Thank you for answering these survey questions. The survey should take about 15 minutes to complete.

We want to know about your experience since the beginning of the pandemic, March 2020 until now. If you worked at more than one long-term care home between March and now, please choose one home and answer the survey questions for that home. The information you provide will help with our investigation.

Patient Ombudsman is interested in hearing about your experiences during the COVID-19 pandemic even if there was no outbreak in the home where you worked.

Please answer the questions based on the best of your knowledge or recollection.

All personal and other information collected for this survey will be handled confidentially and only for the purpose of Patient Ombudsman’s investigation.

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* 1. What was your job/title at the long-term care home where you worked between March and now? Please check the box that fits your role the best.

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* 2. What is the name of the long-term care home where you worked? (Optional)

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* 3. What is the city/town where the long-term care home is located? (Optional)

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* 4. Please check the type of long-term care home:

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* 5. Were there one or more COVID-19 outbreaks in the long-term care home where you worked between March 2020 and now?

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* 6. If there were one or more COVID-19 outbreaks in the home where you worked, when did they begin? (Please check all that apply))

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* 7. If there were one or more outbreaks, who became ill?

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* 8. Were there resident deaths because of COVID-19?

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* 9. Were there staff deaths because of COVID-19?

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* 10. At any time between March 2020 and now, did you work at another health care organization or provide care for someone in their personal residence or home?

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* 11. What other care setting(s) did you work at when you were also working at the long-term care home in 2020? Please check all care settings you worked at.

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* 12. In the spring of 2020, were you told that you could only work for one long-term care home?

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* 13. In the long-term care home where you worked, were you routinely screened about your travel and COVID-19 symptoms between March 2020 and now?

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* 14. Please check all statements that reflect your experience in March 2020.

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* 15. If any of the statements above applied to you, were you able to quarantine/stay at home for at least 14 days?

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* 16. Between March 2020 and now have you had trouble getting tested for COVID-19?

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* 17. Have you had problems getting the results of tests for yourself, your colleagues or residents of the home where you worked? Please check as many as apply to your experience.

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* 18. Since March 2020, did you see any problems/concerns in the care and services to residents that were related to the COVID-19 pandemic? Please check all problem areas that apply.

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* 19. Was there a staff person in charge of infection prevention and control at the home where you worked?

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* 20. Before the COVID-19 pandemic, did your long-term care home provide education/training on infection prevention and control?

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* 21. Did your long-term care home provide supplemental/just-in-time training on infection prevention and control after the pandemic began?

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* 22. Between March 2020 and now, did you feel you had enough training to safely use personal protective equipment (PPE)?

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* 23. Between March 2020 and now, did you have access to the personal protective equipment (PPE) you needed to work safely?

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* 24. If you answered ‘No’ to question 23, why did you not have the personal protective equipment (PPE) you needed? Check all options based on your experience.

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* 25. Did you have concerns about staff at the home not always following infection prevention and control practices or training?

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* 26. Did you receive regular updates on the situation in the home where you worked?

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* 27. How were you kept informed about the situation in your home? Please select as many as apply to your experience.

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* 28. If you had a concern about a situation in the home between March 2020 and now, did you feel comfortable raising your concern with management?

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* 29. Was management responsive to your concerns?

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* 30. Between March 2020 and now, did you report or try to report a situation you considered unacceptable in the long-term care home to someone else?

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* 31. If you answered ‘Yes’ to question 30, who did you contact or try to contact to report your concerns. Check all those you tried to contact.

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* 32. Did your long-term care home offer programs to support your emotional health and well-being or to help you manage stress between March 2020 and now?

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* 33. Between March 2020 and now, were the residents who tested positive or had COVID-19 symptoms quarantined or isolated at the long-term care home where you worked?

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* 34. Were hot/warm/cold zones put in place in the long-term care home where you worked?

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* 35. If you answered ‘No’ to questions 33 or 34, why were these measures not put in place? Check all that apply.

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* 36. If hot/warm/cold zones were put in place, did staff follow instructions about moving from one place to another?

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* 37. Between March and June, were residents who transferred into the long-term care home from hospital or other settings isolated?

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* 38. Between March and September 2020, were essential visitors allowed into the home to visit residents who were very ill or palliative?

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* 39. After September 2020, when the government guidance allowed visits, did your home allow visits?

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* 40. After September 2020, what types of visits were permitted?

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* 41. After September 2020, what types of visitors were allowed? Please check all types of visitors allowed at your home.

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* 42. If visits were restricted after September 2020, what were the reasons? Please check all reasons.

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* 43. Have you received the COVID-19 vaccine?

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* 44. If you chose to not get the vaccine, why not?

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* 45. Is there anything else you’d like to add?

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