On April 4, Trisha returned to work at the CHSLD Herron Residence in Dorval, in the west of the island of Montreal – her first shift in more than a week.
What she saw surprised her. Many of the residents she cared for had disappeared. Their beds were empty.
“I was so scared,” said Trisha. “Where are all these people? I asked the manager. He said,” They are not all dead. “He couldn’t answer me.”
Trisha, whose real identity has been accepted by the CBC for the sake of professional repercussions, described the chaos in Herron, almost a week after the home – a private, unsubsidized long-term care home – was placed under provincial supervision.
Trisha is one of nine Herron staff members the CBC has spoken to in recent days. All worked at home after the resumption of its daily operations by the regional health agency, the CIUSSS de l’Ouest-de-l’Île-de-Montréal
They describe working without proper protective equipment, not knowing which residents tested positive for COVID-19, and being so short of staff on certain shifts that they were unable to meet the needs of base of 130 residents.
The records of the owners of CHSLD Herron indicate that, of the 31 residents known to have died at home since the start of the pandemic, 28 of them died under the supervision of the regional health agency.
E-mails obtained by CBC News indicate that the CIUSSS was aware that the Herron had been short of staff after he came under guardianship, but it did not resolve the problem until April 8 – a week and a half after taking office.
Herron owners Samir Chowieri and his daughters Katherine Tanya and Samantha Chowieri, whose company is called Groupe Katasa, say they went to the regional health agency for help – and that the CIUSSS made matters worse.
The following is an account of what has happened inside the Herron since the time the administrators asked for help, based on interviews with nine people who work or worked there and of documents obtained by CBC News.
Until March 27, CHSLD Herron was frequently understaffed, but functioning, staff said.
On that date, the first resident of Herron tested positive for COVID-19. He was taken to hospital and died later.
The nurses also fell ill: six of the seven registered nurses on staff had symptoms of COVID and out of seven licensed practical nurses (LPNs), only four were still in good health.
Admittedly by Herron, he did not have appropriate personal protective equipment for the personnel. Email correspondence between Samantha Chowieri and the CIUSSS shows that Chowieri requested PPE from the regional health agency on March 23 but was refused.
On March 28, three other LPNs fell ill and returned home, leaving only one LPN standing.
About a quarter of caregivers (beneficiary attendants, or patient attendants) also stopped working – either because they had COVID symptoms, or because they felt it was no longer safe to work at CHSLD Herron.
Within a few weeks, a quarter of these patients tested positive for COVID-19.
Ask for help
At a press conference on April 11, Prime Minister François Legault accused staff of “abandoning” the Herron and its residents.
Not true, according to documents from the Katasa Group: most of the absent employees were waiting to be tested or were already sick.
On March 29, Samantha Chowieri texted Brigitte Auger, Deputy Director of Long Term Care at CIUSSS. She no longer had a licensed practical nurse or a licensed practical nurse.
“We no longer have nursing assistants available this evening. Call me because we are no longer able to provide the necessary services. None of the agencies wants to come,” said the text.
At 2:49 p.m., Auger responded.
“Hello, during a conference call with the ministry. I received your e-mail, employees entered?”
Chowieri replied, “We need support, do you have any other means we can use to help you?”
At 4:29 p.m., Auger responded that a doctor and nurse were about to help. Later, she texted again to say that she had found a nurse and a nurse to help them.
By all accounts, what these replacement health care workers found inside the house was obnoxious.
The bedridden residents were lying in sheets stained brown up to their necks in the excrement, it had been so long since their diapers had been changed. Some were dehydrated and not fed.
“The conditions were disgusting. The patients were drenched in urine and excrement,” said Loredana Mule, a replacement nurse who worked that night. “It was pretty awful.”
The head of professional services at CIUSSS, Dr. Nadine Larente, is the doctor who went to help. She said to the French language newspaper The Press the place was in chaos: a licensed practical nurse and two caregivers were trying to treat 130 residents. Food trays had been placed on the floor, the dishes intact because residents with reduced mobility could not reach them.
Larente called home and asked her husband and teenagers to come and feed everyone.
At the end of this shift, the last remaining LPN from Herron’s staff returned home and never returned.
That night, a resident of Herron died in the hospital. A second died at home. The CIUSSS has placed CHSLD Herron under guardianship.
No improvement in staffing levels
The same night, shortly after midnight on March 30, CHSLD Herron co-owner Samantha Chowieri sent an email to the families of the residents.
“You can be assured that all residents and employees who have come into contact with these affected people have been placed in administrative segregation. As a safety measure, all residents are confined to their rooms and we monitor them all closely by visiting their rooms. regularly, “he said.
“Due to the number of staff subjected to preventive measures and certain positive tests, we have had a reduced staff since this morning. We contacted the CIUSSS for support and finally received a response to our request this evening.”
“The CIUSSS is working on site with the CHSLD Herron team to recover all normal services. We hope to quickly put our regular staff back on the floors.”
