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In Australia commercial groups comprise only about 25% of the aged care marketplace. There is one large market listed company, a few larger private companies and multiple small commercial operators. The banks own large numbers of nursing homes. With government driving the sector in this direction marketplace thinking has come to dominate the ethos and manner of operation of the entire sector. This web page summarises this situation, looks at patterns of dysfunction, and links to pages describing a selection of these companies.
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FOR PROFIT NURSING HOME COMPANIES
In Australia about 70% of nursing homes have been and still are not-for-profit entities owned by church, community and government. There have been only a small number of large nursing home companies and most of these have not been listed on the share market. Until the late 1990s Moran Health care dominated and is probably still the largest.
Among the private players, the Sydney-based Moran Health Care Group claims to be the largest, running 51 centres and more than 4000 beds. Other big guns include the sharemarket-listed DCA Group, TriCare, Regis Group and Retirement Care Australia, which is majority owned by the Macquarie Bank cash-box Macquarie Capital Alliance Group.
Feb 2006 The bigger for profit companies
Growing old is a growth industry The Age February 22, 2006
It was only after the newly elected coalition federal government decided to turn the sector into a competitive marketplace in 1996 that market listed corporations and main stream financial institutions targeted the sector.
There have been a number of small to medium sized private operators in the market. Some, usually family owned groups had established homes in the 1960s and were motivated to serve the community. I am not suggesting that there were no problems or that there were no dysfunctional individuals during this period. I do not have information.
Most of the larger established private operators entered the market at a time when probity and a community ethic played a much greater part. They have largely targeted the wealthy sections of the population - those who can pay extra. This extra funding has meant that they have not been as pressured by costs as those serving the lower end of the market.
A number of motivated individual operators established small local community homes which served the less well off during this period. They have not had the resources or the abilities to upgrade services to modern standards. The sector was turned into a competitive marketplace. Under the new accreditation systems, care and building standards were set. These small homes were no longer financially viable and fell way below accreditation requirements which some were incapable of meeting. A number of motivated and dedicated older carers who had given years of service were villified in the press and branded.
As I understand developments conservative state coalition governments, particularly in Victoria in the early 1990s encouraged private enterprise to enter nursing home care. Many smaller operators entered the marketplace, some without knowledge and with more interested in profit than care. This occurred particularly in Victoria under the Kennett government. There are now a large number of small operators owning one to five homes and there have been many problems.
Governments have been fiscally orientated and driven by economists. They have consequently restricted funding and rationalised the impact on care. Smaller homes in particular have been pressured and there has been insufficient profitability to carry out needed maintenance, fund care and generate the profits to which entrepreneurs feel they are entitled.
In examining the for profit sector it is important to distinguish between the newer market listed companies with a primary duty to shareholders and large financiers, and the unlisted privately owned companies which have more latitude in funding care when they are so motivated, but are also less publicly accountable. We have recently developed a third group in which the financiers own the nursing homes but they are operated for their benefit by related but usually unlisted for profit companies. It is likely that the pressures for profits and away from care will be similar to the listed corporations.
Australia has followed the USA in turning aged care into a marketplace but this is a much more recent development. It rapidly gained momentum with the election of a federal coalition government in 1996. In spite of the regulatory failures in the USA, Australia elected to rely on regulatory oversight to contain any problems. It has not worked in the past. On this site are a series of linked pages looking at the reasons why regulation and government oversight have failed. More specific pages examining failures in regulation in the USA and Australia. These were written in 2000. Revelations from a series of scandals since 2000 culminating in the 2006 rape scandals show that accreditation and complaint systems are still not working in aged care.
Australia has used the market friendly failed accreditation model in order to accomplish this claiming it is different to the USA. Recurrent scandals suggest that it is not working and that the difference is in form rather than functon. The US experience suggests that the only regulatory mechanism with any efficacy in a market driven system is costly law suits.
In the USA data indicating the incidence of preventable complications such as pressure sores, weight loss and contractures are documented in the state oversight processes. If this information is collected in Australia then it is either not analysed or is not available to us. Instead we have a series of snapshots of individual adverse reports which are very briefly available before they are replaced by another favourable review. We are left with impressions and a series of scandals. We can only draw tentative inferences and make informed guesses about individual situations. When taken overall the multiple allegations and clear trends are damning.
