References for Extendicare

Extendicare is a Canadian company whose main operations are in the USA. Like its competitors it overextended itself. It suffered a change in fortunes consequent on the 1997 changes in Medicare funding. It sustained large losses and survived by selling in the USA to pay off the debt it was struggling to service. The reports suggest that it may also have adopted a policy of deliberate understaffing in order to reduce costs - something the company vigorously denies.

COMMENT:- The first 4 extracts show Extendicare's business activities and the beginnings of the sell off up to Feb 2000. It has recently started expanding in Canada where conditions are more welcoming.

NURSING HOME WILL SHUT DOWN; HIGHLAND CITES CUTS IN MEDICARE
Capital Times (Madison, WI.) October 5, 1999, Tuesday, ALL EDITIONS

Extendicare is one of the largest residential care companies in North America with 323 facilities, capacity for 32,400 residents, and 44,100 employees.

Extendicare Inc. Responds To Share Price Change
MARKHAM, ONTARIO--(BUSINESS WIRE)--Oct. 14, 1999-

Extendicare also provides medical specialty services, including subacute care and rehabilitative therapy services, and other medical supplies and services in the United States, as well as home health care and rehabilitative therapy services in Canada.

Extendicare Inc. Expects to Report Fourth Quarter 1999 Results by March 31, 2000
Business Wire February 23, 2000, Wednesday

Extendicare is one of the largest operators of long-term care facilities in North America. On December 31, 1999, the Corporation operated 297 facilities, with capacity for 29,500 residents in the United States and Canada. Extendicare also provides medical specialty services, including subacute care and rehabilitative therapy services, and other medical supplies and services in the United States, as well as home health care and rehabilitative therapy services in Canada.

Extendicare Inc. Announces Appointment of Shelly Jamieson as President of Extendicare-Canada Inc.
(BUSINESS WIRE)--April 3, 2000

Extendicare (Canada) operates 60 facilities - including 56 nursing homes, three retirement homes and a chronic care unit with total capacity for more than 7,500 residents. Home care services are provided by ParaMed Home Health Care, while rehabilitative therapy services are available through Accident Injury Management Clinics Inc. (AIM).

Taking Care; Major players in seniors housing
Hamilton Spectator (Ontario, Canada) June 8, 2002

Nursing home giant Extendicare Inc., founded in 1968, is one of the largest long-term-care operators in North America. It has 217 facilities in Canada and the U.S., with space for more than 26,000 residents, about 5,000 of them in Ontario. Its holdings include 42 homes across the continent, including 76 new assisted living spaces to be built in Ontario. - - - - - The company has switched focus to Ontario, where it is going through a $125-million building program as one of the three major private firms which won big long-term-care bed awards. It will house 1,100 seniors in eight new Ontario centres.

Visit Extendicare's Web Site @ http://www.extendicare.com

Banking: financing trends in an acquisitive health care market - focus on long-term care.
Journal of Health Care Finance June 22, 1998
Gordon, Lawrence J.; Bressler, Andrew

The merger and acquisition (M&A) frenzy sweeping the health care industry has been particularly intense in the long-term care sector. As a result, the financial community - both lenders and investors - now views this sector differently and the approach to long-term care financing has changed. based on our experience, we focus on six factors driving consolidation in the sector and - through the use of four transactions as a platform - discuss the key credit issues and risks faced by long-term care companies today.

Select Transactions

Extendicare's acquisition of Arbor Health Care

Canadian-based Extendicare acquired Arbor Health Care for $ 432 million, including the assumption of $ 107 million in debt in late 1997. The combined company will operate 310 facilities with 32,000 beds in the United States and Canada. (Extendicare derives approximately 75 percent of its revenue from its U.S. operations.) The merger will give Extendicare increased market share in two key markets (Ohio and Florida) with the ability to provide additional ancillary services. Extendicare also should benefit from Arbor's expertise in higher acuity skilled nursing, an increasingly important business segment as the U.S. government transitions to a PPS for Medicare skilled nursing services.
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With regard to senior leverage, Sun was the most levered transaction at the time of closing at 4.4:1.0, while Extendicare was the least levered at 3.0:1.0. However, Sun leases most of its facilities; in contrast, Extendicare owns the majority of its facilities.

Several Nursing Home Companies Placed on S&P CreditWatch Negative
PR Newswire November 3, 1998

Standard & Poor's today placed its ratings for several nursing home companies on CreditWatch with negative implications (see list below). The CreditWatch listings affect over $8 billion in rated debt.
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The ratings and outlooks for HCR Manor Care Inc., Extendicare Health Services Inc., and Sun Healthcare Group Inc. remain unchanged.

