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The decision to prioritize vaccinations by age means nearly all residents of nursing homes and residential care facilities (aka group homes) have been vaccinated. In this third wave of the pandemic, it is rare to find a resident who has COVID-19. And there have been only six reported cases among staff during this outbreak.
Two of those six staff members were at the Clarmar Residential Care facility in Dartmouth. One was reported on Tuesday, April 27, and the second on Thursday, April 28.
Then on Saturday, the Department of Health reported that two residents of Clarmar had tested positive, and those cases were connected to one of the staff members who had previously tested positive.
Clarmar is licensed for 24 beds and cares for people with physical and intellectual disabilities.
After the two Clamar employees tested positive last week, I asked the Department of Health if staff at the home had been vaccinated; Health Department spokesperson Dan Harrison emailed: “Staff and residents who wanted vaccinations received them. You will have to contact the facility for any further data.”
It’s possible the residents who tested positive did not consent to be vaccinated or had a phobia about needles; we don’t know because the administrator of the home has not responded to our repeated requests for comment.
But we do know that Clamar has a troubling history of regulatory non-compliance that has been documented in a series of provincial inspection reports. Are that history of non-compliance and the current cases of COVID connected? It’s impossible to make a direct causal relationship between the two, but it’s worth reviewing Clamar’s track record.
In 2017 and again in 2018, inspectors reported 18 deficiencies that Clarmar was required to address in order to keep its licence. These inspections noted: bedrooms were cold, there were few or inconsistent care plans for individuals, there were no procedures to review personal directives around end-of-life decisions, there was no system for dealing with residents’ funds, and there was no evidence of staff orientation or annual performance reviews.
The November 2017 inspection report told Clarmar to revise its emergency plan to include dealing with an evacuation, spill, or a “violent person.”
In a bizarre turn of events, two days after that inspection, on November 23, 2017, police were called to Clarmar because a 64-year-old old male resident violently assaulted a 70-year-old male resident. The victim died at the home, following what police called “a medical event.” No charges were laid.
“By December 18, the attached action plan template outlining the corrective actions to be taken must be completed,” reads the Nov 2017 inspection report. “It is imperative that prompt action is taken to address these deficiencies and ensure Clarmar Residential Care Facility is brought into compliance.”
The Health Department did not close the facility but instead issued a three-month temporary licence to give the home time to comply. At that time, Clarmar was owned by Clark Dorey. Clark died in 2019 at age 79 and information filed with the Registry of Joint Stocks shows his wife Margaret Dorey continues to operate the family business.
Clarmar’s 2020 inspection
Those inspection reports were obtained using Freedom of Information legislation. Today, such inspection reports are easily available to the public by visiting the “Continuing Care” section of the Department of Health website.
Clarmar’s most recent inspection — pre-COVID — was in February 2020. The inspector listed 16 “requirements” the home must meet to keep its licence. Here are a few of those requirements:
• The licensee shall ensure a list of emergency and non-emergency names, phone numbers and addresses is posted in an accessible place near a telephone in each home. The list should state, “In the event of an emergency, dial 911” and shall include the local fire department, police department, Emergency Management Office, ambulance services and physicians.
• The licensee shall ensure there is an active program for the prevention, control and investigation of infectious, communicable diseases. This includes the monitoring of infection rates (surveillance) and the sharing of this information, internally and with the Department of Health and Wellness upon request.
• There shall be a record kept for each resident of a home for special care who is receiving drugs, and the record shall indicate the resident’s name, address, age, sex, weight, food and drug sensitivities and allergies; the type and dosage of drug; the manner in which the drug is to be administered; the physician who prescribed the drug; the date of the prescription and the date of discontinuance.
• The licensee shall ensure an interdisciplinary care conference, that includes the resident and/or authorized designate and the family members approved by the resident, is conducted within six weeks of admission to the home and annually thereafter, or more frequently as the resident’s individual needs require.
• The licensee shall ensure management and staff meetings are held a minimum of quarterly.
• The licensee shall ensure there are procedures in place to direct staff in the event of an expected death or an unexpected death
The Northwood complex in Halifax experienced an outbreak of COVID in the spring 2020 that left 53 residents dead.
But since vaccinations of nursing home residents and staff began in January, Clarmar Residential Care Facility is the only long-term care home to report positive COVID cases among both staff and residents. Last month, there were positive cases among staff at Ocean View nursing home in Eastern Passage (one employee), Northwood (one employee), and Glasgow Hall in Dartmouth (two employees), but there have been no other cases reported among staff in long-term care facilities during this third wave, and none at all involving residents, except for at Clamar.
Vaccines have been offered to all health care workers but not all workers in long-term care have been inoculated. Asked a few weeks ago, the Department of Health estimated the percentage of staff in long-term care who had been vaccinated was hovering at about 60%. It’s unclear why the percentage was so low and it’s probable the vaccination rate is higher today because of the concern around the latest surge in cases.
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