If we look at the homes sanctioned by the accreditation agency and consider that only 30% of the market is for-profit then proportionally the number of for-profit homes sanctioned by the agency is glaringly disproportional.
The accreditation agency accredites homes and not the owners. While it is the owners who allocate funding and determine the policies and practices which ultimately improve or compromise care, adverse findings in a home do not usually impact on the company although it must be an approved provider. While unsavoury individuals can be barred from being directors they remain owners and retain all the economic influence that gives them..
In the USA market listed corporate chains have fairly consistently had inferior outcomes to not for profit operations. They rank among the lower half and have 2 to 4 times as many preventable complications. In Australia we simply do not have that information although a 1999 study found that care in for profit homes was significantly lower.
Jenkins and Braithwaite used multiple regression to analyse the quality of care as assessed by the 31 outcomes standards in force in 1999 in 410 Australian nursing homes. Their survey had good validity and reliability, as measured by independent ratings made by two simultaneous inspections of the same homes.
Aug 2001 Care in for profit nursing homes is worse
They found that the quality of care was significantly lower in profit making nursing homes than in nonprofit nursing homes. One reason was that in profit making homes there was significantly greater pressure on directors of nursing to reach financial goals by cutting corners on quality. Data from the United States support the finding that profit making nursing homes have lower care standards.
The challenge of regulating care for older people in Australia by John Braithwaite BMJ 2001;323:443-6 ---- August 25, 2001
Not only do we not have all the information but the only real market listed company DCA is too new. It is still in an early heavily funded growth phase and is not yet strongly pressured to generate profits.
In the USA private for-profit (not market listed) operators have a broad spread of standards across the spectrum. Several moderately sized groups are among the best operators in the country but others are among the very worst. We can surmise from the reports that this has much to do with motivation, whether care for the residents or the generation of wealth are primary.
In Australia we seem to be developing a similar pattern. Some of the older unlisted family companies have a good track record. At the other end of the spectrum unlisted private for profit operators dominate the problem homes.
(Oct 2007) A major development in the USA and Australia during the 21st century has been the purchase of nursing homes by private equity groups. The market dynamics of this new group of investors suggest that they will have a further adverse impact on care - a thesis rejected by the recent senate inquiry into private equity. A recent inquiry in the USA has revealed a significant deterioration in standards in those nursing homes acquired by private equity.
Click Here for a web page addressing private equity ownership of nursing homes in Australia.
Only one market listed company Milstern has been in business long enough to compare with the USA. It was only listed for a short period and has been controlled by one person. Reports suggest that it followed the US pattern by cutting care to increase profits.
A single adverse report in a DCA hospital may or may not be a pointer to things to come. The problems in that home were rapidly addressed.
Milstern Health Care
Unlike other for profit groups Milstern did not target the wealthy. It depended on government funding for its profitability. It was market listed for only 6 years. Millie Phillips, who made her fortune in nickel mining has been an owner of nursing homes since the 1960s. She floated the company in 1986 but it did not do well during the market collapse in the 1980s and afterwards. The company was delisted in 1993. It does not seem to have prospered in nursing homes and it is clear that little was done to update the facilities.
Milstern is important because its behaviour is so similar to the US aged care companies. In 2001, soon after the Riverside scandal it was revealed that there had been long standing problems in some Milstern nursing homes, particularly the Ritz and Yagoona homes in NSW. Reports indicate that Phillips had culled staff in order to make nursing homes, which were already making money, more profitable. Not only were the homes in a dreadful state of neglect with essential features such as hot showers and call bells not working but standards of care were compromised by among other things not buying continence equipment and not paying suppliers. Staff who complained were harassed.
In spite of all this the homes did not lose accreditation, nor were they penalised. When inspectors recommended that accreditation be removed senior staff overturned the decision. The company simply ignored requirements laid down in previous inspections. Millie Phillips was a friend of the minister and a donor to her political party.
Click Here to explore Milstern Health Cares history and conduct in more detail.
