Nursing home and seniors' home challenges, facility changes and resident COVID-19 cases, 2021
Released: 2022-09-13
In 2021, the second year of the COVID-19 pandemic—marked by several variants of concern, such as Delta and Omicron—nursing homes (also called long-term care homes) and seniors' homes (also called retirement homes or assisted living facilities) continued to report COVID-19 cases across Canada. These facilities are not only places of care, they are the living spaces of many vulnerable Canadians. Since the start of the pandemic, COVID-19 has had a disproportionate impact on these homes and their residents.
The impacts are made clear in a new study released today, using data collected through the Nursing and Residential Care Facility Survey 2021, titled "Impacts of COVID-19 on Canadian nursing homes and seniors' homes in 2021." This study addresses current data gaps during the pandemic's second year and provides new insights into these homes and their residents across regions in Canada, such as Infection Prevention and Control (IPC) protocols and practices, and changes made to facilities in direct response to the pandemic.
The incidence of COVID-19 among residents was common in these homes in 2021. Overall, 43% of nursing homes in the provinces had at least one resident with COVID-19. By region, 64% of nursing homes in Alberta had at least one resident case of COVID-19 in 2021, followed by Ontario (57%), Manitoba (44%), Quebec (44%), British Columbia (38%), Saskatchewan (35%), and the Atlantic provinces (13%). These geographic differences help highlight the different impacts of the virus across Canada.
Understanding some of the factors associated with COVID-19 incidence in nursing homes and seniors' homes can help inform future research and facility care standards. Results released today show that homes with at least one COVID-19 case among employees were more likely to have at least one resident case than homes that did not have an employee case. The odds were 9 times higher in nursing homes and 16 times higher in seniors' homes. Facility size was also an important predictor of having at least one resident case of COVID-19. Compared with the smallest facilities (25 or fewer residents), the odds of having at least one resident with COVID-19 in the largest facilities (over 100 residents) was approximately 3.6 times higher among both nursing homes and seniors' homes.
Nursing homes and seniors' homes also faced staffing-related difficulties in 2021 in providing care to residents. For example, increased hours worked by direct care employees, increases in their overtime hours, and heightened absenteeism due to factors such as self-isolation or needing to care for family members. More than half of nursing homes and seniors' homes reported other direct care staffing challenges, such as restrictions on hiring or staff being limited to working at one facility at a time when compared with the same period the previous year.
Additionally, an increase in critical staffing shortages was reported in over half of nursing homes and roughly half of seniors' homes. Critical staffing shortages are employee shortages which impact employee safety or the quality of resident care and can include shortages of workers, particularly in key roles, such as directors of care, nurses or personal support workers.
Many facilities reported an increase of various IPC protocols and practices in 2021. Roughly two out of every five (44%) nursing homes and about half of all seniors' homes (49%) reported that hand hygiene had increased. Management of the flow or placement of residents, visitors or employees increased among roughly two-fifths of nursing homes (41%) and seniors' homes (41%), while 34% of nursing homes and 36% of seniors' homes further reduced or suspended in-person contact.
Additionally, roughly half of both nursing homes (48%) and seniors' homes (49%) reported that their personal protective equipment practices increased in 2021. These increases provide insight into some of the many additional measures taken throughout the pandemic's second year.
Finally, the article released today provides statistics for an additional factor in understanding nursing homes and seniors' homes in 2021: the increased availability of COVID-19 vaccines. Vaccination campaigns for COVID-19 began across Canada in late 2020, and most residents and staff in nursing homes and seniors' homes were fully vaccinated by the end of 2021. Overall, 84% of nursing homes and seniors' homes reported that at least 95% of their residents were fully vaccinated and 86% reported that at least 95% of their employees were fully vaccinated.
Note to readers
This article is the first to use preliminary results from the 2021 Nursing and Residential Care Facility Survey (NRCFS), which collected basic information on facility characteristics, such as employee and resident counts for the 2020/2021 fiscal year, as well as information related to the COVID-19 pandemic from January 1, 2021, up to and including December 31, 2021.
Nursing care facilities are also commonly known as long-term care homes or nursing homes. Nursing homes are primarily engaged in providing inpatient nursing and rehabilitative services as well as continuous personal care services. Some hospitals also provide these services and were included in the analysis. Community care facilities for the elderly are also known as seniors' homes. Seniors' homes are largely engaged in providing residential and personal care services for the elderly as well as persons who are either unable to fully care for themselves or who do not wish to live independently.
Residents and staff considered fully vaccinated against COVID-19 have either:
- received both doses of a vaccine that requires two doses (such as Pfizer-BioNTech, Moderna, AstraZeneca, or COVISHIELD COVID-19 vaccines)
- received one dose of a vaccine that only requires one dose (such as the Janssen COVID-19 vaccine)
- received one dose of a COVID-19 vaccine after a laboratory-confirmed COVID-19 infection (only in Quebec).
The response rate at the time of analysis was 60.9% (n = 4,527 facilities). The results presented in The Daily and the accompanying article are based on 2,422 nursing homes and seniors' homes that reported having at least one bed, at least one resident and at least one employee. Excluded were facilities in the territories due to an insufficient number of responding facilities, as well as those that did not meet the listed criteria, or were considered to be out of scope for the survey. Public facilities in Quebec did not participate in this survey.
While these results do not use sample weights which account for non-response and the results are considered preliminary, the official NRCFS data release will provide generalizable results. The official release of the NRCFS microdata file and summary data tables on facility characteristics within the industry (e.g., number of employees, services offered by facilities) is scheduled for release in October 2022.
Products
The full article "Impacts of COVID-19 on Canadian nursing homes and seniors' homes in 2021" is now available as part of the publication StatCan COVID-19: Data to Insights for a Better Canada (45280001).
Contact information
For more information, or to enquire about the concepts, methods or data quality of this release, contact us (toll-free 1-800-263-1136; 514-283-8300; infostats@statcan.gc.ca) or Media Relations (statcan.mediahotline-ligneinfomedias.statcan@statcan.gc.ca).
- Date modified: