Re: Another mass shooting
Posted: Tue Dec 04, 2018 6:47 am
While we can all agree that "the government" needs to do better, let's not pretend that privatization is a miraculous panacea:
Overdoses, bedsores, broken bones: What happened when a private-equity firm sought to care for society’s most vulnerable
To the state inspectors visiting the HCR ManorCare nursing home here last year, the signs of neglect were conspicuous. A disabled man who had long, dirty fingernails told them he was tended to “once in a blue moon.” The bedside “call buttons” were so poorly staffed that some residents regularly soiled themselves while waiting for help to the bathroom. A woman dying of uterine cancer was left on a bedpan for so long that she bruised.
The lack of care had devastating consequences. One man had been dosed with so many opioids that he had to be rushed to a hospital, according to the inspection reports. During an undersupervised bus trip to church — one staff member was escorting six patients who could not walk without help — a resident flipped backward on a wheelchair ramp and suffered a brain hemorrhage.
...Under the ownership of the Carlyle Group, one of the richest private-equity firms in the world, the ManorCare nursing-home chain struggled financially until it filed for bankruptcy in March. During the five years preceding the bankruptcy, the second-largest nursing-home chain in the United States exposed its roughly 25,000 patients to increasing health risks, according to inspection records analyzed by The Washington Post.
The number of health-code violations found at the chain each year rose 26 percent between 2013 and 2017, according to a Post review of 230 of the chain’s retirement homes. Over that period, the yearly number of health-code violations at company nursing homes rose from 1,584 to almost 2,000. The number of citations increased for, among other things, neither preventing nor treating bed sores; medication errors; not providing proper care for people who need special services such as injections, colostomies and prostheses; and not assisting patients with eating and personal hygiene.
Counting only the more serious violations, those categorized as “potential for more than minimal harm,” “immediate jeopardy” and “actual harm,” The Post found the number of HCR ManorCare violations rose 29 percent in the years before the bankruptcy filing.
The rise in health-code violations at the chain began after Carlyle and investors completed a 2011 financial deal that extracted $1.3 billion from the company for investors but also saddled the chain with what proved to be untenable financial obligations, according to interviews and financial documents. Under the terms of the deal, HCR ManorCare sold nearly all of the real estate in its nursing-home empire and then agreed to pay rent to the new owners.
Taking the money out of ManorCare constrained company finances. Shortly after the maneuver, the company announced hundreds of layoffs. In a little over a year, some nursing homes were not making enough to pay rent. Over the next several years, cost-cutting programs followed, according to financial statements obtained by The Post.
...“Carlyle was a very interesting group to deal with,” said Andrew Porch, a consultant on quality statistics to whom HCR ManorCare referred questions about health-code violations. “They’re all bankers and investment people. We had some very tough conversations where they did not know a thing about this business at all.”
...Ludovic Phalippou, a professor at Oxford who wrote the textbook “Private Equity Laid Bare,” says it is a question of whether private-equity methods are appropriate in all fields.
He has praised the ability of private equity to streamline companies but he has also described the firms’ approach as “capitalism on steroids.”
He said, for example, that while private-equity ownership of nursing homes is accepted in the United States, people in some other countries would be “aghast” at the idea.
“People will wonder whether this pure capitalism is appropriate in nursing homes,” Phalippou said. “The health and welfare of the old people who live there depend on them.”...
Overdoses, bedsores, broken bones: What happened when a private-equity firm sought to care for society’s most vulnerable
To the state inspectors visiting the HCR ManorCare nursing home here last year, the signs of neglect were conspicuous. A disabled man who had long, dirty fingernails told them he was tended to “once in a blue moon.” The bedside “call buttons” were so poorly staffed that some residents regularly soiled themselves while waiting for help to the bathroom. A woman dying of uterine cancer was left on a bedpan for so long that she bruised.
The lack of care had devastating consequences. One man had been dosed with so many opioids that he had to be rushed to a hospital, according to the inspection reports. During an undersupervised bus trip to church — one staff member was escorting six patients who could not walk without help — a resident flipped backward on a wheelchair ramp and suffered a brain hemorrhage.
...Under the ownership of the Carlyle Group, one of the richest private-equity firms in the world, the ManorCare nursing-home chain struggled financially until it filed for bankruptcy in March. During the five years preceding the bankruptcy, the second-largest nursing-home chain in the United States exposed its roughly 25,000 patients to increasing health risks, according to inspection records analyzed by The Washington Post.
The number of health-code violations found at the chain each year rose 26 percent between 2013 and 2017, according to a Post review of 230 of the chain’s retirement homes. Over that period, the yearly number of health-code violations at company nursing homes rose from 1,584 to almost 2,000. The number of citations increased for, among other things, neither preventing nor treating bed sores; medication errors; not providing proper care for people who need special services such as injections, colostomies and prostheses; and not assisting patients with eating and personal hygiene.
Counting only the more serious violations, those categorized as “potential for more than minimal harm,” “immediate jeopardy” and “actual harm,” The Post found the number of HCR ManorCare violations rose 29 percent in the years before the bankruptcy filing.
The rise in health-code violations at the chain began after Carlyle and investors completed a 2011 financial deal that extracted $1.3 billion from the company for investors but also saddled the chain with what proved to be untenable financial obligations, according to interviews and financial documents. Under the terms of the deal, HCR ManorCare sold nearly all of the real estate in its nursing-home empire and then agreed to pay rent to the new owners.
Taking the money out of ManorCare constrained company finances. Shortly after the maneuver, the company announced hundreds of layoffs. In a little over a year, some nursing homes were not making enough to pay rent. Over the next several years, cost-cutting programs followed, according to financial statements obtained by The Post.
...“Carlyle was a very interesting group to deal with,” said Andrew Porch, a consultant on quality statistics to whom HCR ManorCare referred questions about health-code violations. “They’re all bankers and investment people. We had some very tough conversations where they did not know a thing about this business at all.”
...Ludovic Phalippou, a professor at Oxford who wrote the textbook “Private Equity Laid Bare,” says it is a question of whether private-equity methods are appropriate in all fields.
He has praised the ability of private equity to streamline companies but he has also described the firms’ approach as “capitalism on steroids.”
He said, for example, that while private-equity ownership of nursing homes is accepted in the United States, people in some other countries would be “aghast” at the idea.
“People will wonder whether this pure capitalism is appropriate in nursing homes,” Phalippou said. “The health and welfare of the old people who live there depend on them.”...