DCA and its subsidiary Amity Group
The large commercial operation DCA is a recent entry (1998) into the nursing home market. It is currently the only large stock market listed operator in this marketplace. It entered this market in 1998 and sold off much of its existing business empire to expand very rapidly and take a commanding position in the nursing home marketplace.
It had a two pronged strategy using its profitable diagnostic radiology business to bank role its expansion into nursing homes. It claimed there were opportunities in economies of size and efficiency and it could make the sector profitable where others had struggled. Not only has it grown to dominate in Australia but it has made major purchases in New Zealand where it is now a major player.
It is too early for major systemic problems in care to develop - the company has been buying nursing homes and pouring resources into them to upgrade them targeting the wealthier sectors of the marketplace.
There has been one major instance which might point to the future. An accreditation inspection of one of its homes in September 2004 revealed serious problems in staff morale and failures in care. The accreditation report is very similar to the reports so common in the USA. The home was not penalised and the company rushed staff to the home to sort out the problems very rapidly. The adverse report was soon removed from the agencies web site and replaced by the next fully compliant one. There was no press coverage.
One can only speculate as to whether this is another instance of a large and credible company in political favour getting preferential treatment. Adverse publicity about the care it provided would have been embarrassing for a government already on the back foot in this area.
The company has recently (2006) given a profit downgrade blaming competition to its radiology business from public hospitals. This seems an unlikely explanation. Investors abandoned the stock in droves suspecting something more systemic. A hint as to what this might be is given by renewed pressure on government to allow it to put up its nursing home charges.
Click Here to go to the DCA page where these issues are explored in detail comparing its policies with similar US groups
STOP PRESS:- In September 2006 the same two multinational Citigroup venture capital subsidiaries (CVC Asia Pacific and CVC Capital partners) that led the purchase of Mayne Health's hospitals in 2003 to form Affinity Health have successfully mounted a takeover of the ailing DCA. The deal was subject to approval from multiple regulators.
NSW Health were so concerned about Citigroup's probity and its track record of misusing those it had a professional responsibility to serve that they mounted an 18 month investigation. They granted hospital licenses subject to conditions which imposed limitations on its operations. Affinity Health elected to sell the hospitals to Ramsay Health Care at this time.
Nursing homes are far more vulnerable to commercial forces than hospitals. The extent to which the process for establishing approved providers (set up in 1997) is independent of market friendly government influence will be revealed. It is also significant that the protective probity provisions on which NSW based its investigation were removed from aged care requirements to please the corporate lobby in 1997.
If this consortium required retraint to own hospitals then its ownership of nursing homes is far more problematic. As the collapse of Mayne Health revealed doctors in hospitals have leverage because they bring the patients. They can use it to restrain companies from excesses as the companies must meet their requirements if the doctors are to bring their patients. Doctors have no leverage in nursing homes as they do not bring the residents.
Click Here to read the letter from NSW Health relating to Affinity Health's license apprication.
Objections were lodged and after a 4 months delay when the matter was off the front pages a reply from the department indicated that under the legislation they were not required to evaluate multinational's buying Australian nursing home companies. The government had created the loophole so that multinationals could bypass our regulations and would not suffer the probity problems that US hospital corporations had run foul of in state licensing regulations. The public statements, revelations about the minister's character, and a review of recent and earlier correspondence provide a facinating insight into the way the country is run behind the public facade. In March 2007 I wrote another page about it.
A reply after the sale, from the government department granting approval status, indicated that Citigroup had not been required to seek approval status under the regulations. This was taken up politically and the two ministers responsible have now indicated that the regulations will be changed.
Click Here to go to the "Citigroup Buys DCA" web page
UPDATE OCTOBER 2007:- BUPA, the UK insurer and health care provider has purchased the nursing homes from Citigroup's CVC Asia pacific. While BUPA makes much of its not for profit status it often behaves with for profit aggressiveness as it pursues profit and growth.
Click Here for a new web page that examines BUPA's history and the issues surrounding its operations.
It is far from clear whether BUPA will now have to face the approval process or whether it, like Citigroup, will be excused. There are issues to address there. The matter is addressed at the foot of the Citigroup Buys DCA page (link above) and progress is being tracked on a new BUPA approval web page.
