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Feds order 'thorough' audit of Sunnybrook Veterans Centre

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Feds order 'thorough' audit of Sunnybrook Veterans Centre

The Canadian Press
Posted: Nov 15, 2012 6:21 PM ET
Last Updated: Nov 15, 2012 8:07 PM ET

The federal government has ordered a thorough audit of the country's largest veterans' facility following complaints from family members about substandard care, The Canadian Press has learned.

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.
2 officials sent to Sunnybrook

Still, 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.

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 email.

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 Dr. Jocelyn Charles, medical director.

"We've volunteered, and we've been audited twice."

Asked when the most recent audit was carried out, 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.
Last Health Ministry audit was in 2005

In a subsequent email this week, 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, 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," 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.

Mike Blais:
These letters are presented in an effort of complete transparency. The CVA believes in working in the light, that our efforts must be guided by principle and fairness. Be advised that all issues we have addressed in a public manner have been addressed in the weeks/months prior to with the department/ministry and that our escalation level of activity inclusive of protest is dictated by response. be also advised that we have developed a very good relationship with Veterans Affairs Canada when we have engaged on issues that are related to quality of care for our WW2 and Korean era veterans.

If you have a father or mother in care that is a veterans and is not being accorded the dignified treatment you believe they are entitled to, please contact me.

From: Mike Blais <>
Date: Thu, Nov 15, 2012 at 8:59 PM
Subject: Re: Sunnybrook Hospital Concerns.
To: Keith Hillier <>

>>> Mike Blais <> 11/15/2012 9:09 am >>>

Hope all is well.

I hear that you have been in Australia, hope you enjoyed the trip and did not get to roasted on the beach sucking back some frosty Fosters.

Brevity aside, I have been contacted by some families of veterans who are at Sunnybrook and serious concerns have been raised. I was informed this morning that more will be forthcoming. As you know, Keith, I have taken a proactive stance on the care of veterans residing at St Anne's and Parkwood in the past and am determined to ensure Quality of Care standards for this generation of vets are maintained regardless of whose jurisdiction the hospital falls under. The issues that have been brought forth are directly related to quality of care, as such, I feel obligated to respond affirmatively to the request for assistance.

That being said, I would prefer to approach this issue in a dignified manner bereft of public demonstration as we felt was necessary to attain safeguards at St Annes.

I have always been forthright and willing to work with the department, this is no exception. Hopefully, we can address these issues in a unified sense, Keith and I would propose a mechanism wherein we can resolve theses issues. I suggest that we present a common front based on compassion, host a gathering wherein the department can be apprised of the families concerns in a non threatening atmosphere followed by a transparent tour of the facility and meetings with the directorship.

I think this is a common sense approach, Keith, that is required to
reassure the families and restore the level of trust they and there loved ones deserve.

This is a serious issue, Keith and during my consultations over the past
week plus, I have received a great deal of support for pro-active advocacy from veterans in the GTA and southern Ontario. I am also quite confident, as demonstrated already by the families press conference last week, they are willing to fight in a public forum.

I am hoping that we can avoid this negative aspect and working together, resolve this issue to everybody's satisfaction through dialog, sincerity and as always, with primary goal of improving the lives of of our veterans, in this case, those who are most vulnerable as they are suffering from dementia.

I would encourage you to make this a priority, Keith, as i understand it, there are other civilian, media and political aspects to the equation.


Mike  305 357 3306  ///  305 359 9247


On Thu, Nov 15, 2012 at 5:03 PM, Keith Hillier <> wrote:
Good afternoon Mr. Blais,
As you know, Keith is travelling. In his absence, I'd like to follow-up with you in order to action your e-mail...

Thanks, Kim Peters (for Keith Hillier)

Kim Peters
Quality Issues & Control Manager
Service Delivery Branch
Veterans Affairs Canada

* I will be speaking with Kim in am.

