New Brunswick nursing homes that reported high COVID-19 infection rates lacked infection prevention and control practices, and were not properly inspected, says a report by the auditor general.
Some nursing homes had fewer than the required number of staff, and the Department of Social Development wasn’t able to properly enforce the rules, Paul Martin concludes in his report, tabled at the legislative assembly Thursday.
Of the 358 people in New Brunswick who lost their lives to the pandemic as of March 31, 2022, 90 were nursing home residents and one was a staff member.
The Department of Social Development was aware of systemic issues facing nursing homes well before COVID-19, Martin said, adding that the province did not have an updated pandemic plan and had not provided nursing homes with additional funding to prepare for the possibility of a pandemic.
“We reviewed inspection results for a sample of 30 nursing homes and noted non-compliance with appropriate care staff ratios rose from 30 per cent to 87 per cent between the years 2018 and 2022,” Martin’s report said.
“Non-compliance with the requirement for a full-time registered nurse at all times rose from 10 per cent to 40 per cent between the years 2018 and 2022.”
As well, the auditor general concluded that the province failed to properly enforce infection prevention and control rules at nursing homes.
The federal government recommends that provinces employ one infection and control inspector per 150 to 200 beds, but the report said the province had hired two specialists for the entire province.
“According to the (Department of Social Development), the specialists made efforts to work with each home in outbreak, but with the number of nursing homes experiencing outbreaks they were unable to visit every home in person.”
Martin said that inspectors had few mechanisms to enforce the rules. They could modify a nursing home licence or revoke it, or place the care home into trusteeship. But he said the province was reluctant to revoke licences during the pandemic because of the potential harm to residents.
And modifying licences — the primary enforcement mechanism — has not proven effective, the report said. “Several nursing homes operate under a modified licence,” it said.
“While nursing home inspection reports are available on the departmental website, the status of the home’s licence is not. This is important information for residents and their families to assist in their decision-making processes.”
Martin also noted in his report that employees at the Department of Social Development reported that the risk of contamination was high because infection control rules weren’t being followed and staff lacked training on how to use personal protective equipment.
“Many issues existed well before 2020 and were exacerbated during the COVID-19 pandemic,” Martin said in the report. “These issues will continue to weaken the system of care for residents in nursing homes across the province until adequately addressed.”
This report by The Canadian Press was first published Sept. 7, 2023.