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Nursing Home Abuse Concerns Rise in Florida Amid Manor Care Purchase, Publication of Nursing Home "Watch List"

Jan 2, 2008 | Parker Waichman Alonso LLP

The issue of nursing home abuse is making news in Florida, where the Service Employees International Union (SEIU) and some state lawmakers are urging regulators to examine the issues  of nursing home abuse and neglect as they consider granting a nursing home license to a private equity firm that recently purchased facilities in Florida and around the country.  The Carlyle Group purchased HCR Manor Care for $4.9 million, and now owns 29 nursing throughout Florida.   The SEIU and other nursing home advocates fear that the Carlyle Group will move to cut costs at the nursing homes it owns, something that could put nursing home residents at risk for abuse and neglect.  Those concerns have only been heightened by the Florida nursing home “watch list” which already cites some Manor Care properties for providing inadequate care to nursing home patients.

Recently, private investment firms have looked to nursing homes as a possible route to easy money. These firms buy facilities, drastically reduce their costs, then turn around and sell them at huge profits.  Private investment groups have been targeting some of the biggest nursing home concerns, in turn affecting the care of millions of patients. In addition to Carlyle’s purchases of HCR Manor Car, Genesis Healthcare Corp. agreed to be bought by private equity in January, and Beverly Enterprises went private in 2005.

But these acquisitions could be coming at a great cost to nursing home patients. According to a New York Times investigation, facilities owned by private investment firms score worse than national rates in 12 of 14 indicators regulators used to track ailments of nursing home residents. And the Centers for Medicare and Medicaid Services says that residents of such nursing homes suffer more from depression, loss of mobility and the loss of the ability to dress and bath themselves. And both federal and state regulators told the New York Times that citations for quality-of-care deficiencies, like moldy food and restraining residents for long periods of time, rose at every large nursing home chain that was acquired by a private investment group. While the Manor Care sale has been approved by shareholders, Florida is one of several states still deciding whether to give Carlyle a license to run the nursing homes.

Meanwhile, a Florida nursing home “watch list” indicates that many nursing homes in the state are problematic, and two of Manor Care’s nursing homes are already on that list. According to inspection records, staff at Manor Care Health Services in Boca Raton served residents cold food, failed to wash their hands before administering medicines and did not follow doctors' orders to remove catheters and treat patients' wounds. In all, 139 of the state's 650 nursing homes are on the watch list.  The watch list is part of the state Agency for Health Care Administration's nursing home guide, which grades facilities based on inspection results and is updated every three months. The nursing homes are ranked relative to each other with the best homes getting five stars and the worst getting one star. In addition to Manor Care, some of the homes on the list were also owned by major chains including Classic Residence by Hyatt, which owns 76 nursing homes in the United States.