Nursing homes are more than profits

By PETER NEHR, Special to the Times
Published October 30, 2007

Vivian Hewitt's mother, Alice Garcia, was a resident at the Habana Healthcare Center, a nursing home in Tampa. She died after she developed a pressure sore that became infected with feces due to what Vivian believes was negligent care.

Ms. Garcia was not alone. Over three years, 15 residents at Habana died, also from what their families contend was the nursing home's negligence. Tragedies in nursing homes are not unusual, but what happened at Habana was arguably part of a broader pattern of the deteriorating care in nursing homes that are purchased by large private investment firms.

Over the last seven years, purchasing nursing homes has become a lucrative business for these firms. However, a recent New York Times analysis found that nursing home residents have not fared nearly as well. When private equity firms take over, the quality of patient care provided falls dramatically. The number of patient-care deficiencies, like moldy food and the administration of wrong medications, was almost 19 percent higher than the national average at homes owned by large investment companies, even as such citations declined at other nursing homes across the country.

As an elected state representative, one of my most important duties is to provide for the safety of my constituents. As you read this, the largest nursing home chain in the United States, HCR Manor Care, is being purchased by the Carlyle Group, a private equity firm that owns Dunkin' Donuts, Baskin Robbins and Hertz Rental Cars. The details of this acquisition are particularly worrisome. Carlyle will pay for the company by loading it down with $5.5-billion in debt. To pay back this debt, Manor Care will have strong incentives to do what 60 percent of other nursing homes purchased by private investment firms have done: cut costs by significantly reducing staffing, sometimes below federally recommended levels, and cutting other budget items at the expense of patient care.

At the same time, Manor Care's executives will be making up to $250-million in this deal and the Carlyle Group stands to make up to $60-million.

Even more disturbing is the fact that the only other Carlyle-owned long-term care provider, LifeCare Hospitals, was alleged to have responsibility for the terrible tragedies when 24 patients in a New Orleans LifeCare hospital died awaiting evacuation after Hurricane Katrina. A pending class action lawsuit alleges the patients died as a result of LifeCare's negligence, and that the facility lacked adequate backup power sources and had evacuation plans that were insufficient and not followed closely. The lawsuit does not raise claims against Carlyle. However, this incident should give us pause about whether LifeCare's parent company is fit to be the guardian of some of Florida's most vulnerable citizens.

Right now, Florida's Agency for Healthcare Administration is determining whether or not to approve the Carlyle Group's application for a license to operate Manor Care's 29 Florida nursing homes, one of which is in my district. Because this decision will directly impact thousands of Manor Care workers and residents, and their families, it is vital that AHCA subject this application to a thorough investigation and allow opportunities for community members to weigh in on this important decision.

I believe in a business' right to make a profit. But nursing homes should not be just another investment opportunity; they should be a safe haven for our loved ones. Buying Manor Care nursing homes means taking on the responsibility of caring for our mothers, fathers, grandmothers and grandfathers. I have joined with many other legislators, Manor Care residents, health care workers and senior advocacy groups across the state in calling on AHCA to thoroughly investigate the Carlyle Group's fitness to operate nursing homes, to organize a formal opportunity for public comment and scrutiny, and to commit to full transparency as they consider a decision that will affect the health and safety of so many of our seniors.

I am not saying that these specific investors will be dangerous for our citizens, but a public hearing and a thorough investigation would alleviate many concerns. The safety of all our citizens, especially our elderly, should be our top priority.

Peter Nehr is a state representative from Tarpon Springs. His e-mail address is peter.nehr@myfloridahouse.gov.

[Last modified October 29, 2007, 21:22:40]