REGINA — The final report following an inquiry by the provincial ombudsman into the deadly COVID-19 outbreak at Regina Parkside Extendicare has found the facility was “woefully unprepared” to manage such circumstances.
The long-term care facility saw a very high rate of COVID-19 infection during the two-month outbreak from November 2020 to January 2021, with a reported 194 out of 198 residents and 132 staff confirmed to have tested positive for the virus.
Forty-two residents died during this time, including 39 whose deaths were caused by COVID-19 complications. Three other residents had tested positive, but COVID-19 was not identified as the cause.
After several health-care unions and the Saskatchewan NDP called for a public inquiry into the outbreak earlier this year, the provincial government instead sought an independent ombudsman investigation at the end of January.
A deep probe by provincial ombudsman Mary McFadyen included the review of over 20,000 documents submitted by Extendicare, the Ministry of Health and the Saskatchewan Health Authority, including emails, meeting reports, policies, and more.
Over 100 interviews with staff, management, provincial officials and families of Parkside residents were also completed.
McFayden’s investigation determined that all three entities were aware that the Regina Parkside facility was not equipped to manage an outbreak of COVID-19 safely, and did not take adequate steps to address problems of overcrowding and understaffing.
The report also found that the protective policies issued by the health authority, like mask wearing and physical distancing, were not properly adhered to or enforced by management at Parkside.
“As early as March 2020, Authority and Extendicare officials were aware that Parkside would be in serious trouble if it were to have a major COVID-19 outbreak because so many of its residents were crowded into 4-bed rooms,” said the report.
“Despite discussing this concern, neither of them took meaningful, proactive and effective steps to deal with it before the outbreak.”
McFadyen said that Extendicare failed to make sure Parkside was taking appropriate measures to reduce transmission, and that the SHA had a similar “hands-off” approach that did not help.
“There were some areas where effective oversight [from the SHA] was lacking, and where the Authority should have taken a greater, leadership role,” said the report.
In her final report, McFadyen made eight total recommendations, beginning with a call on Extendicare to issue a formal written apology to the families of those who died during the outbreak, and to all others “whose lives were disrupted because they got COVID-19, because they were displaced from their home to other facilities, and because they had to live through the outbreak.”
Seniors Minister Everett Hindley offered an apology to families on behalf of the provincial government, and accepted the recommendations directed to the SHA.
The SHA has now been appointed administrator for all Extendicare long-term facilities in the province for the next 30 days, to ensure compliance with the recommendations.
Report results: a long-term capacity problem
Both Extendicare and the provincial government have been aware of the capacity issues at the Parkside facility for at least a decade, according to the ombudsman’s report, and that the aging building did not meet “reasonable standards.”
Extendicare was reportedly in discussion with the Ministry of Health regarding concerns about the 4-bed rooms at Parkside in 2020, but did not take any steps towards eliminating their use before the outbreak occurred.
Approximately 86 per cent of the rooms at Parkside were being shared by either two or four residents, at the time.
Overcrowding had already been identified as a problem as far back as 2010, with reports stating that it was causing an increased risk of infection transmission, proven by the facility having “consistently more outbreaks than other facilities over the years.”
Reducing the facility’s four-bed rooms to two-bed rooms would result in a 30 per cent drop in revenue for the for-profit operators, which was identified as one of several reasons behind the hesitancy from Extendicare and the SHA to make the change.
Parkside’s regional director told the ombudsman investigation that bed capacity was not reduced because “the decision had to be made by the [provincial health] Authority.”
Since the outbreak, all four-bed rooms have been reduced to two-bed rooms as of March 31, 2021, taking the facility’s capacity down to 160. Hindley said that a two-bed cap for rooms in long-term care facilities across the province is also now in place.
In addition to capacity concerns, structural problems at the facility were also identified, which resulted in crowded common areas and no space for residents to properly isolate when infected.
Problems also stemmed from a “lax” enforcement policy from Parkside, said the report, in several areas.
The facility was not consistently screening staff or enforcing physical distancing and masking orders.Staff were only provided one mask per shift and a paper bag to store it in, despite SHA recommendations and provisions, and employees were not wearing masks during breaks in the staff room.
“Staff were entering Parkside with COVID-19 symptoms and then eating and visiting with one another on their breaks without wearing masks or staying apart,” said the report. “Residents were lining up for their meals without masks.”
“While the Authority made it clear to Parkside that it should be using four masks per day [for staff], it did not try to enforce it.”
The facility also did not prepare isolation spaces for residents according to its own pandemic plan, said the report, instead moving residents in a way that may have increased transmission.
Residents with positive COVID test results were housed in the main wing, instead of another area designated by the facility’s pandemic plan, which meant staff were moving between COVID and non-COVID areas freely.
The SHA did temporarily take over operations of Parkside Extendicare in December of 2020, well into the outbreak, to provide staffing support for the facility.
That operational shift changed again in February, when the SHA rescinded operations back to Extendicare.
A number of the issues highlighted in the ombudsman’s report showed that though Extendicare did have appropriate policies and the health authority provided “reasonable support,” many of the issues the facility faced stemmed from a lack of room inside it’s building.
McFadyen said the Parkside facility, originally built in the mid-60s, did not have adequate physical space for staff to safely move and care for residents, or to properly distance in common areas.
The private company, which is contracted by the SHA, has been lobbying the provincial government since 2010 to replace it’s three long-term care facilities in Regina, including Parkside.
No movement on the discussion seems to have taken place.
Extendicare has issued a statement on the report, indicating that it will consider the recommendations from the ombudsman but not commit to accepting them. It also called on more funding from the SHA to provide better minimum care standards.