Ramsay Health Care
Ramsay Health Care is a hospital company which developed an interest in nursing homes in 2002. It entered the market by aggressively buying and building. When the large portfolio of Mayne hospitals which had been bought by a Citigroup consortium called CVC Asia Pacific came on the market unexpectedly Ramsay bought them. It found its hands were full and it elected to sell its aged care facilities.
Click Here to examine Ramsays excursion into aged care
This was a not for profit retirement village operator which owned four nursing home/hostel facilities. It demutualised and listed on the share market. It still operates a small number of nursing home beds but is expanding rapidly in retirement villages.
Click Here for more about Aevum
The Banks and property trusts - Private Equity
Ownership of nursing homes by private equity groups has grown rapidly and their potential influence is now a serious concern. In Australia it is the banks that have capitalised on the governments corporatisation agenda. Most of the large banks (which are market listed) have formed subsidiary companies, sometimes in alliance with others. These companies own but do not operate the nursing homes themselves. Instead they form relationships with private unlisted groups who operate the homes. Their capital is protected should the service prove to be unprofitable and the private operator go under. They seem to be hedging their bets about the profitability of the sector. They have also expanded into other countries. Macquarie bank has led the way.
Click Here to explore the role of the banks and other private equity groups
Retirement Care Australia (Macquarie bank)
Macquarie Bank has entered the nursing home business in a big way and one of its major vehicles for this in Australia is Retirement Care Australia. Although it took a little searching on Retirement Care Australia's web site, this was only a Macquarie bank controlled trust and it did not actually operate the nursing homes it owned. It leased or cooperated with other companies that actually ran the services in the homes. Moran and Tricare operated most of the homes. RCA recently merged with Regis and Regis now operates all the nursing homes.
Click Here for more about Macquarie Bank and Retirement Care Australia.
Domain Aged Care
Domain Aged Care was owned by Gold Coast private equity company MFS. MFS and Domain were both involved in some disturbing activities as a consequence of their mode of operation. There are interesting insights into the way private equity operates. When MFS collapsed Domain was sold to Principal Health Care.
Click Here for more about MFS and Domain Aged Care
Until the arrival of DCA in 1998 the majority of for profit companies owning nursing homes were quite small. Moran Health Care was the exception. The "industry" (as contrasted with "service") was fragmented and this was seen as undesirable. There seem to be large numbers of small for-profit companies, many of them in Victoria. This may be due to encouragement by the Kennett coalition government in the 1990s.
Victoria has by far the largest number of sanctioned nursing homes with Queensland coming second with half that number and the other states half that number again ( see Aged Care Crisis pie diagram on their home page)
A disproportionate number of nursing home accreditation problems have occurred in Victoria and in nursing homes whose owners names suggest that they are small commercial entities. Because they are unlisted there is very little publicly available information about these companies. I have looked for information about the larger companies and about some of those sanctioned . Press reports over the last 6 years indicate the extent of the problems in Victoria.
Dr Segal's warning follows yesterday's Herald Sun report that an official review had rated Victoria's nursing homes Australia's worst.
Jul 1999 Official review
NURSING HOMES FUNDS FEAR. Herald-Sun July 17, 1999
AT least 11 Victorian nursing homes were rated worse last year than Riverside Nursing Home, which was put on notice last week for giving 57 residents kerosene baths.
Mar 2000 Twenty one of 44 bad homes are in Victoria
The 11 homes were rated as having the potential to place residents at serious risk, while another 10 Victorian homes were rated "unacceptable", the same as Riverside's assessment last July.
Across Australia, 44 homes were rated unacceptable, including 18 named as placing residents at serious risk.
Alert over 11 homes. Herald-Sun March 1, 2000
Four separate coroners reports blamed nursing homes for deaths in Victoria in March 2000. Reports obtained by the "Herald Sun" disclosed improper staff training, inadequate medical procedures and poor handling of patients by staff were among some of the contributing factors to patient deaths.