COMMENT:- A clean bill of health above but profits are already falling below.

Extendicare Health Services, Inc., a Wholly Owned United States Subsidiary of Extendicare Inc., Reports Third Quarter Results for 1998
Business Wire November 12, 1998

Extendicare Health Services, Inc. ("EHSI") today reported revenue of $ 289.9 million in the 1998 third quarter, compared to revenue of $ 225.2 million in the same period last year. EHSI, a wholly owned United States subsidiary of Extendicare Inc., recorded an unusual item in the 1998 third quarter of $ 21.2 million after tax. Prior to the unusual item, net earnings in the quarter ended September 30, 1998 were $ 3.0 million, compared to $ 8.2 million in the 1997 third quarter

Some fear government remains too "cozy' with industry;
The Tampa Tribune November 15, 1998
VICKIE CHACHERE

Politics and connections play roles in the nursing home regulation system.

State Rep. Carl Littlefield dubs it the "unholy alliance" - the relationship between Florida's largest nursing home trade association and the agency that regulates the industry.
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Jim Krog, former chief of staff for Gov. Lawton Chiles, lobbies for Extendicare.

GOOD NURSING HOME CARE INCLUDES GOOD REGULATION
The Palm Beach Post November 25, 1998

With more and more Floridians facing decisions about putting themselves or relatives into nursing homes, more and more nursing homes are becoming part of large chains. As the trend continues, the state will have to spend more and more time on regulation.
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How politically powerful is the industry becoming? Jim Krog, former chief of staff for Gov. Chiles, lobbies for Extendicare. Former state Sen. Curt Kiser lobbies for Genesis Eldercare Network. Former Sen. Ken Plante does the same for Vencor. With all that influence, can the industry drag out penalties with legal appeals?

Shutdown Forces Residents Out of Md. Nursing Home
The Washington Post January 10, 1999

In the last room on the right in Greenbelt Nursing and Rehabilitation Center's west wing, Blanche Hickman fumed yesterday as she packed up the belongings of her blind, 78-year-old mother, Marion Evans.

For three years, Evans had lived there. But now she was forced to leave, following federal and state officials' decision to stop all Medicare and Medicaid payments to the facility because they said it had become a health hazard.
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Like many residents' relatives, Hickman is filled with resentment about the shutdown. She is angry at the nursing home owner, a chain that has 244 facilities in 15 states, for failing to fix numerous problems for an entire year.
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But everyone is moving out, and about 85 employees have been told they will be paid through February as long as they don't resign before they are dismissed.

A federal judge authorized the shutdown Dec. 28 after a full year of accusations that the nursing home operators ignored orders to fix rampant problems repeatedly identified in a series of inspections.
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After repeatedly finding problems at Greenbelt from January through July, the state health department and HCFA planned to fine the facility $ 90,000. Then, U.S. Attorney Lynne Battaglia filed suit against Greenbelt in August, charging that it misrepresented its efforts to improve conditions at the home. In September, HCFA decided to forgo the fines and instead to revoke Greenbelt's Medicare certification.

Extendicare Inc. Announces Details of Dividends
Business Wire January 18, 1999, Monday
MARKHAM, Ontario

Jan. 18, 1999--Extendicare Inc. announced today the following details of the dividends on its Class I Preferred Shares, declared on December 15, 1998, and payable on February 15, 1999 to shareholders of record as at January 29, 1999.

COMMENT:- In the USA Extendicare owned its own facilities. In Canada it leased. Perhaps this reflects where the money was?

Poised for an ageing population: Backed by the Reichmann family, CPL Long Term Care now dominates the nursing home industry
National Post (formerly The Financial Post)February 27, 1999
Paul Bagnell

We're in a business where, frankly, we don't have a lot of competition in the Canadian market,' says Barry Reichmann, offering one of several explanations he has for the impressive track record of the nursing home business of which he is president.
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Although there are many nursing home owners in Canada, CPL is the only large public player chasing acquisitions and able to tap equity markets to finance costly, multi-facility acquisitions. Extendicare Inc., the large Toronto-based nursing home operator, hasn't bought a Canadian nursing home for years, instead focusing on increasing the number of homes it manages for other owners.

