Risk levels at long-term care homes under microscope at Wettlaufer inquiry

Long-term care homes deemed to be higher risk undergo more stringent inspections by the province, but the homes' risk level depends in part on whether they self-report serious incidents, the inquiry into long-term care homes heard Tuesday at the Elgin County courthouse in St. Thomas. 

Philip Moorman, who works in long-term care inspections with the Ontario Ministry of Health and Long-Term Care, testified that the idea was to keep a closer eye on homes with recurring problems.

"The premise is that if you understand which homes are poor or are risk, then you can take action to mitigate," Moorman said. 

But inquiry lawyer Megan Stephens pressed Moorman about whether this system means that homes might fly under the radar by being ranked low risk, and never undergoing more stringent inspections. She also suggested the threat of being placed in a higher risk category might disincentivize homes from reporting issues. 

Moorman said he didn't have information to support whether that may be the case.

"There's a requirement to report and if they don't report, there can be a finding of noncompliance, then it can lead to an order, which I think is quite an incentive to report, I would think," he said.

The ministry's new inspection system was implemented in 2010 and intended to introduce comprehensive annual inspections at the homes. Karen Simpson, former director of the ministry's long-term care inspections branch, testified that the level of scrutiny depended on homes self-reporting critical incidents.

Simpson said some critical incidents at the Caressant Care home in Woodstock, Ont., where nurse Elizabeth Wettlaufer killed seven patients in her care, were not reported to the ministry in a timely way, making it hard for inspectors to notice a trend. 

After wrapping up testimony related to long-term care homes, the inquiry is also expected to hear this week from those who oversee in-home care delivery. After quitting her job at Meadow Park nursing home in London, Ont., Wettlaufer worked for a temp agency where she tried to kill others with insulin overdoses.

Wettlaufer worked at three Ontario nursing homes before she confessed to killing eight patients in her care and trying to kill or harm six others between 2007 and 2016: Caressant Care in Woodstock, Meadow Park in London and Telfer Place in Paris.

Wettlaufer, 51, was sentenced in June 2017 to eight concurrent life terms in prison. 

The inquiry began in June and runs until September.