Mar 2000 Deaths
Coroners say home to blame Herald Sun March 16, 2000 (ABIX ABSTRACT)
A Senate estimates committee on aged care heard yesterday that all five Australian nursing homes under sanction by the Department of Aged Care for failing to meet industry standards were in Victoria - Riverside in Patterson Lakes, Belvedere Park in Sydenham, Kenilworth Private in Ivanhoe, Cambrai in East St Kilda and Chelsea Park in Chelsea.
May 2000 Senate Committee
Estimates Committee figures also show that between 1998 and 1999, nine of the 16 nursing homes sanctioned were Victorian. Three remain under sanction this year.
Senator Evans said there were many smaller operators in Victoria, while other states tended to have non-profit or larger operations.
A `poor' state of aged care. The Australian May 25, 2000
Victoria is home to 16 of the 20 nursing homes, which were given extra time to meet accreditation standards on Monday.
Jan 2001 Sixteen of 20 are in Victoria
The homes are run by private operators, charities and religious groups.
$50m to stop rot in homes for aged. Australian January 3, 2001
MORE than half the Victorian nursing homes inspected by authorities this year failed to meet Federal Government standards.
Jun 2002 Half of those inspected
HOMES FAIL Herald-Sun June 24, 2002
THE BIGGER PRIVATE COMPANIES
The larger privately owned companies have grown to own nursing homes in several states.
BUPA is the giant UK not for profit operator. Its commercial success probably has much to do with its for profit mode of operation and I therefore include it here. It provides insurance coverage as well as health care services in multiple countries. Australia makes a large contribution to its profits. It is a major health insurer in Australia and has recently purchased DCA's nursing homes from Citigroup. If the churches are excluded it is now the largest operator of private nursing homes in Australia.
Issues raised by BUPA are the appropriateness of its commercial approach and whether its actions are a betrayal of the trust of those who become members because of the way it markets its not for profit commitment to them.
Click Here for a web page about BUPA.
BUPA is also an issue because ministers have made promises about closing a major loophole in the approved provider requirements. There are some issues which should be explored and what happens will be a test of whether these ministers have fulfilled their undertakings.
Click Here for a web page which tracks these developments.
Moran Health Care
Founded by self made businessman Doug Moran in the 1950s this privately owned company has been Australias largest nursing home company. It has also dabbled in hospitals where its Taj Mahal style luxury medical villages sought to attract the wealthy from Asia. This attracted press coverage.
I have not found many adverse reports about Moran nursing homes but the volume of material is so large that a detailed search was not undertaken. Moran has targeted wealthier residents and has consequently had the resources to provide the sort of care which does not result in law suits and press coverage.
Moran Healthcare sold and leased back most of its nursing homes in order to raise the capital needed to fund an expansion into the United Kingdom and Ireland. The enterprise was a disaster and the UK company went bankrupt. It seems possible that the company is in trouble as Moran has sold some and has tried to sell other nursing homes. Moran denies this. Moran has sold his mansion.
Doug Moran has had close connections with the coalition government and seems to have played an important role in developing government policy for aged care - a policy which was rejected by Australian citizens who forced the government to back away.
The Moran familys personal life as revealed in very public allegations and law suits have titillated the press. This has coincided with the financial problems. The disclosures do raise concerns about the sort of people who have been running this company and assumed responsibility for vulnerable Australians. Were probity an issue in nursing home ownership this might have raised eyebrows.
Moran threatened libel action in regard to some comments on the nursing home page. The original was removed. It has been revised (Jan 2007) to correct an error and make other comments clearer. Moran has been asked to comment and refute the assertions he disputes. The page will hopefully soon be back up with his comments.
Click Here to go to the three pages about Moran Health Cares nursing homes, hospitals and the family story.
This private Queensland Retirement Village and nursing home company owned by the OShea family has linked up with Macquarie bank and will be operating many of their facilities. Prior to this it operated 15 Queensland nursing homes. While it has targeted the top end of the market it will now be looking at a different sector.
It is worrying that it is now favouring larger (perhaps more impersonal) nursing homes because they are economically more viable. There are also worrying complaints about care from nurses and some adverse publicity about a resident who was kept against her will.
Tricare objected to some of the comments made and I have reworded the page so that my concerns cannot be misinterpreted and so that it is more balanced. Tricare has been invited to comment.