5 Healthcare Firms Ratings Cut By S&P Over Medicare Changes
Dow Jones Newswires March 3, 1999

NEW YORK -- Standard & Poor's said it lowered the ratings for five companies, and their subsidiaries, being impacted by Medicare's adoption of the restrictive Prospective Payment System (PPS) for the reimbursement of nursing homes.
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In addition, the outlook on Extendicare Health Services Inc. was revised to negative from stable, S&P said. Ratings for the company were affirmed.

RATINGS LOWERED AND REMAINING ON CREDITWATCH NEGATIVE

- - - - - - - - - - - - - - - - - - -To
- Extendicare Health Services Inc.

Corporate credit rating- - - - - B+
Subordinated debt - - - - - - - B-
Bank loan rating - - - - - - - -B+

Labor's next recruits
St. Petersburg Times March 15, 1999

Before the latest push to organize, unions had achieved modest inroads at bay-area nursing homes owned by Extendicare of Milwaukee. Service Employees Union Local 1115 represents five nursing homes in St. Petersburg and one in Ocala, for a total of about 300 workers.

"Unions protect workers' jobs," said Daisy Moultrie, an executive board member of Local 1115 and a nursing assistant at Greenbrook Nursing & Rehabilitation Center in St. Petersburg.

A young CNA was recently fired because a supervisor did not like her body language, Moultrie said, but the union got her job back after the workers protested the dismissal.

Without a union, she said, "the law gives management a right to say "Daisy, I don't want you to work here,' and out the door you go."

Moultrie and other union stewards at area homes owned by Extendicare often meet over coffee at a Shoney's Restaurant to talk negotiating strategy. The Service Employees Union plans to use the shop stewards as key organizers of other homes when it makes its push in the bay area.

"I want members to talk to potential members," said Nick Abate, business manager with Local 1115.

Nursing homes in staff crunch; Worker shortage called threat to patient care
Milwaukee Journal Sentinel March 21, 1999

A serious shortage of health care workers is bringing patient neglect and frustration to a growing number of Wisconsin nursing homes and is threatening access to home care for the elderly and disabled.
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Management turmoil can play a part in staffing problems. Willowcrest Care nursing home in South Milwaukee ran through seven administrators and four nursing directors last year, when it was cited for widespread poor care and short staffing. A 1999 survey found much-improved conditions.

Virtually the entire staff turned over at Willowcrest after a longtime administrator left and the building added 50 beds, according to Mike Mervis, spokesman for Milwaukee-based Extendicare Health Services, a for-profit provider. Filling openings was difficult, but the home is fully staffed now, he said.
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Hanging on to staff

For -profit nursing homes have the most dificulty retaining nursing staff compared with their competitors, the latest figures show Nursing turnover is linked to quality of care.

Extendicare Health Services, Inc., a Wholly Owned United States Subsidiary of Extendicare Inc., Reports First Quarter Results for 1999
Business Wire May 12, 1999

May 12, 1999-- Extendicare Health Services, Inc. (EHSI) today reported a net loss of $ 5.8 million in the 1999 first quarter, compared to net earnings of $ 1.9 million in the prior year period.

Extendicare finds it hard to stem losses: News rips 12% off stock
National Post (Canada) May 13, 1999

Investors ran for the exits yesterday after Extendicare Inc. (EXEa /TSE) posted lower than expected first-quarter earnings and warned of more pain to come.

WASHINGTON AT WORK; Insider Bemoans What He Wished For
The New York Times May 20, 1999

As Republican national chairman, Haley Barbour designed his party's campaign to cut the growth of Medicare. Now he has taken on a new assignment. As a lobbyist for a dozen large nursing home companies, he pleads with Congress for relief from the law he helped write.
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He confirmed that his clients included the Sun Healthcare Group of Albuquerque, N.M.; Vencor Inc. of Louisville, Ky.; the Mariner Post-Acute Network Inc. of Atlanta; Beverly Enterprises of Fort Smith, Ark.; HCR Manor Care Inc. of Toledo, Ohio; Genesis Health Ventures of Kennett Square, Pa., and Extendicare Inc. of Markham, Ontario.

Extendicare Inc. Reports Second Quarter Results for 1999
Business Wire August 11, 1999, Wednesday

Aug. 11, 1999--Extendicare Inc reported a net loss in the second quarter of 1999 of $ 9.9 million ($ 0.14 per share) compared to net earnings of $ 10.6 million ($ 0.14 per share) in the prior year period.

