Caregivers point to this as yet another example of Carlyle-ManorCare management failing to treat its workers fairly.  The OSHA investigation is expected to take about six months.

Read more about the incident in the Express-Times.

The legislation would require nursing homes to show they have the proper funding and insurance before the state grants operating licenses and increases disclosure requirements for proposed nursing home sales. Homes would have to notify residents of changes of ownership and make clear who is ultimately responsible for the quality of care.

The move comes following the Carlyle Group’s buyout of ManorCare nursing homes, one of the state’s largest nursing home chains. Lawmakers held hearings around Michigan to give constituents the opportunity to express concerns about the buyout, which ranged from difficulties knowing who is actually responsible for care to concerns about whether the buyout could increase pressure to cut staffing and other costs.

The move comes following the Carlyle Group’s buyout of ManorCare nursing homes, one of the state’s largest nursing home chains. Lawmakers held hearings around Michigan to give constituents the opportunity to express concerns about the buyout, which ranged from difficulties knowing who is actually responsible for care to concerns about whether the buyout firm will cut staffing to increase profits.

"When private investors come to Michigan shopping for nursing homes, it is our parents, grandparents, family friends and loved ones who may be adversely affected. We want to make sure that doesn't happened here," said Representative Robert Jones (D-Kalamazoo).

The legislation in the works would require nursing homes to show they have the proper funding, insurance, and quality record before the state grants operating licenses and increases disclosure requirements for proposed nursing home sales. Homes would have to notify residents of changes of ownership and make clear who is ultimately responsible for the quality of care.

The Fair Oaks facility has a history of patient care problems according to the most recent government survey data available.  The facility was cited for 16 patient care deficiencies in its most recent survey in 2007, more than twice the state average, and high-risk long-stay residents were 86% more likely to have pressure sores than similar residents in an average Virginia nursing home.  Workers left the action resolved to spread their message more broadly, taking it to the streets in the South.

While seeking approval to acquire ManorCare last year, Carlyle committed to provide Pennsylvania regulators with weekly reports on staffing levels and advance notification of any permanent staffing cuts.  But now ManorCare is refusing to provide that information to the people most directly affected:  nursing home residents and family members, as well as families looking for the best nursing home for their loved one.  “Why does ManorCare need a legal justification to disclose this information,” asked nursing home activist Erica McDuffie.  “And how could Manor Care deny that family members have a right to know about the quality of care provided to their loved ones?”

Read the letter and ManorCare’s response.

ANNAPOLIS – Seniors in Maryland’s nursing homes have reason to sleep better tonight. Governor Martin O’Malley signed two bills last Thursday that will do a better job of holding nursing homes accountable for the quality of care they provide.

Lawmakers introduced the legislation in response to concerns of nursing home transparency and accountability raised by advocates, caregivers, and family members – concerns highlighted last year when the Carlyle Group, one of the world’s largest private equity buyout firms, sought permission to operate ManorCare nursing homes in the state.

The bills’ technical titles are “Person Who Operate Nursing Homes – Licensure” (HB 1187) and “Task Force to Study Financial Matters Relating to Long–Term Care Facilities” (HB 807).

The bills may be accessed at http://mlis.state.md.us/#bill

Members of the Pennsylvania House Democratic leadership voiced continued concern over Carlyle’s buyout of HCR Manor Care in an open letter to state regulators last week.

Lawmakers sought to ensure that Carlyle-ManorCare was abiding by its commitment to provide continuing disclosures of direct care staff levels and 30-day advance notification of permanent staffing cuts. In an effort last year to gain regulatory approval for the $6.6 billion buyout, Carlyle-ManorCare took the unusual step of committing to provide the Pennsylvania Departments of Health and Public Welfare with these and other disclosures in a document dated November 30, 2007. The letter from lawmakers was sent May 20 and addressed to Secretary of Health Calvin Johnson and Secretary of Public Welfare Estelle Richman.

The May 20 letter follows demands by advocates for Carlyle-ManorCare to abide by its public commitments to provide adequate staffing, quality care, and training for frontline caregivers. Advocates are also urging Carlyle-ManorCare to extend the specific commitments made to Pennsylvania regulators to each of the other 31 states in which the company operates nursing homes.

Read the May 20, 2008 letter.

Read Carlyle's committments to lawmakers. 

The U.S. Department of Health and Human Services’ Office of the Inspector General released a report last month recommending that Carlyle-ManorCare’s Heartland Health Care Center of Bedford, Texas refund $158,000 to the Medicare program and provide training to its staff on SNF medical necessity and documentation requirements. While seeking regulatory approval to purchase ManorCare last year, Carlyle issued a “Patients First” pledge promising to provide education and training to its staff. However, Carlyle-ManorCare has fought back against recent efforts by caregivers at ManorCare’s Towson, MD facility to secure a fully funded training program.

The OIG’s report has now been referred to an HHS action officer who will make the final decision on what steps to take. The OIG’s recommendations follow its finding that in 94% of the claims it reviewed the facility provided residents with services that were either medically unnecessary at the skill or resource level claimed, or not adequately supported by documentation.

Medically unnecessary services and billing errors in skilled nursing facilities were projected to cost the Medicare program more than $352 million in Fiscal Year 2007, according to a government report released earlier this month. The report is available at https://www.cms.hhs.gov/apps/er_report/index.asp.

The OIG’s full report may be viewed at http://www.oig.hhs.gov/oas/reports/region6/60700045.pdf

“For example last winter, the Carlyle Group, one of the world’s largest private equity buyout firms, completed a $6.6 billion leveraged buyout of HCR Manor Care, the nation’s largest nursing home care provider,” testified Tom DeBruin, former nursing home caregiver and President of SEIU Healthcare Pennsylvania. “Common sense suggests that there is reason to be worried about cost-cutting pressure at a company that has just taken on up to $5.5 billion in new debt.”

The hearing examined growing problems with nursing home transparency and accountability, particularly in this climate of private equity buyouts and chain consolidation. Representatives stressed the need for more readily available public information about ownership, operation, and quality in nursing homes.

“Our regulatory system — mired in the past when nursing homes were owned by small companies — is inadequate to address the problems and challenged posed by mammoth multi-state corporations, LLCs and private equity firms that dominate the industry,” testified Connecticut Attorney General Richard Blumenthal.