also noted that two of Revera's homes, Kildonan in Winnipeg and Valleyview in Brandon, had no resident deaths, and Beacon Hill Lodge had a single resident die from the pandemic.

"Some observers have taken ideological positions on the ownership of long term care homes despite the data that demonstrates that level of community spread and the age/configuration of buildings, not ownership model, are the significant variables identified by experts as significant to understanding outbreaks," Roberts said in a prepared statement.

Nearly half of of COVID deaths related to nursing homes

St. Norbert Personal Care Home, a for-profit home with 91 beds, had the third-highest death rate in the city, with 24 deaths. Followed close behind was Park Manor, which had the highest death rate among non-profits in the city, with 26 deaths at its 100-bed facility.

From the start of the pandemic to March 2, for profit-homes accounted for 194 of long term care deaths in Manitoba, 192 were at non-profit homes and 57 deaths were at publicly owned and operated homes. 

However, given the for-profits share of beds — about 25 per cent of long term care beds in the province — compared to the non-profit and public homes, its death rate was higher.

Officials at the Winnipeg Regional Health Authority, which provides funding and oversight to all Winnipeg personal care homes, declined an interview and declined to comment on the analysis.

In a prepared statement, spokesperson Paul Turenne said a WRHA clinical lead provided support to Charleswood Care Centre throughout its COVID-19 outbreak.

In response to questions by CBC on St. Norbert's death rate, a spokesperson for the nursing home said, "There are so many factors that have and continue to play a role in the pandemic effects and responses and we are unable to comment on comparisons as we don't have sufficient information or qualifications to do so."

Other provinces find similar outcomes at nursing homes

The question of taking the "profit" out of long term care has come to the forefront since the pandemic as several studies and media reports have shown similar results when it comes to outcomes in long-term care.

In Ontario, a CBC News Marketplace analysis found several Ontario for-profit homes had death rates higher than the non-profit and publicly-run nursing homes

Meanwhile a separate CBC analysis found private for-profit homes for seniors in British Columbia were over-represented among residences that have experienced COVID-19 outbreaks in the province.

Dr. Nathan Stall is a geriatrician based out of Sinai Hospital in Toronto who found similar results to the CBC analysis when it comes to Ontario for-profit long term care homes in a study released this summer.

"Most of the outbreaks started off in these homes that were crowded, that had precarious staffing situations that fell apart," he said.

Manitoba Health Minister Heather Stefanson says her department is working on implementing recommendations from the Maples Long Term Care Home report. (John Einarson/CBC)

He said there have been criticisms of his paper which found evidence that for-profit PCH homes have larger COVID-19 outbreaks and more deaths of residents from COVID-19 than nonprofit and publicly funded homes in Ontario.

"To deny the problem and to try and explain it away with factors that tend to be more common in the for-profit sector, it is just fact," said Stall.

"They have older buildings, they've had worse issues with staffing. They tend to pay their staff less. That needs to be acknowledged and that needs to be addressed to try and bring up the quality of care in those homes,"

Lack of staffing was one of the main findings of a report commissioned by the health minister to investigate what went wrong at Maples Personal Care Home after eight people died in the span of 48 hours in early November.

Health Minister Heather Stefanson declined an interview for this story and declined to comment on CBC's analysis. 

In a prepared statement, she said she is committed to implementing the recommendations of the Maples report to improve care at all personal care homes in the province "regardless of ownership."

Dr. Nathan Stall is a geriatrician at Mount Sinai Hospital in Toronto. He says staffing shortages and multiple occupancy rooms are risk factors in PCHs. (David Common/CBC)

Stall says multiple occupancy rooms are linked to the spread of COVID-19 and other infections.

A CBC investigation last October revealed four pairs of residents remained in a shared room at Parkview Place after at least one tested positive for COVID-19. Parkview has 36 shared rooms in its facility. 

Stall said outbreaks like what happened at Maples "can never happen again" and the staffing crisis and multiple occupancy rooms need to be addressed. 

Union calls for end of private ownership model

Revera is 100 per cent owned by the Public Sector Pension Investment Board which manages the pensions of federal workers who belong to the The Public Service Alliance of Canada.

The Canadian Union of Public Employees represents about 5,600 support workers at long term care homes in Manitoba, including about 1,100 in private facilities operated by Extendicare and Revera.

The pandemic underlined problems in the private for-profit ownership model, said Shannon McAteer, CUPE's health care co-ordinator.

"We definitely are supportive of public, not-for-profit, personal care home and long term care facilities," McAteer said. 

"When it becomes about the bottom line, and not about the resident care, the resident care suffers."

For-profit care homes have higher COVID-19 death rates among Winnipeg nursing homes

6 months ago
3:01
As covid-19 spread through nursing homes across the province, a CBC News analysis has revealed more seniors died in for-profit facilities, than in publicly run, or non profit homes. 3:01

Methodology note:

CBC News calculated the per bed rate of COVID-19-related deaths for each not-for-profit, for-profit and public personal care home in Manitoba. The figures used in the analysis, which were provided by the Manitoba Government, are current to March 2, 2021.

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