SUITS BLEED EXTENDICARE
Calgary Sun (Alberta, Canada) August 12, 1999

Lawsuits in Florida helped push Extendicare Inc., a major North American operator of long-term-care facilities, into a second-quarter loss of $ 9.9 million, compared with net earnings of $ 10.6 million a year earlier.

UPC Health Network in talks with Walgreen No accord reached yet on potential sale of durable equipment firm
Milwaukee Journal Sentinel September 21, 1999

Milwaukee-based UPC Health Network is in negotiations with Walgreen Co. over a potential sale of the durable health equipment company to the Deerfield, Ill.-based pharmacy giant, it was learned Monday.

"We don't have a definitive agreement," said Michael Mervis, a public relations company executive who represents UPC, which is owned by Extendicare Health Services Inc.
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John McLaughlin, president of Extendicare Health Services Inc., Milwaukee, said Monday "the company had nothing to announce." Extendicare is a division of Canada-based Extendicare Inc., a publicly traded company.

NURSING HOME TO CLOSE; SOUTHCREST BLAMES LOW REIMBURSEMENTS RATES
The Spokesman-Review (Spokane, WA) September 25, 1999

A Spokane nursing home is closing Nov. 22, blaming stingy federal reimbursement programs for poor and elderly patients for making the operation unprofitable.

The 80 residents of Southcrest Subacute and Speciality Care Center should find a home at Spokane's two dozen other nursing homes relatively easily, officials with the Washington Department of Social and Health Services say.
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Southcrest handles patients who need to be on breathing machines, called ventilators. Congress' decision to set new limits on what nursing homes are paid for providing those services are a strong part of what killed Southcrest, said Michael Mervis, spokesman for Extendicare Health Services, which owns the nursing home.
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Southcrest was built in 1970. Extendicare purchased it from The Ames Group of Minnesota in 1984.

It decided to close the nursing home after failing to persuade the state to change the way it reimbursed Southcrest for complex cases such as ventilator patients, Mervis said.
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Southcrest had a string of problems with state regulators for providing substandard care a few years ago. More recent inspections have been good, DSHS officials said.
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Extendicare owns 15 other nursing homes in Washington, including Franklin Hills Health and Rehabilitation Center and The Gardens on University in the Spokane Valley.

It also owns the Coeur d'Alene Rehabilitation and Wellness Center and the LaCrosse Health and Rehabilitation Center in Coeur d'Alene.

Extendicare closed one of its other nursing homes, Valleycrest, in 1996 after repeated problems with poor care. The building was sold.

NURSING HOME WILL SHUT DOWN; HIGHLAND CITES CUTS IN MEDICARE
Capital Times (Madison, WI.) October 5, 1999, Tuesday, ALL EDITIONS

A Madison nursing home is taking the dramatic step of permanently closing down because of cuts in Medicare reimbursements that stem from the federal balanced budget agreement.

The decision by Highland Transitional Care Center, 2308 University Ave., puts 102 full- and part-time employees out of work, and leaves the families of 58 elderly residents until March 1 to find a new place for their loved ones to live.

Highland's parent company, Extendicare Health Services, said the facility was losing money under a new Medicare reimbursement system that reduced payments beginning in January.

Stephen Biondi, area vice president of Extendicare's 35 facilities in Wisconsin and Minnesota, said the company as a whole is hurting because of the reduced Medicare money, but there are no plans for any other closures in the state.
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Tschumper also said the facility had been cited several times last spring by inspectors for health and safety violations, although there's no current state or federal action that may have led to the closing.

''They've definitely had some problems,'' Tschumper said.

Records show Highland was ordered to admit no new residents during a 180-day citation period dating to last December, but was able to bring itself into compliance shortly before it would have been stripped of Medicare and Medicaid certification.

The violations in December, February and April rose to ''immediate jeopardy'' that threatened the life of one resident, along with several smaller violations concerning sanitation conditions, sloppy record-keeping and incompetent staff.

Extendicare Inc. Responds To Share Price Change
MARKHAM, ONTARIO--(BUSINESS WIRE)--Oct. 14, 1999-

Extendicare Inc.'s Deputy Chairman and Chief Executive Officer, Dr. Joy D. Calkin, today commented that "Extendicare's management knows of no reason or material change with regard to its business in the United States, Canada or elsewhere that would account for the recent decrease in the Corporation's share price."

Dr. Calkin was responding to a Dow Jones news story on October 13, 1999 that quoted a single unnamed analyst's speculations.

