Carlyle CAN Improve Care at ManorCare: Carlyle Commitments
• The Carlyle Group should ensure that its nursing homes are in compliance with federal minimum resident care regulations at all times.
In the last year alone, Manor Care homes were cited for thousands of deficiencies in resident care, including residents receiving incorrect doses of medicine, receiving insufficient amounts of food and liquids and developing avoidable bedsores. The Carlyle Group needs to make an affirmative commitment to bringing all the Manor Care homes into compliance with federal regulations governing all homes that receive Medicaid and Medicare funds and keeping them in compliance at all times.
• The Carlyle Groups should ensure that its nursing homes are adequately staffed.
In a 2001 study prepared for the Centers for Medicare and Medicaid Services, experts identified a staffing threshold below which quality of care was compromised. According to self reported data, staffing at at least 88% of Manor Care nursing homes does not meet that threshold. If residents are to get sufficient nutrition, correct medication and develop trusting relationships with staff, Carlyle Group needs to affirmatively commit to achieving and maintaining adequate staffing levels.
• The Carlyle Group should disclose the impact of its Manor Care buyout to the nursing home residents, workers and taxpayers in each state.
Nearly two-thirds of Manor Care’s revenue comes from taxpayer-funded Medicaid and Medicare payments. The lack of transparency inherent in the private equity business model is troubling given this dependence on public financing. Therefore, the Carlyle Group needs to commit to full public transparency on the impact of the buyout and its reorganization plans on employees, communities and taxpayers.
• The Carlyle Group should structure its buyout so that Manor Care staff has a role in the reorganization and benefit from its outcome.
As the front-line staff that cares for residents, Manor Care employees bring important experience and best practices to the table. As such, the buyout should create economic opportunities that align the long-term interests of staff in building the value of the company just as has been done for senior management. In order to concentrate on providing the best possible resident care, these employees should be guaranteed a voice at work, paychecks that can support a family, retirement benefits and quality, affordable health care coverage.
• The Carlyle Group should create a Quality Care Fund and a new advisory committee comprised of Manor Care staff, resident advocacy groups and other stakeholders to improve patient care in all Manor Care homes.
By buying Manor Care, the Carlyle Group will be in control of one of the largest long-term and post-acute care companies in the country, a company that depends on taxpayer funded health care programs for more than two-thirds of its revenue. Carlyle should welcome the involvement of Manor Care staff and others on a newly created advisory body that will determine the best practices for addressing current Manor Care staffing and resident care shortcomings. For $250 million a year through the life of the buyout, Carlyle Group could establish an annual Quality Care Fund to implement the committee’s plans and make Manor Care the preeminent company it claims to be.