Click Here to learn more about Tricare
Regis Group Pty Ltd
Regis is one of the largest of the private nursing home operators and has kept a low profile as it grew steadily to 19 facilities in Victoria and Queensland. It head office is in Victoria. Negotiations to sell itself to DCA in 2006 fell through. It then merged with Macquarie banks's Retirement Care Australia so has a major private equity investment.
Click Here for more information about Regis
SMALLER PRIVATE COMPANIES IN VICTORIA
This is where most of the major problems have occurred and where major scandals have exposed deficiencies in policy. The Riverside scandal more than any other exposed the deficiencies in the aged care system.
Illawong Retirement Equity Pty Ltd -- The Riverside Scandal
This was a small Victorian group owning only one home. Riverside was the first of a wave of scandals engulfing the aged care minister in early 2000. It was less than 3 years since the government had introduced its strongly promoted market reform and claimed that its industry friendly accreditation process would contain any adverse outcomes. It was increasingly clear that the system was failing and that the ministers promises were not being met.
Riverside was the catalyst which really exposed what was happening. A large amount was written about it. Bringing all this material together gives a fascinating insight into the workings of the market system in aged care in Australia. It reveals why it was not working and what was wrong with the model and the system. The lessons were there to be learned but the ideologically blind were not going to see them.
We encounter a series of system failures in the market, in the regulators and in the political system. In each totally unsuitable people became involved in a situation for which they were unsuited and which they could not handle. Social processes and procedural requirements worked themselves out relentlessly and all those involved suffered. This is a long read but it is worth the effort.
Click Here to examine the Riverside scandal
Saitta Pty Ltd and Neviskia Pty Ltd (Kenilworth and Belvedere Park)
These two Victorian companies were both largely owned by the same person. He had a criminal conviction which the relevant authorities failed to act on for 3 years even though they were aware of it.
The Belvedere Park Nursing Home and the Kenilworth Nursing Home both in Melbourne were the subject of multiple adverse reports and were repeatedly sanctioned. The managing owner was very aggressive in attacking, challenging and appealing the departments decisions - with considerable success. In the end only one home was eventually closed down. The other still operates.
This was one of the scandals which engulfed the minister at the end of 2000. A detailed examination of what happened gives a fascinating insight of the sort of people who get into this industry and the failure both of the market system and of the regulatory structure which protects the rights of owners rather than citizens.
Click Here for examine the issues in more detail
CIS Holdings (Templestowe Private Nursing Home)
Another small Victorian company which was quite unable to run a home effectively. After being allowed to continue operating for some time it was forced to sell the home in 2001. There were criticisms of the delay in doing this.
Click Here for more
Eildon Nursing Home
This Victorian home was run by a couple. Two weeks after they had sold the home in 2002 the accreditation agency visited and found it to be the worst in the state - 39 deficiencies out of 44. One wonders about the sort of people who could be part of this and where they came from. The home no longer exists - at least not under this name.
Click Here to explore this scandal
McKenzie Aged Care Group (Armitage Nursing Home)
This Victorian group founded in 1998 operated the Armitage Nursing Home where a surprise inspection found major problems in care in 2003. In spite of this the group secured licences to expand in 2004 and they now operate 5 homes in Victoria, NSW and Queensland. It seems that the commercial side of licences and the accreditation authorities are quite separate and the decisions of one have no impact on the other. So much for probity.
Apart from their names we know nothing of the company owners - the people responsible for what happened. The prime problem as always is understaffing and staff morale.
Click Here to go to the web page about the McKenzie Group
Supported Residential Services
(SRS) and Marnotta Pty Ltd
Tangerine Lodge, Ripplebrook Village and Rosedale Manor
These were two related faceless Victorian companies where there is a great deal of coverage of the serous problems in three of their four homes during 2003. We dont even learn the names of the owners. Once again the problem was staffing and morale. The two companies eventually entered bankruptcy.