The letter gave no idea of the seriousness of the Herron’s understaffing. This situation also did not change after March 30, the establishment now being under the supervision of the CIUSSS.
Staff work schedules, provided by the home to CIUSSS and obtained by CBC, show daily shortages. A spokesperson for Herron’s owners said that CIUSSS sent contacts to agencies where the house could find more staff, but that there were never enough workers available.
CBC News spoke to four patients who worked within a week of Herron’s guardianship. Their identity is hidden because they fear for their work.
Between March 30 and April 8, only three caregivers worked on a shift, they said. For an establishment of this size, there should have been 22 patients on duty during the day, 16 in the evening and 5 others at night.
No “hot spots” for infected patients have been established – and residents known to have tested positive for COVID-19 wandered around the floor.
“I was totally shocked,” said one patient. When asked if she had ever seen anything like this, she replied, “Never. Never. Never.”
An attendant described his work from 3:30 p.m. until 7:30 a.m. to meet the needs of the dozens of seniors upstairs. More than one worker described patients who were still dehydrated, hungry and unchanged.
We went to change the diaper of a man who had obviously not been treated for several hours.
“It seems [had defecated] more than one time. Air – I couldn’t even breathe, “she said.
On April 5, a patient came out and decided that she could not return. She said it was a difficult decision, but she works in more than one long-term care home. She said that she did not have the appropriate PPE for the Herron and that she could not risk carrying the virus to her other jobs.
It is not known why the regional health agency did not mobilize more staff earlier.
On April 8, several public health nurses were sent home.
One of them described entering an unknown establishment without training and having to immediately call the hour of death of a resident who died overnight.
“Wednesday was difficult,” she told CBC News. “Wednesday was very difficult, but I think it was because we were three nurses caring for 150 patients.”
In an email dated April 4, Samantha Chowieri wrote to the CIUSSS management.
“We want to cooperate as much as possible. A meeting is necessary to clarify certain points,” she said.
Instead, Herron’s owners received two legal notices: one on April 5 and the other on April 8.
“We are informed that the situation has in no way improved,” said the second opinion.
“As such, I order the CIUSSS West Island to mobilize the orders necessary to provide services to Herron House.”
The legal opinion also requests the Katasa Group to submit its list of employees to the CIUSSS, even if an electronic correspondence sent to CBC News indicates that the agency already had this list in its possession.
The notice also requested information about patients, although staff working inside the facility indicated that patient records and contact details for close relatives were readily available on each floor.
It is unclear why the CIUSSS requested information that had already been provided to it, and the CIUSSS declined to comment.
At a hasty press conference outside Lakeshore Hospital on April 11, the president and CEO of the regional health agency, Lynne McVey, said that the CIUSSS was invoking the ‘section 106 of the provincial law on public health and seizes the house.
This article gives public health authorities the power to take all necessary measures to deal with a threat to the health of the population.
It is not known, however, why the CIUSSS waited 10 days before taking this step, or why it sent two legal opinions – not required by law – before doing so. CBC News asked CIUSSS this question, which did not respond.
Katasa Group denies being “uncooperative”
On April 11, the same day that McVey met with reporters on the lawn outside the Lakeshore General Hospital, and almost two weeks after the CIUSSS placed the Herron under guardianship, Prime Minister Legault canceled a day off planned to announce that 31 people had lost face. died at home since March 13.
Legault explained that the reason it had taken so long to determine the death toll was that the owners of the Herron were not cooperative.
He said there would be police and public health inquiries into what happened. Later that same day, the Quebec coroner announced that he would also investigate.
Shortly after, the Katasa Group sent a letter to the Legault office, outlining all of the ways the owners of the Herron say the CIUSSS was wrong. Co-owner Katherine Chowieri said that the regional health agency had not provided adequate protective equipment for staff and that no “hot spots” had been created in the home.
She stated that Katasa had emailed the house schedules to the CIUSSS in advance, and that the CIUSSS had refused to meet with them “, instead deciding to retain legal services to send us two letters of cessation and abstention asking us to give them the information we gave them on a daily basis. “
She said that once the CIUSSS had placed the house under guardianship, the staff were not informed of the residents who had tested positive for COVID-19, putting them all at risk.
CBC News attempted to submit all of these allegations to the CIUSSS, but refused to respond.
In a statement, the regional health agency said that it was not until the evening of April 10 that it got the information that 31 people died.
“We were transparent, based on the information we had,” said the statement.
According to the release, the situation has stabilized and is improving, and all residents of Herron have now been tested for COVID-19.
“I think the CIUSSS has done everything it can to provide care to the CHSLD Herron,” said Danielle McCann, Quebec Minister of Health, on Friday. “What is important is to wait for the outcome of the investigation.”
The public health nurse sent to the CHSLD Herron on April 8 continues to work there and recognizes that the situation has improved.
She says that since the house gained notoriety in the media, the phone rings. The nurses and attendants pick it up. They are greeted by strangers, calling them murderers and killers.