Dr. Calkin pointed out that "Extendicare has made all of its scheduled debt repayments, including most recently those due at September 30, 1999 and the Corporation has available sufficient bank lines to meet its obligations.
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A previously announced transaction to sell one facility in Texas closed on June 30, 1999 and the sale of two facilities in Ohio closed on September 30, 1999. As well, due diligence activities are currently in the advanced stage for the sale of the U.K. division.
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Dr. Calkin continued. "We believe that Extendicare is in a relatively strong competitive position based on a number of factors, including Extendicare's 88 percent ownership of its assets, as well as the Corporation's many years of successful operation under the PPS-like Canadian system.

Investors renew their faith in Extendicare
National Post (Canada) October 15, 1999

Long-term care provider Extendicare Inc. yesterday pulled back from a deep, dark abyss.

The Toronto-based company's stock (EXEa/TSE) stumbled to a 52-week low of $2.12 on Wednesday after a Dow Jones report that it may have trouble meeting repayments on its $1.1-billion of debt.

But some positive comments from analysts yesterday turned sentiment around, with investors sensing that most of the bad news was already discounted and that the precipitous decline of the past week was overdone. The shares rallied from a mid-session low of $2.60 to close up 30 cents at $3.30.

Extendicare Inc. Reports Third Quarter Results for 1999
Business Wire November 10, 1999, Wednesday Nov. 10, 1999--

Extendicare Inc. reported a net loss in the third quarter of 1999 of $ 6.0 million ($ 0.08 per share) compared to net earnings of $ 41.8 million ($ 0.54 per share) in the same period last year. Prior to unusual items, the net loss from health care operations in the third quarter of 1999 was $ 6.2 million ($ 0.09 per share), compared to net earnings of $ 9.9 million ($ 0.12 per share) in the prior year period.
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This was encouraging, even though high litigation costs related to the exceptionally difficult legislative environment for long-term care providers in Florida reduced Extendicare's consolidated earnings.

Extendicare Announces Sale
Business Wire December 1, 1999, Wednesday

Extendicare Inc. today announced that it has sold UPC Home Health Care of Milwaukee, Wisconsin to Walgreens Advance Care Inc., a wholly owned subsidiary of Walgreen Co. of Deerfield, Illinois for gross proceeds of US $12.7 million. Proceeds of the transaction will be used to reduce the Corporation's debt under its term credit facilities. The sale closed on November 30, 1999.

Extendicare sells U.K. operations
National Post (Canada) December 08, 1999

Extendicare Inc. announced the sale of its United Kingdom operations yesterday

LEVERAGE WEIGHS HEALTH CARE CO DOWN TO B1
Loan Market Week December 20, 1999

Moody's Investors Service has downgraded Extendicare Health Services $ 600 million, secured credit facility to B1 from Ba3 because of the company's high level of leverage and tight liquidity. The ratings also take into account the deterioration of the company's financial condition following Medicare's implementation of the prospective payment system, Moody's said.

Extendicare Sells Six Florida Facilities For US $40.5 Million
Business Wire December 30, 1999, Thursday

Extendicare Inc. today announced that its wholly owned U.S. subsidiary, Extendicare Health Services, Inc., has sold the shares of Florida 6 Health Care Facilities, Inc. to Tandem Health Care, Inc. of Moon Township, Pennsylvania for US $40.5 million. The transaction closed on December 30, 1999. Florida 6 Health Care Facilities, Inc. owns and operates six nursing homes in the State of Florida.

Dementia care worries persist despite slaying suspect's death
THE INDIANAPOLIS STAR January 08, 2000, Saturday

A former nursing home resident with dementia who was charged in a fatal attack on another resident has died after suffering a stroke, authorities said Friday.

James Moore, 66, had become the focus of a case that raised questions about appropriate care for potentially violent dementia patients.

Among the issues:

Should aggressive patients be placed amid other residents in nursing homes or be segregated?
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"When you put your parent" into a nursing home, said Republican Rep. Vaneta G. Becker, "you want to feel confident that they're going to be safe."
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Straukamp, who had senile dementia, reportedly was standing in a Westpark hallway with her arms folded when Moore walked quickly up to her. As a staff member shouted "No!" Moore slammed Straukamp into the wall, and she dropped unconscious to the floor. She died three weeks later in another nursing home.
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The agency is investigating the circumstances surrounding Straukamp's death. It also is scrutinizing allegations raised by Straukamp's family that Moore had demonstrated violent behavior in the past with other Westpark residents.
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A spokesman for Extendicare Health Services in Milwaukee, which owns Westpark, strongly defended Westpark's care.

