A Toronto long-term-care home is shutting down to make room for condos — will other homes follow when their licences expire?

The business of long-term care isn’t glamorous. William and Vera aren’t glamorous either, but they are the poster children — rather, poster seniors — in the story of private equity coming soon to a long-term-care home near you.
Best friends, William and Vera give each other much-needed support as they navigate the bumpy closure of Cedarvale Terrace, the long-term-care facility they call home. 
Cedarvale’s licence to operate was supposed to expire in 2025, but in 2022 the for-profit owners asked the province to speed up its shutdown by two years. The province complied.
In 2023, Stafford Homes bought the Cedarvale property for $32 million and will tear down the six-storey facility, replacing it with a 19-storey condo building in Toronto’s Forest Hill as soon as the last residents leave.
When neighbour and advocate Barbara Chernin asked Home and Community Care Support Services about options for William and Vera, she learned the list provided by the province included 11 Toronto long-term-care facilities whose 30-year licences are scheduled to expire by June 2025. Four of those 11 homes are city-run or non-profit and unlikely to shut down, but seven are for-profit and their futures are less certain.
The seven for-profit facilities provide a combined 1,100 beds. The public has not been told whether the businesses will renew their licences. If they were to close, 67 per cent of the current for-profit, long-term-care operations in Toronto could be shuttered by 2025 — on top of the 510 beds in homes that are scheduled to close.
The Ontario Long Term Care Association, which represents 70 per cent of Ontario’s homes, declined to answer a question about whether the seven facilities will continue to operate after 2025.
William, Vera and other residents of the home were told they’d have to get out by March 2024; but options are limited, and they have no idea where they will end up. According to the latest government documentation, the Toronto Central catchment area has 12,272 long-term-care beds, including city-run, non-profit and for-profit facilities, but they already have a wait-list of 30,949 people, up 72 per cent since last April.
Vera Rode, 73, trained racehorses at Woodbine Racetrack in her prime. William Mastin III, 64, was a construction worker. Both now in wheelchairs, they told me all remaining residents of Cedarvale Terrace have been regrouped to the fourth floor. Except for them, many of the other residents have dementia. William says it’s like living in a zombie movie.
“They don’t know where they are. They wander in and out of rooms.” Staffing is so slim, no one has time to prevent people from coming in and rifling through William or Vera’s possessions.
William and Vera are very clear-minded, but say they are getting less help with basic needs, and they say food has become so inedible they’re often hungry.
Cedarvale used to offer 218 people long-term care, provided by a staff of 270, according to Nicola Major, spokesperson for Responsive Health Management (RHM), the company that operates the facility. According to Major, as of the first week of March, 10 personal care workers, across three shifts, were providing direct care for the 19 people still at Cedarvale.
There are also managers, supervisors, administrators, cleaners and cooks, but wave after wave of layoffs have seen experienced workers leave, some with decades of experience caring for Cedarvale residents.   
William says staffing now includes international students with no experience. William and Vera say their rooms are plagued by cockroaches. They say the cook quit two weeks ago, and they’re still trying to hire a new one.
RHM disputes these claims, saying in an email the cook didn’t quit, there have been no reports about cockroaches and that they haven’t hired students to replace staff.
RHM spokesperson Major notes that “all team members are appropriately trained and are oriented based on legislative requirements” and that “the home has regular pest control services.” She added that the company strives to “provide excellent care and services to the residents and support them through this process of transition. We also continue to check in with residents who have transitioned to a new home of their choice.”
It’s not easy being a nomad in a wheelchair. Vera came to Cedarvale from Vermont Square, a long-term-care facility on Bathurst Street that was sold in 2021.
The first choice of a new home that William was offered was The O’Neill Centre on Christie Street, whose licence expires in 2025.
William has turned down all eight options he’s been offered because they are all shared rooms, smaller than his current private room, and cost $2,000 or more a month, almost double the co-payment rate Vera and William are charged for their private rooms at Cedarvale ($1,138, covered by their pensions). Nobody has explained to them who will cover the difference. They don’t have the money to pay more.   
William is holding out for a place at Kensington Gardens, a not-for-profit in the heart of Kensington Market. It cares for 350 people, but had a wait-list of 1,445 people as of Dec. 31, 2023. “I’m going where he goes,” Vera says. But they both know that hanging on to this friendship will take a miracle.
The provincial government announces long-term-care beds it’s adding to the system, but it doesn’t mention what has been lost. It has the data but no longer publishes the total number of long-term-care beds in Ontario and did not respond to multiple requests for up-to-date data for this article.
For reference, in January 2020, just before the pandemic hit, there were 78,363 long-term-care beds in Ontario.
You’d think it wouldn’t be a hard question to answer: Has the number of beds in Toronto gone up, down or remained the same since the pandemic? It’s taxpayers’ money, after all.
While the government has chosen not to provide this summary information, a painstaking piecing together of information from public sources suggests we may be in the process of losing more long-term-care beds than we’re adding in Toronto. 
A search on the Toronto Central website found the seven for-profit facilities with licences set to expire in 2025 provide a combined 1,100 beds. These are older homes that would require their owners to invest a lot of capital to meet required upgrades by 2025. Or their owners could generate a lot of capital, by selling the properties to developers hungry for land to build more condos.
Many of the properties are real estate gold mines, located in some of the most affluent neighbourhoods of the downtown core. Why shouldn’t these owners choose condos over care? They’re for-profit businesses, after all, not charities.
Business is business; but the business of taking care of each other is getting harder, especially if we lose more than 1,600 long-term-care beds while struggling with a current wait-list of 31,000 people, just as the population of the elderly booms.
Statistics Canada says there were 277,585 residents aged 80 or older in Toronto in 2022, up 83,394 from a decade before. That’s a much more rapid increase than across the province as a whole. Ontario’s population of those aged 80 and older is expected to double by 2040. While the vast majority of the elderly age on their own, a third or more need long-term care; and that’s a third of a rapidly growing population.
More people need help but there’s less help to be had. Relying on an unreliable part of the care equation doesn’t help.
The proportion of for-profit long-term-care homes in Ontario is the highest in the country, at 57 per cent. Toronto is less dependent — 35 per cent — because of the large number of municipal homes and non-profits that serve cultural communities; but the wait-lists for these homes are astronomical, and neither non-profits nor city-run facilities are growing.
Capacity is being added in the Greater Toronto Area — according to an Ontario government announcement in 2023, we’re ”up to 1,272 net new beds” over an unspecified period — but they’re on hospital properties in Ajax, Mississauga and the former Humber River Hospital on Finch Avenue, far flung from the communities where most of Toronto’s elderly have lived their lives. We’re literally selling the lifelines that keep people connected to their people.
Bill and Vera’s story is a cautionary tale of what is to come. Expect more stories like theirs as more long-term-care homes close by 2025 and for-profit care morphs into something more ruthless, more complex and more difficult to track.
This article was edited from a previous version that mistakenly referred to Kensington Gardens as one of Toronto’s 10 municipally owned and run facilities.  In fact, it is a not-for-profit long term care home run by Kensington Health.