Click Here for the story and the problems
Enhance Aged Care (Chelsea Park and Chelsea Private Nursing Home)
Enhance Aged Care is a Victorian company where there is no information about the principals responsible. One can only suspect that these were people who wanted to capitalise on the aged care bonanza and targeted staffing in order to do so. Violent residents wandered the home unchecked. The scandal occurred in 2003/4
They owned two facilities on the same campus south of Melbourne. Staffing was deficient and nothing was done until police investigated a death. Until this happened regulators had happily accredited the home. This does not sound like something new. After the scandal the company sold its nursing homes to DCA.
Click Here to explore what happened
Peel Street Management Services Pty Ltd (Mews Aged Care Facility)
A member of the Victorian Aged Care Association was a director of this company. It was sanctioned in 2004. Incredibly details of the inspection and the reason for the sanctions was not released until 6 months later when the sanctions had expired.
Click Here for the story
Muskjest Pty Ltd (Emerald Glades Nursing Home)
The two owners in this Victorian companys only reason for buying a nursing home was profitability. They seem to have done nothing but frustrate the effort to provide care by understaffing, underfeeding and undersupplying. When nurses lodged complaints in 2004 they were fired. The home was allowed to continue operating and sanctions have been lifted.
Click Here for the Muskjest story
Lasalto, Easyplan and Lestlin Nominees
These unrelated small Victorian operators own only one or two homes each. They were criticised and/or had trouble with accreditation during 2004 and 2005.
Click Here for more information
Ellis Residential Care
and Ellfam Nominees
(Paynesville Aged Care Facility and George Vowell Centre)
These are two interrelated Victorian companies owned by the Ellis family. The group have been prominent in Victoria where they once owned 10 nursing homes. They have represented the industry in dealings with government.
They have had problems in two of their homes, Paynesville Aged Care Facility and George Vowell Nursing Home. The scandal in the George Vowel home, where four 90 year olds were raped or sexually abused in 2006, was the trigger which set off another series of federal investigations and further patching of the system.
Click Here for more information
Dampier Bay Pty Ltd (St Lawrence Nursing Home)
The Victorian nursing home owned by this company failed accreditation and entered bankruptcy in 2006. It transpired that its new owner in 2003 had no knowledge of aged care, no experience and was clearly incapable of learning. The problem of people with these qualifications being allowed into the sector as recently as 2003 is another example of the unwillingness of this government to do anything about the aged care crisis when this conflicted with their ideological belief system.
Click Here to explore what happened
Hastings Regional Nursing Home Pty Ltd
This was a small 30 bed nursing home owned by one family. Government awarded it an extra 30 beds in 2002 but it was not profitable enough to build them. It struggled financially and care steadily deteriorated until sanctions were put in place. These pushed the business into receivership with rapid closure of the home and distress for residents and staff. As with Riverside there is a startling disconnection between the views of the residents and those of the agency. It is a good illustration of what is happening in aged care.
Click Here to explore this company
Navatha Nominees and Locksley Manor (Blackburn Aged Care Facility)
This was another small Victorian nursing home with a community of functioning carers and residents. In 2006 this entire community was shattered and scattered by a bitter dispute between the manager and owner from whom he leased the building. The home was closed at considerable personal cost to all parties. The regulators did no more than mediate. Because this was a commercial dispute the market friendly legislation did not give them the power to intervene in the interests of the residents.
Click Here to explore this example of failed regulation.
SMALLER PRIVATE COMPANIES IN OTHER STATES
Small operators in other states also had problems but there are fewer of them than in Victoria. Some medium sized groups seem to have performed well.
Aegis Aged Care Group
Founded in 1983 Aegis is a wholly owned Western Australian company. Its web site lists it as owning 15 facilities and building 3 more. The 2004/5 list of approved providers lists 7 nursing homes. It is involved with Curtin university and the WA in a number of innovative projects. I have not looked to see what each of its facilities provides but this is at http://www.aegiscare.com.au/
Its web site lists it as providing low care (hostel) care at 8 facilities, high care services at 10 facilities, dementia services at 8, and experimental extra care services at one. It has targeted the wealthy sector with 5 facilities supplying more luxurious "Extra Services"
It is an affiliate of the Royal College of Nursing. It claims an excellent accreditation record and I did not find any adverse reports
Sauve Enterprises and Craigcare (Elizabeth House, Plumpton Villa, Berwick Village, Ravenswood Court)
West Australian Craigcare was acquired by an executive who left the troubled Moran in 2003 to form Sauve Enterprises. It operates retirement villages and nursing homes. It has linked up with Westpac and seems to be concentrating on expansion into nursing homes. This expansion was followed in 2006 by multiple failures in accreditation standards in its new Victorian homes.