$10,000 fine sought from nursing home
THE INDIANAPOLIS STAR March 02, 2000

The Indiana State Department of Health is recommending that an Evansville nursing home where a female patient died after a violent attack by a dementia patient be fined the maximum civil penalty allowed, $10,000.

The agency's decision was outlined in a letter dated Feb. 16 to Westpark Rehabilitation Center and released Wednesday.
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The letter to the Evansville firm indicates the civil fine request followed three inspections on Nov. 18, 1999, Jan. 3 and Feb. 8 to investigate complaints.

The third visit led the Department of Health to conclude there was a pattern of deficiencies at the nursing home.
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"It's apparent from the record here there were residents living in fear of this resident, and staff also," Coleman said.

Of particular concern was the lack of a consistent documentation system for dealing with these people in general.
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"That's what you fear the most in a facility, is a systems breakdown in a critical area. That's what we had here."

NURSING HOMES WANT SUIT LIMITS; LOBBYISTS: BANKRUPTCIES SHOW NEED FOR TIGHTER LAW
The Palm Beach Post March 3, 2000, Friday

Spurred by a statewide epidemic in nursing home bankruptcies, the nursing home lobby is pushing legislation that would make it harder to sue Florida homes.
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"Companies that are performing pretty well across this country are considering seriously the threat of being in Florida," said Joy Calkin, chief executive of Extendicare Health Services, a Wisconsin chain with 250 nursing homes in 14 states. When companies such as Extendicare that have not had major losses from lawsuits are leaving, "you should be worried."

In December, Extendicare sold six of its 33 Florida nursing homes for $ 40 million, and it plans to continue its exit. Florida accounts for only one-sixth of its beds but ninety percent of its lawsuit costs, Calkin said.

The ASP Approach: Experience Equals New Products
InformationWeek March 6, 2000

It's the euphemism du jour: Refocus on your core business. But the Internet has given that truism a new twist. Just ask Extendicare Inc. and West Group Inc.

In the last few months, Extendicare, a $1.45 billion health-services provider, sold a hospital and 14 nursing homes in England for $42 million and a medical specialty equipment and home-care services company in Wisconsin for nearly $13 million, to focus on its long-term care homes in the United States and Canada. Extendicare, through its Extendicare Health Systems Inc. unit, expects to recoup some of the revenue lost from sold-off operations through an Internet business it's creating, called Atelier Systems, which the Milwaukee company labels a "virtual care provider." In IT lingo, Atelier is an application service provider, or ASP, that will lease to smaller nursing- home companies the applications Extendicare created to run its business.

Extendicare Inc. Reports Fourth Quarter Results for 1999
Business Wire March 20, 2000, Monday

Extendicare Inc. (TSE:EXE)(NYSE:EXE.A, TSE:EXE.A) reported a net loss in the fourth quarter of 1999 of $136.5 million ($1.82 per share) compared to net earnings of $4.2 million ($0.06 per share) in the same period last year.
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Extendicare is in compliance with its bank covenants and remains current on its payment obligations. The current level of cash flow and available bank lines are sufficient to support ongoing operations and commitments. On March 16, 2000,
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In the normal course of business, Extendicare discusses with its fiscal intermediaries the treatment of various items related to Medicare cost reports of prior years. Differences of opinion can be settled through a formal appeal to the Provider Relations Review Board (PRRB) of the Health Care Financing Administration of the Department of Health and Human Services.

The Corporation has been notified by a fiscal intermediary of several adjustments for services rendered in prior years. The Corporation disagrees with the adjustments and is currently in discussions with the fiscal intermediary regarding these issues. Concurrently, the Corporation has filed one appeal to the PRRB and is in the process of filing others. Although the Corporation remains confident of winning these appeals, consistent with industry practice it has recorded a $39.5 million (US $27.4 million) general reserve for items in dispute and/or under appeal.

Extendicare Inc. Expects to Report Fourth Quarter 1999 Results by March 31, 2000
Business Wire February 23, 2000, Wednesday

Extendicare Inc. announced that it is continuing to assess the valuation of its long-term receivables as of December 31, 1999 and therefore has not yet completed its year-end financial statements. The Corporation expects to release its 1999 fourth-quarter and year-end results by the end of March 2000.

Consequently, Extendicare's wholly owned United States subsidiary, Extendicare Health Services, Inc., expects to request and obtain from the Securities and Exchange Commission an extension for the filing of its 10-K for the year ended December 31, 1999.

