In an effort to come to grips with a series of complaints about its quality of care and how those complaints are dealt with, the country's largest veterans facility has called in an outside expert to look at the situation.
The review of the Sunnybrook Veteran's Centre this week comes in addition to an official audit by the federal government that is currently underway.
The new audit will focus on those beds funded by Ontario's Ministry of Health, a cost of about $29.2 million a year, but has disavowed any responsibility for oversight of the centre.
The review, which begins this week, is being carried out by Karima Velji. The senior executive at Baycrest, a prominent research hospital focused on the elderly, is also an assistant nursing professor at the University of Toronto.
"We would like you to focus on quality of care in the provincially funded chronic-care beds, with an in-depth focus on the processes used to resolve complaints," Sunnybrook's executive vice-president Malcolm Moffat said in a letter to Velji.
In a series of articles in recent months, The Canadian Press highlighted concerns raised by relatives and attendants about what they see as serious deficiencies in the basic care of the most frail of the 500 veterans at the centre.
Complaints include delayed feedings, rough handling, residents left languishing in hallways or bed, unsanitary conditions and unexplained injuries. Relatives said Sunnybrook was dismissive of, or hostile to, their efforts to raise concerns.
The articles also identified a lack of government oversight of the facility, which one senior provincial official called a federal-provincial "grey area."
Sunnybrook has steadfastly maintained its care is as good as, or better, than comparable facilities. It cites surveys showing industry-leading levels of patient and relative satisfaction and top scores on voluntary care reviews.
In response to the publicized complaints, Steven Blaney, minister of veterans affairs, ordered the first thorough audit of the facility in more than seven years. Results are expected in the near future.
"I'm not certain that (Veterans Affairs Canada) felt they have complete jurisdiction over all of the beds," said Sunnybrook spokesman Craig DuHamel.
"So, we felt that inviting another external reviewer in to focus solely on those beds that are funded by the Ministry of Health and Long Term Care ... would help round (the audit) out a little bit more."
DuHamel said a copy of Velji's findings will be forwarded to a senior Ontario bureaucrat for any feedback the province might want to provide.
"We will review those findings and will look to the hospital to see what actions they may take as a result," said Ontario Health Ministry spokesman Dave Jensen.
One relative, Debra Stuart, said she had accepted invitations to meet Velji or attend a focus group despite her concern Sunnybrook was orchestrating the review.
"The families are skeptical about the objectivity and transparency," Stuart said.
Mike Blais, president of Canadian Veterans Advocacy and a member of a newly minted external advisory group on Sunnybrook set up by Veterans Affairs and chaired by the veterans ombudsman, said he, too, had his doubts.
"Without an independent quality of care audit launched by the province to ensure accountability over the 310 chronic care beds they're responsible for, justice will not be served," Blais said.
The problem, he said, is what he called a lack of accountability and oversight at the provincial level.
"If the federal government has downloaded all these veterans-based hospitals ... there also is a moral obligation that has been downloaded to the provinces as well," Blais said.
"I identify it as a matter of required legislation."
Blaney's spokesman, Niklaus Schwenker, said the government welcomed the new review.