The federal government has ordered a thorough audit of the country's largest veterans facility following complaints from family members about substandard care.
A senior official, who requested anonymity, said Veterans Affairs Minister Steven Blaney gave the order on Thursday after hearing the "disturbing" allegations of neglect of frail vets at the Sunnybrook Veterans Centre.
The audit would focus both on how taxpayers' money is being spent and on the quality of the care provided, the official said.
"We're just trying to make sure that what veterans are getting there is of top-notch quality," he said from Ottawa. "We want to make sure we're basing our action on credible evidence; the audit is the only tool to allow us to really determine what's going on the ground there."
The official said the aim is to have the audit completed by early next year. It will be as thorough and as detailed as possible, include conversations with relatives of patients, and the results would be made public, he said.
In articles last week, The Canadian Press outlined several concerns raised by relatives, who said they had been stonewalled by Sunnybrook in trying to have them addressed.
Among the issues were claims of vets forced to endure unsanitary conditions, delays in bathing and feeding, soiled sheets, dead mice in rooms, and constant room and caregiver changes.
Relatives also decried what they called a lack of accountability.
For its part, Sunnybrook says its care meets or exceeds standards, patient and family surveys show exceptional levels of satisfaction, and it is always willing to address any concerns.
Still, Mr. Blaney sent two senior officials last Friday to look into the complaints. They met briefly with Sunnybrook managers, who assured them the concerns were being addressed, although the families were skeptical.
The senior official said Thursday the visit was simply to get an initial sense of the situation and to send a signal Ottawa was watching.
Mr. Blaney's spokesman later confirmed the audit directive and said the Minister was keeping a close eye on the situation.
"Minister Blaney takes the concerns of veterans and their families very seriously and that's why he is taking clear action to investigate and address these concerns," Niklaus Schwenker said in an e-mail.
The 500-bed Sunnybrook Veterans Centre – something of a regulatory orphan – reports exclusively to the federal government even though it takes in tens of millions of dollars from both the province and Ottawa.
In an interview two weeks ago, Sunnybrook management said the facility acts as if it were under Ontario law, and cited provincial Ministry of Health audits in support of its contention the care allegations were coming from a handful of malcontents.
"The Ministry of Health had to agree to do it," said Jocelyn Charles, medical director. "We've volunteered, and we've been audited twice."
Asked when the most recent audit was carried out, Dr. Charles said: "The last one was two – was it one or two years ago?"
"Yes, maybe even a little bit more than that," Dorothy Ferguson, Sunnybrook's operations director, interjected.
In a subsequent e-mail this week, Ms. Ferguson said Health Ministry officials in fact last audited the facility's 190 long-term-care beds in spring 2004, and again in November of 2005.
On Thursday, Dr. Charles said the audit that occurred one or two years ago was in fact a review done by a national independent non-profit organization, Accreditation Canada, which took place in 2010.
"I'm sorry I didn't make that clear," Dr. Charles said.
The veterans centre also relies on the non-profit to review its 310 complex continuing-care beds – which fall under provincial legislation, are paid for by Ontario, but are accountable only to Ottawa.
An Accreditation Canada spokeswoman explained the organization creates and markets health-care standards, and takes a "mentor-like" approach in advising facilities how to improve any weak spots and celebrate their strengths.
Normally, under Ontario's increasingly stricter rules, the province's 630 long-term-care homes are inspected at least once a year to ensure they meet government standards. Inspections include interviews with residents and family members. Results are public.
Not so for Sunnybrook.
"The ministry has no involvement in any oversight," said David Jensen, a spokesman for the Ontario Health Ministry.
"This [auditing] wasn't a part of any long-term-care-home type of inspection."
He also said he could find no record of the audit.
Either way, Sunnybrook insists it meets or exceeds Ontario's quality standards – even though an audit in 2005 would have been two years before the province legislated those standards.
Sunnybrook also points to patient and family satisfaction surveys as evidence its care is exemplary.
Since the story was published, however, several other people have come forward to raise concerns – some on condition the identities of their loved ones not be disclosed to Sunnybrook.
One family reported their loved one died after a fall. Another said they discovered their elderly relative with a tooth knocked out, apparently after the essentially immobile patient had wriggled out of his bed.