Supply of helpers for elderly decreases
The Associated Press State & Local Wire April 4, 2000

Wisconsin's supply of trained personnel to care for elderly and disabled people is shrinking with nursing-home budget limitations contributing to the problem, the state long-term care ombudsman says.
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More than 14 percent of the positions in Wisconsin nursing homes are vacant, Potaracke said Monday during a two-day conference on hiring care workers.

Conference comments include:
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Government reimbusement to nursing homes for Medicare is not enough to avoid bankruptcy in many cases, said Steve Biondi, regional vice president of Extendicare Health Services, a national chain based in Milwaukee.

His company has avoided bankruptcy but had to close a Madison home because the state's Medicare reinbursement rates were inadequate, Biondi said.

Extendicare Inc. Announces Appointment of Shelly Jamieson as President of Extendicare-Canada Inc.
(BUSINESS WIRE)--April 3, 2000

Extendicare Inc. today announced the appointment of Shelly Jamieson as President of Extendicare (Canada) Inc., effective immediately. Ms. Jamieson assumes management responsibility for Extendicare's Canadian operations from Gary Chatfield upon his retirement.

Feds want tougher fine on nursing home following patient death
The Associated Press State & Local Wire April 10, 2000

A federal agency wants to impose a $1,000-a-day fine on a nursing home where a patient with dementia fatally attacked an elderly woman last year.

The Indiana State Department of Health had recommended that Westpark Rehabilitation Center be assessed a $10,000 fine for violations that came to light after the resident's death last October.

But officials with the Health Care Financing Administration, which oversees Medicare and Medicaid, said they may impose a fine of $1,000 a day, to Feb. 8, until all the problems cited at the nursing home are corrected.
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The nursing home's corporate owner said the problems have been corrected.
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Sandlin said based on the inspectors' report, the federal agency will decide if the problems were corrected and what the fine will be.

Extendicare Inc. Reports First Quarter Results for 2000
Business Wire May 10, 2000, Wednesday

Extendicare Inc. reported a loss in the first quarter of 2000 of $11.9 million ($0.16 per share) compared to a loss of $7.3 million ($0.10 per share) in the same period last year.

Extendicare's operating cash flow in the first quarter of 2000, prior to working capital changes, was $9.6 million ($0.13 per share) compared with $12.7 million ($0.17 per share) in 1999. The decline reflected the increase in general and professional liability costs.

COMMENT:- Note that Extendicare represents the industry on committees

State panel tackles care crisis; --- Its mission comes as state nursing homes face bankruptcy from skyrocketing liability insurance.
Sarasota Herald-Tribune July 16, 2000

Nineteen people have six months to solve some of the most vexing and expensive issues facing the state of Florida.

They are on a panel that will recommend by Jan. 1 how the state should deal with long-term care for the state's burgeoning elderly population. Named the Task Force on the Availability and Affordability of Long Term Care , a creation of the state Legislature, the group meets for the first time Monday.
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Aside from McKay, Brogan and Connor, the panel includes:

* Joy Calkin, chief executive officer of Extendicare Health Services in Milwaukee, representing the nursing home industry.

Top 15 nursing home chains
Modern Healthcare By the Numbers Supplement July 31, 2000

Table ranks top 15 nursing home chains by number of beds as of 1/99 Beverly Enterprises had 62,293 beds

Rank Company Beds

10 Extendicare Health Milwaukee 21,718
(Note Extendicare is the 10 ^th largest in the USA)

Mel Rhinelander Becomes Extendicare's Chief Executive Officer
CCN Disclosure 08/01/2000

MARKHAM, ONTARIO-- The Board of Directors of Extendicare Inc. is pleased to announce the appointment of Mel Rhinelander as Chief Executive Officer, effective immediately. Mr. Rhinelander was elected as a Director of the Corporation at its Annual Meeting in May 2000. He replaces Dr. Joy Calkin who retired as CEO on August 1, 2000.

Care center passes state inspection; Nursing home back in clear after state agency ruled; it mishandled resident; ruling on fine to come
The Spokesman-Review (Spokane, WA) August 11, 2000

The nursing home put on probation last month and recommended for a $ 5,000 fine is back in good order, the state Department of Health and Welfare said.

LaCrosse Health and Rehabilitation Center was put on probation July 17 for how it handled an 87-year-old woman with Alzheimer's who allegedly attacked fellow patients in a locked ward.
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The bureau's report concluded that the woman had verbally, physically and sexually abused more than 10 of her fellow patients in the ward, and that LaCrosse had failed to respond adequately to the problems.