For Canada’s veterans, government rhetoric and policies are at war with each other

Gerald Caplan

The Globe and Mail

Published Friday, Nov. 16 2012, 12:44 PM EST

Last updated Friday, Nov. 16 2012, 12:44 PM EST

Remembrance Day has always sent ambiguous messages to Canadians – are we celebrating the glories or the horrors of war? – but the valour of those who fought has rarely been in doubt. To the dead we could only give thanks. To the survivors, we had a debt that must be paid in full.

Given the particular devotion of the Harper government to all things militaristic, especially the heroism of the troops it dispatched to Afghanistan, it was a given that when our boys and girls came home, their every need, material and psychological, would be cared for.

For reasons that defy rational analysis, this has been very far from true. I’m not sure how many Canadians understand this baffling phenomenon. Yet simply following the Globe and Mail’s coverage in the days around Remembrance Day last week reveals much of the real story.

On Nov. 9, for example, the Globe ran a story titled Families Say Nursing Home Neglects Vets. The culprit was the Sunnybrook Health Centre in Toronto, which gets funding from both the federal and Ontario governments.

On Nov. 10, a story headlined Veterans Minister Closed Privacy Probe told the remarkable story of retired captain Sean Bruyea. His criticisms of the benefit system imposed on vets led to a major violation of his confidential medical and psychiatric files by the Department of Veteran Affairs, which was hunting information it could use to discredit him. Now the Minister has instructed the veterans’ ombudsman to shut down his investigation into this clear breach of Captain Bruyea’s privacy, one of nine complaints of privacy violations in five years.

Again on Nov. 10, in portraits of three vets, the Globe introduced Major Mark Campbell who lost both his legs in Afghanistan to a roadside bomb. Major Campbell is suing his employer, the Canadian Forces, who “abandoned” him and his family. His wife, a full-time forces reservist, feels “betrayed” by the military. They say “they have been forced to claw for every benefit and that the military has fought them along the way. In particular, he has waged a battle against Canada’s New Veterans’ Charter which – despite its rosy name – he says dramatically clawed back benefits for injured soldiers in the midst of the Afghan mission.” He found that “the institution you’ve devoted your entire life and loyalty to has turned around and stabbed you in the back.”

On the same day, a letter to the editor argued that instead of spending $28-million to commemorate the 200-year old war of 1812, the money could better be spent “assisting veterans who served and suffered in more recent conflicts.”

Finally, on the day after Nov. 11, a front page story announced that Canadian Forces families won support for mental health. The article noted that it took “repeated criticism from Canada’s military ombudsman” before the military offered such support.

Such stories actually began to appear soon after the Harper government came to power. The bitter attacks launched against his government by disillusioned vets began early and have continued ever since. When it comes to our vets, Harper government rhetoric and policies are in a virtual war, with pro-vet policies being the big loser.

Who would have foreseen that this government, of all governments, would see veterans repeatedly demonstrating publicly to protest their treatment? This year, disabled veterans and military widows assembled on Parliament Hill, as reported by Canadian Press, “to paint a stark picture of bureaucratic indifference and red tape that flies in the face of reassurances from the government, which says the care of military families is a top priority.”

The report continued: “Few of the government’s touted programs meant to help combat veterans find civilian jobs actually help the disabled, said retired master corporal Dave Desjardins, who is paralyzed from the waist down... Tracy Kerr, wife of a triple amputee who fought in Afghanistan, said she and her family have battled for years to get basic needs, such as a lift to get her husband in and out of the bathtub.”

Who could have believed that disabled vets would take their own government to court to make it stop clawing back part of their pensions? Or that their own government would spend $750,000 in legal fees to fight them? Or that their government would not admit defeat until a judge sides with the vets?

Who would have thought that the first veterans ombudsman, Colonel Pat Stogran, a 30-year vet, would not be re-appointed because of his harsh criticisms of the very government that appointed him? “It is beyond my comprehension,” Col. Stogran declared, “how the system could knowingly deny so many of our veterans the services and benefits that the people and the government of Canada recognized a long, long time ago as being their obligation to provide.”

