A report recently released by Revera Inc. has been widely dismissed as a public relations exercise to explain away the high death toll at its network of for-profit long-term care (LTC) homes during COVID-19's first wave. Revera is a wholly owned subsidiary of the Public Sector Pension Investment Board (PSP), a federal crown corporation that manages the pension plans of federal public service workers. For months, PSAC members have been calling on the federal government to facilitate talks between PSP and provincial health ministries in support of a transition to public ownership.  

The report, which comes as the national movement to stop private, for-profit long-term care in Canada gains steam, purports to make recommendations to “prevent the pandemic from causing further suffering” at its facilities. Yet, the 90-page document somehow fails to address one of the most widely discussed risk factors for resident deaths in long term care: the profit status of homes.  

A Canadian Medical Association Journal study of the pandemic’s first wave found that residents of for-profit LTC homes in Ontario with outbreaks were disproportionately more likely to die from COVID-19 than those living at a public, municipal facility with outbreaks. Given this, one would expect a report produced by “independent experts” to devote at least a small section to examining these findings in greater detail. Instead, the report is completely silent on this.

Revera still experiencing high death toll 

COVID-19's second wave is now well underway and the evidence so far shows Revera has again failed to ensure the safety of residents.  

Throughout Revera’s report, which was drafted by experts chosen by the for-profit corporation, recommendations are made on improving operational and administrative practices to address identified areas of concern. And more often than not, Revera’s response is that the recommendation has been “already implemented” or “is in progress.”

If this is the case, how does Revera explain the 53 outbreaks, 1,086 resident infections, 619 staff infections, and 222 deaths of residents in Revera long-term care facilities since September 2020? The report offers no explanation for this latest alarming trend. In fact, it is reasonable to expect that COVID-19 deaths in Revera long-term care facilities during this second wave — 222 as of December 9 — will soon exceed the 266 COVID-19 deaths in its facilities during the first wave.

PSAC remains concerned about pension plan’s ownership of Revera 

“The Revera report is a slick corporate public relations exercise — a desperate attempt at self-exoneration,” said PSAC National President Chris Aylward. “PSAC members remain deeply concerned by their pension plan’s ownership of Revera. Providing good care for our elders means taking private profits out of long-term care.” 

Take action: Tell the federal government to make Revera public  

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BACKGROUND: For-profit long term care has a poor record 

While the pandemic has underscored deep problems with private, for-profit long term care chains, extensive research has long shown that residents experience worse outcomes in for-profit facilities than in non-profit homes:

• A 2015 analysis focusing on Ontario determined that “for-profit facilities have significantly higher rates of both mortality and hospital admissions.”  

• A systematic review of over 80 studies published in 2009 concluded that “on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes.” 

• A 2006 review of LTC homes in Manitoba found that residents in for-profit facilities tended to be admitted to hospitals or seen by physicians more often for “key adverse events,” such as hip fractures and respiratory infections.   

• A review of North American trends from as far back as 1990 to 2002 concluded that “for-profit nursing homes appear to provide lower quality of care in many important areas of process and outcome.”  

It is also well documented that for-profit operators spend considerably less on residents than non-profit facilities, and have lower staffing levels:  

• The British Columbia Seniors Advocate review published in 2020 found that non-profit facilities “spend $10,000 or 24% more per year on care for each resident” than for-profit operations and that “for-profit care homes failed to deliver 207,000 funded direct care hours.” 

• A 2016 study of the situation in Ontario found that “for-profit LTC homes – especially those owned by a chain organization – provided significantly fewer hours of care.” 

• A 2013 report on Alberta LTC homes found that “for-profit facilities fell short of the staffing levels that indicate reasonable quality elder care by over 90 minutes of care per resident, per day.” 

• A 2005 study found that non-profit facilities generally have “higher staffing levels” and that public money directed at private LTC operations translates into “significantly fewer” hours of care for residents than in non-profit facilities.