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Following the emergence of community spread in Metro Halifax, the province has announced six locations where residents of long-term care homes who test positive for COVID-19 may be transferred to receive specialized care.
Five of these “Regional Care Units” will be located in hospitals and one will be set up in a building connected to the Ocean View Continuing Care Centre in Dartmouth.
“Residents in our continuing care system are some of the most vulnerable when it comes to COVID-19,” said Leo Glavine, Minister of Health and Wellness. “We have made changes to strengthen how the sector responds to a second wave of the virus and Regional Care Units (RCUs) for nursing home residents who test positive is one of these measures.”
Sixty-five Nova Scotians died during the first wave of the pandemic, more than 85% of whom lived in one of the 133 nursing homes and residential care facilities that care for nearly 8,000 people across the province. The Department of Health will spend $6.2 million to set up RCUs, which will be staffed by the nurses, continuing care assistants, and infection prevention and control experts recruited by the Nova Scotia Health Authority. It’s a “best practices” model endorsed by Infection Prevention and Control Canada, a multi-disciplinary group with members from nursing, medicine, and epidemiology.
The new RCUs will be located at: Cape Breton Regional Hospital, St. Martha’s Regional Hospital, Colchester East Hants Health Centre, Valley Regional Hospital, Yarmouth Regional Hospital, and Ocean View Continuing Care Centre in Eastern Passage.
This change won’t be without controversy and confusion. The news release from the Department of Health says “work is underway to finalize guidelines on when a resident is transferred to a Regional Care Unit versus being cared for in place.” That’s a key decision. It also says organizations that operate large or multiple facilities (such as Shannex, Northwood, and Gem Group) “may choose” to establish “the regional care unit model” in their own nursing homes rather than transfer residents out.
These statements suggest many long-term care facilities are reluctant to move residents from the place they consider their home. The province has gone along with allowing large operators to retain a number of empty beds for “COVID units” in separate wings or on separate floors, as they did during the first wave.
Response from nursing homes
“Shannex is prepared to care for residents affected by COVID-19 with specific spaces, or four regional designated care areas (DCAs), within our communities,” wrote Gillian Costello, senior communications manager for Shannex Inc. “Our DCAs were established during the first wave of COVID-19 and remain in place should they be needed to care for residents during the second wave. They have a separate entrance, proper ventilation installed, and offer increased staffing levels with dedicated teams working exclusively in these areas.”
A Shannex home in Sydney experienced an outbreak and one resident died before the outbreak was contained.
By contrast, at Northwood in Halifax — a 50-year-old building where 485 people lived — a COVID unit was established on a separate floor, but it was simply overwhelmed by too many cases, and 53 residents died.
Northwood today has 90 fewer residents and has eliminated most of its shared rooms. It too has specialized infection control staff and plans to keep residents who contract COVID “in place.” As of yesterday, the home has suspended “outings” by residents except for medical appointments.
“Northwood will continue to treat residents on site in both our Bedford and Halifax Campuses,” according to an email received from Murray Stenton, Northwood’s communications officer. “As part of our infection prevention and control practices, we have continued to swab staff and residents if anyone displays possible COVID-19 symptoms. Northwood continues to follow the guidance of Public Health regarding appropriate testing protocols.”
Testing is something the Examiner has been asking the Department of Health about but has not received an answer. Specifically, if an outbreak in a nursing home takes place tomorrow, are “rapid tests” available for staff and residents? This could assist with decision-making as well as shorten the length of time staff are self-isolating.
Ocean View steps up
There are more than 90 nursing homes in the province but only one — a community-run home in Eastern Passage with 176 residents — accepted the province’s invitation to locate a Regional Care Unit that will accept COVID-positive residents from other long-term care facilities. A 25-bed Regional Care Unit will be located in a building connected to Ocean View’s main residence by a tunnel.
“We feel it’s out duty to be part of this solution,” said Ocean View CEO Dion Mouland. “The province has recognized the need to support long term care (LTC) homes differently to prevent the spread of COVID-19. Regional Care Units will allow LTC residents who are ill with COVID-19 to be transferred to a space where they can be cared for by teams who are specially focused on COVID-19 infection prevention and care.”
The responsibility for operating the RCU will be on Ocean View Continuing Care Centre but the recruitment and payment of separate staff for the RCU will be carried out by the Nova Scotia Health Authority. The RCU has separate entrances and the tunnel that connects to the main building accesses a shared kitchen. In his letter to families of residents, Ocean View CEO Dion Mouland went to lengths to reassure them.
“The RCU will operate as a stand-alone unit, located in the part of our building known as Harbourside. The RCU space will be totally separated from Ocean View’s space. Our Ocean View community will remember how successful our separate Outbreak Unit was during the first wave of COVID – the RCU will build on that concept, but will be even further closed off and securely separated.”
Ocean View had one COVID case last spring and that resident recovered.
Opposition responds
In a news release yesterday, NDP Health critic Susan Leblanc noted that while many things have changed since COVID entered our lives nine months ago, one thing that has not changed is people sharing accommodations and bathrooms — 425 of rooms in long-term care are shared.
“For the last seven years, the Liberal government has overlooked long-term care in a way that is unconscionable and shameful,” said NDP Leader Gary Burrill. “We need to begin immediately with investments in new and redeveloped facilities that will make it possible for every resident to have a room they can call their own, and staffing to provide the care that they deserve.”
In his response September 21 to recommendations from the Northwood Review, former Health Minister Randy Delorey committed to reducing 30 situations of “triple bunking” in nursing homes. Here’s an update two months later.
“There are 24 rooms across seven facilities with occupancy greater than two people,” says Marla MacInnis, communication advisor for the Department of Health. “That said, not all of these beds may currently be occupied as there are vacancies still remaining from the first wave. Transition plans are being developed to reduce capacity over time.”
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