And he added this stunning revelation: “I was told by a senior Treasury Board analyst… that it is in the government’s best interest to have soldiers killed overseas rather than wounded because the liability is shorter term.” How could the government survive such a scandal?

Who would have believed, as CP reported, that a fund earmarked to give impoverished veterans a dignified burial has turned down more than two-thirds of applications made since 2006? Or that of the requests approved, Ottawa offers just over $3,600 to cover costs?

Reporter Murray Brewster offered an interesting perspective. “ The Harper government through Veterans Affairs has poured millions of dollars into the restoration of local war monuments over the last two federal budgets. These photo-op friendly projects are unveiled by local MPs with much fanfare,” he wrote.

It’s funny with this government. The war dead are the heroes. They can rest in peace knowing we remember and honour them. The survivors are not so sure.

Woman Accuses Sunnybrook of Putting on a Show for Federal Officials

Posted By: Amber Gero · 11/16/2012 9:34:00 AM

Amid allegations of abuse, neglect and poor staffing levels, new allegations arose Friday morning about the situation at the Veterans Centre at Sunnybrook Hospital.

In a Newstalk 1010 exclusive Debra Stuart says she was at the facility visiting her 90-year-old father, when two senior officials with Veterans Affairs Canada arrived to go through the facility and meet with staff.

“It was quite a spectacle to see what was happening on the floor. The staffing was five times what it is on a typical day.  There were doctors, administrators, nurses all kinds of staff were running around. That is not a true objective reflection of the day to day situation on that floor.”Debra Stuart told Newstalk 1010’s Amber Gero.

Stuarts says this audit must be transparent and objective, saying Sunnybrook officials have shown that they do not take the complaints of family members seriously, and in some cases, deny complaints were even made to begin with.

Debra Stuart says the audit also have to be done quickly so these veterans’ last days can be comfortable and they can be treated properly.

Stuart says on numerous occasions her father has gone hours without eating, his meal sitting cold on a side table.  Her 90-year-old father has fallen and been left unsupervised for hours, and baths have been delayed because of the shortage of staff.

Reports surfaced last week with family members issuing allegations of neglect and short-staffing levels that have left their already vulnerable loved ones in an even more vulnerable state.

Sunnybrook officials denied the allegations saying they meet or exceed provincial standards of care, however according to those officials the last audit happened more than seven years ago and before the Ontario government brought in new rules for long-term care facilities.

The Ontario Ministry of health has no involvement in the oversight of the Sunnybrook Veteran’s Centre.

The Canadian Press has learned that since these allegations surfaced, the Veterans Affairs Minister has ordered an audit of the facility.

(Photo courtesy of the Canadian Press)

Loved ones voice more concerns about Sunnybrook veterans

The Canadian Press
Posted: Nov 18, 2012 1:55 PM ET
Last Updated: Nov 18, 2012 5:21 PM ET

Articles about complaints of substandard care at Canada's largest facility for war veterans have prompted several more people to come forward with stories of neglect.

Some involved injuries to the frail elderly, who live out their last days and months at Sunnybrook Veterans Centre.

John Marriott said his family was appalled this spring when they found his ailing 96-year-old father-in-law with a bloody mouth, and discovered his front tooth had been knocked out.

Sunnybrook's explanation, he said, was that the virtually immobile man had somehow wriggled his way out of bed and fallen.

"We've been so traumatized by all of this," Marriott said. "It's like 'One Flew over the Cuckoo's Nest' lite."

The new complaints, as was the case previously, come mostly from part of the 500-bed vets centre that houses the most infirm vets rather than the part which resembles a pleasant retirement lodge.

Some, fearing reprisals, agreed to speak only on condition of strict anonymity, making it difficult to verify their accounts. Others were less reticent.