Click Here to look at Craigcare.
Kennedy Health Care Group (Kenna Investments Pty Ltd)
According to this groups web pages it was founded in 1970. It is a family owned company based in Kogarah, NSW. Its web page (http://www.kennedyhealthcare.com.au/) states that "Currently comprising 8 aged-care facilities and 2 retirement villages, our company provides high and assisted level nursing care to more than 700 residents, as well as self-care to more than 50 residents in the Sydney and Wollongong areas. - - "
It is building a 474 bed nursing home in NSW and I wonder how a complex this size can be a real home where everyone knows each other as contrasted with an impersonal service?
A 1996 press report claimed that the Kilbride Nursing Home was being investigated by the Health Care Complaints Commissioner. I did not find any other adverse information about this group and it seems to function well.
Thompson Health Care
This is another family company (http://www.thompsonhealthcare.com.au/) established in 1965 by Faith and Wal Thompson and operated by 3 generations of the family. It operates 9 nursing homes in NSW. I have not found any reports to suggest that there have been problems in these homes. Most of the reports relate to the difficulties they have had in upgrading or rebuilding their older homes. The Kenilworth home they operate in NSW is not the one with the same name that was closed down in Melbourne in 2000/1
Alchera Park Nursing Home
This was another for profit nursing home owned by an individual but in Queensland. Once again understaffing and a failure of authorities to act in spite of shocking care were key concerns in 2000. It still operates.
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Trans Dominion Holdings and
(Sir Charles Mitchell Nursing Home)
The first of these two companies was the owner of the Sir Charles Mitchell Nursing Home in NSW in 2001 when it was sanctioned. The second owned it in 2002 when it was sanctioned once more. This home and another in NSW are still run by Farad Nominees.
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Gonzales Nominees Pty
(Albury and District Private Nursing Home)
The home run by this company in Albury NSW has been a recurrent offender since 1996. This continued after Gonzales acquired the company. There were problems in 2001 and 2003. Nurses complained to the agency about what was happening there. Once again managers at the accreditation agency overruled assessors advice that accreditation be cancelled.
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Bresant Pty Ltd (St Catherine's Nursing Home)
Owned by a doctor who should have known what was required, this South Australian one nursing home operator failed 20 of the 44 criteria in 2004. It was extremely tardy in dealing with the problems failing 14 in 2005.
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Tolega Pty Ltd and
Karoona Pty Ltd
(Barton Vale and St David's Nursing Homes)
Tolega, a new company in 2005 owned only one home, the Barton Vale Nursing Home in South Australia. It had been given approved status even though a director had been involved in a previously sanctioned company, Karoona, which had gone out of business after its St Davids was sanctioned. Within months the new home was a mess.
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Peninsula Care Pty Ltd
This is a Queensland company owned by a Victorian family. The family owned another nursing home company in Victoria. They were convicted on Medicare fraud in Queensland in 1999 and imprisoned. In 2006 it was revealed that in spite of this they had continued to own both companies appointing their children as directors. There had been little if any adverse publicity about this in Victoria at the time and the name of their Victorian company was not disclosed.
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Aged Care Crisis Centre:- If you are looking for additional information or full news articles you should explore the Aged Care Crisis eNews Bulletins which highlight issues and then link to supporting material. A search page that allows you to search the Aged Care Crisis site for the many media reports is particularly useful. Enter the name of the company or nursing home you are interested in. Discussion forums provide access to stories and comments, related to key issues and experiences, by those who encounter the system as recipients and those who experience it as providers of care.
Australian Consumers' Association's <http://www.choice.com.au/> 2006 report on aged care facilities and nursing homes is a useful resource for those thinking about a nursing home for themselves or a relative. The full report can be downloaded as a pdf file
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This page created Sept 2006 by Michael Wynne
updated Jan 07, Mar 07, Jul 07, Oct 07,Sep 08