New report reinforces need to make Revera long-term care public

A new report on the international operations of Revera Inc., the second largest operator of for-profit long-term care homes in Canada, further strengthens PSAC’s call for the federal Public Sector Pension Plan Investment Board (PSPIB) to transfer its ownership of Revera to public hands. According to the Centre for International Corporate Tax Accountability and Research (CICTAR), it appears that Revera and its partners are funneling hundreds of millions of dollars through well-known tax havens as part of an aggressive tax-avoidance scheme.

Revera is a wholly owned subsidiary of PSPIB, a federal crown corporation that manages the pension plans of federal public service workers. The company is the target of a growing campaign to take profits out of long-term care, given the high death toll experienced at its facilities during the pandemic. As of late January, well over 400 residents in Revera long-term care facilities died of COVID-19 since the second wave began in September 2020.

It is quite stunning and deeply disappointing to learn that a federally-owned corporation may also be making use of offshore tax-havens to avoid paying taxes,” said Chris Aylward, PSAC National President. “Let me be clear: PSAC members don’t want to their pension fund to profit off the suffering of our elders and we certainly don’t want it associated with a corporation that is avoiding paying taxes that fund vital public services — whether at home or abroad.”

Aylward sent a letter to PSPIB in May 2020 requesting that the pension manager begin discussions with provincial health authorities to transition Revera Inc. to public ownership. Since then, hundreds of PSAC members have written to the Trudeau government in support of such a transition. Regrettably, Revera has chosen to respond to this growing concern from pension plan beneficiaries by dialing up its public relations spin.

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

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. Moreover, 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.


January 28, 2021