Oma Anirood said she was dismayed to discover her husband, Charles Taylor, 92, was left strapped in a wheelchair in a second-floor "K-Wing" hallway in his own waste for hours on end.

"If you are walking and you have your faculties, it's not a bad wing," she said.

"But if you don't know what you're doing, and you can't make decisions it's horrible. It's better you die. No point living. Who wants to sit in feces and a wet diaper all day?"

At one point, she said, she pointed out that her husband's roommate — a man without immediate family to visit him — had bed sores after days of lying in bed.

"This guy hasn't got out of bed for like five days," she said she told a manager. "They're pushing the food down his throat and leaving him in bed."

Sunnybrook, which calls its care exemplary, did act on that complaint, Anirood said.

Spokesman Craig DuHamel said the facility could not respond to patient complaints through the media but was always open to discussing issues with family.

One worker at the hospital said most nurses are caring and do their best but there are too few staff to look after the extremely frail patients.

The woman, who asked not to be identified because she is afraid of losing her job, said vets are frequently left in hallways.

"I see them just sitting in one corner for hours. It's really sad," she said. "They're sitting there with their dirty diapers. It's a lack of staff."

She said it's commonplace for three nurses to be trying to feed 15 or 16 vets, and she contradicted Sunnybrook's claims that patients are never left alone, saying she found one man choking recently with no one around to help him.
Managers say hospital well-regarded by patients, families

The Canadian Press articles outlining the complaints of several relatives about the treatment of their loved ones prompted the minister of veterans affairs to order a full-scale audit of the centre, and sparked adamant denials of any problems from Sunnybrook.

Senior managers blamed the complaints on a handful of malcontents, and pointed to surveys showing sector-leading patient and family satisfaction.

"It's not true," said one woman, who came forward after seeing a Sunnybrook representative dismiss the concerns.

"There is a huge problem when people become sick there, when they need extra care."

The woman, who asked she not be identified, said she was horrified at the poor care her father received.

"I had to fight them. He was crying in pain," she said. "It was horrendous care. I'm just so angry at Sunnybrook."

While Sunnybrook said it laid off 20 full- and part-time registered nurses in April — it says it has about 500 nurses for its 500 residents and patients — operations director Dorothy Ferguson said most were still working, and patient-staff ratios were as good or better than anywhere comparable.

The facility also maintains it voluntarily meets or exceeds Ontario standards, although no one has done a thorough, independent care audit in years.

Some online readers have jumped to the centre's defence, with one, for example, saying the care was excellent and his father was "always treated with utmost respect."

One woman, who has been keeping a journal of incidents, said there is a serious lack of accountability at Sunnybrook, which is unique in that it receives both provincial and federal funding, but reports only to Veterans Affairs Canada.

Fearing retaliation against her 91-year-old father, she, too, asked not to be identified. She said she's seen nurses verbally abusing patients, handling them roughly, or ignoring pleas for help.

"Sunnybrook is supposed to be the best but it's nothing to what everyone thinks it is," she said.

The Ontario Nurses Association, which speaks for registered nurses, refused to discuss the working environment at Sunnybrook.

Mike Blais, president of Canadian Veterans Advocacy, said if the allegations are valid, it is "completely unacceptable," noting "these old guys can't speak for themselves."

Delayed feedings or patients left without hearing aids — among the complaints — may seem trivial, he said, but go to the heart of the matter.

"All these small things may seem irrelevant among people, but that's the level of compassion," Blais said.

"If we don't have people who are taking (seriously) these very basic common courtesies that are such an important facet of quality-of-life care for these guys, what else is missing?"

Niklaus Schwenker, spokesman for Veterans Affairs Minister Steven Blaney, called the concerns "troubling."

"While we await the results of the audit, we look forward to working with the Ontario Ministry of Health to fully investigate the situation," Schwenker said Sunday.


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