Pushed out

Retirement homes being squeezed out by regulations

Ten people live at Publow Retirement Home on King Street in Picton. It is their home. It is close to shops and services downtown and within walking distance to almost anything one might need. It feels like home. Residents gather at lunch time around a large oak table—all its leaves are permanently inserted to give it the length the fill the large dining room with a view of the garden. They chat about the news, brag about their grandchildren and complain about the weather.

There are quiet, comfortable corners to sit and read. There is a larger area to gather and watch television. Each resident room is decorated and equipped to suit its occupant. No two rooms are alike—each as different and unique as the folks who live here. They are mostly women and a few men. Military veteran George Wright lives here. Few have pensions—most get by on their savings and social security.

Their home is under threat. As is every other retirement home in the province. A gathering storm of bureaucracy and regulations is choking small, mostly rural, retirement home operators. Some have already given up—others are on the edge.

“Where will they go?” asks Bernadette Storms of Publow House. She has owned and operated Publow House since 2007. Early next year, she will surrender her retirement home licence—not because she wants to, but because she can no longer afford to manage the regulatory requirements.

“Many of my residents can’t afford to live at the Wellings or the Manor on Loyalist Parkway. It just breaks my heart.”

But Storms says she can’t fight off the tentacles of regulation fast enough.

She and her husband, Steve opened Publow to serve a need in the community, to provide a safe and comfortable home—not an institution. She has little time now to serve her residents— it is consumed by regulation compliance.

“The bureaucracy puts me behind my computer most of the day—rather than here with the residents,” says Storms.

The challenges aren’t exactly new—but the increasing frequency of random inspections, a litany of orders and the sheer cost of staying ahead of the mounting paperwork is forcing her to make a very difficult decision. She expects others will follow.

The trouble started with a tragedy in Quebec.

Just after midnight on January 23, 2014, a fire started in the kitchen of Residence du Havre in L’Isle-Verte, about 230 kilometres east of Quebec City. Thirty-two residents of the retirement home died that night. A coroner’s inquest found a long list of problems, including gaping shortfalls in the town’s firefighting capacity and emergency response. But what stood out in the Coroner’s findings, was that the home wasn’t equipped with a sprinkler system, nor did it have an emergency evacuation plan.

The Retirement Home Regulatory Authority was established by the Ontario government in 2011, as a brand-new bureaucracy created to monitor and regulate the retirement home sector. It charges each home a licensing fee, in return it seeks to govern the workings inside each home for the safety of residents.

Linda Moxam sets out lunch around the communal dining table at Publow House in Picton.

The 2014 tragedy in Quebec invigorated the regulatory authority with a new sense of purpose and determination. That year, the Ontario government announced that retirement homes would be required to install sprinkler systems within five years. Many rural retirement home operators have said this will put them out of business. It has made no impact.

Publow House is on a municipal water system, yet the cost to retrofit this home is untenable. For Carriage House in Cherry Valley, the provincial decree could put it out of business.

Earlier this summer, the province said it was putting up $6.5 million to assist these homes to meet this requirement. Nothing has been offered to Storms in terms of relief or assistance.

But the issue is bigger than just the cost. Publow House is an old Picton home. It would be a massive undertaking to install a fire sprinkler system in this home. It would mean closing the home for weeks and perhaps months—forcing residents to find other accommodations in the interim.

“Where are they supposed to live in the meantime?” asks Bernadette rhetorically.

The Storms can’t continue like this. They have decided to give up their retirement home licence in the new year. They’ve hired a lawyer to advise them through the process. They fear that if they mishandle this transition they could be subject to tough penalties under the Provincial Offences Act.

So in February, Publow House will become a room and board facility only. What this means is that that neither Bernadette nor her care staff will be permitted to administer or monitor medication for the residents. As of February, it will be illegal for them to help residents with their pills. She shakes her head in disbelief because she fears these regulations are making her residents less safe.

“It is heartbreaking,” explains Storms. “Some residents will have to move. But if this doesn’t work we will have to close.”

She says her decision is not due to one single thing, but rather the steady and unrelenting burden of government interference in her business. She says the system benefits large institutions with the staff and resources who can manoeuvre through the regulatory burden. She believes the system is stacked against small, family operations like Publow House.

Mark Jacoby is the manager of communications for the Retirement Home Regulatory Authority. He says his organization’s “paramount concern is to protect the approximately 55,000 senior citizens living in more than 700 licensed retirement homes in Ontario.”

“We conduct regular inspections of all retirement homes,” said Jacoby by email. “When we find homes do not meet minimum standards of care, we may issue orders and work with them to bring them into compliance. When we talk about minimum standards of care, we are talking about things like safe preparation and handling of food; resident safety; ensuring there are plans in place and properly trained staff who can evacuate residents in case of a fire; and ensuring that properly trained people are available to administer medication.”

Yet the burden of these regulations is forcing small rural retirement homes like Publow House to surrender their ability to assist residents with their medication. Bernadette Storms asks how this helps her residents.

Many of the regulations do in fact seem as though they are written for much larger facilities. For instance, Storms is required by the RHRA to have, and maintain a snow removal contract with an external provider, and she must have paperwork to prove it.

“When it snows, I roll over and wake up Steve and he shovels the walks. We don’t have or need a service. It’s just sad.”

Publow House employs five part-time caregivers and two more occasional workers.

“They are trying to make us all institutions,” said Bernadette. “They are herding us all into large, corporate and sterile facilities. Residents are being treated like cattle to be managed. They have no say in any of this. They don’t deserve this.”