On Wednesday, the bureau reinspected the nursing home and did not report any violations.

Extendicare Inc. Reports Second Quarter Results For 2000
Business Wire August 14, 2000, Monday

Extendicare Inc. reported a loss in the second quarter of 2000 of$6.8 million ($0.10 loss per share) compared to a loss of $9.9 million ($0.14 loss per share) in the same period last year.
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Extendicare is in compliance with its bank covenants and remains current with respect to all of its payment obligations. Cash flow and available bank lines are sufficient to support the present levels of operations and commitments.

Extendicare cuts loss
The Gazette (Montreal) August 15, 2000, Tuesday, FINAL

Nursing-home operator Extendicare Inc., which has said it plans to sell $100 million U.S. worth of assets in the wake of cuts to U.S. Medicare funding for long-term care, has trimmed its second-quarter loss to $6.8 million.

EXTENDICARE LOWERS QUARTERLY LOSS
The Toronto Star August 15, 2000, Tuesday, Edition 1

Nursing home firm's income also falls

FROM CANADIAN PRESS Toronto-based nursing home operator Extendicare Inc., which has said it plans to sell $100 million (U.S.) worth of assets in the wake of U.S. Medicare funding cuts for long-term care, has trimmed its second-quarter loss to $6.8 million (Canadian).
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Extendicare is one of the largest operators of long-term care centres in North America and generates more than three-quarters of its business in the United States.

PREPARED TESTIMONY OF JOHN RANSOM DIRECTOR OF HEALTHCARE RESEARCH RAYMOND JAMES & ASSOCIATES BEFORE THE SENATE COMMITTEE ON AGING
Federal News Service September 5, 2000, Tuesday
http://aging.senate.gov/hr57jr.htm

The stronger management teams began to acquire their public competitors. A sampling of transactions follows: In June 1997, Genesis Health purchased Multicare for $1.4 billion (11 x EBITDA). In November 1997, Extendicare purchased Arbor for $450 million in October 1997 (11x EBITDA).
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As a result, the public companies added over $5 billion in transactional debt at high EBITDA multiples. Market caps peak at $14 billion in March 1998, despite the gathering storm clouds:

PREPARED TESTIMONY OF LAURA A. DUMMIT ASSOCIATE DIRECTOR HEALTH FINANCING AND PUBLIC HEALTH ISSUES HEALTH, EDUCATION AND HUMAN SERVICES DIVISION UNITED STATES GENERAL ACCOUNTING OFFICE BEFORE THE SENATE COMMITTEE ON AGING
Federal News Service September 5, 2000, Tuesday
http://www.gao.gov/new.items/he00192t.pdf
SUBJECT - NURSING HOMES: AGGREGATE MEDICARE PAYMENTS ARE ADEQUATE DESPITE BANKRUPTCIES

Mr. Chairman and Members of the Committee:

I am pleased to be here today as you discuss the causes of the bankruptcies of large corporations owning nursing homes, particularly whether recent Medicare payment reforms affected the bankruptcies, and implications for nursing home residents.
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NURSING HOME PERFORMANCE UNDER PPS IS PRIMARILY A FUNCTION OF PREVIOUS BUSINESS PRACTICES

The nursing home chains that have filed for bankruptcy in recent months have blamed the Medicare PPS for their financial difficulties. Yet our work indicates that the problems experienced by these corporations can be traced to strategic business decisions made during a period when Medicare was exercising too little control over its payments.
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Without the prospect of overly generous, rapidly rising Medicare revenues, these publicly owned corporations were forced to post asset impairment losses on their balance sheets. Accounting principles dictate that such losses be calculated and recognized to inform investors that future expected revenue streams will be lower than anticipated.
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CONCLUSIONS

As anticipated, BBA reforms have had significant effects on the delivery, cost, and use of SNF services. The changes wrought by the BBA have required providers to adjust both their patterns of care and their business strategies. These adjustments have not been easy for some, and those who have experienced the most difficulty have been quick to attribute their problems to inadequate Medicare payments and call for additional federal dollars. However, our analysis indicates that the nursing homes' responses are adaptations to appropriately tightened Medicare payments following a period of unchecked growth.
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FOOTNOTES:

8 The companies included in our analysis were: Beverly Enterprises, Inc., Extendicare Health Services, Inc., HCR-Manor Care, Inc., Integrated Health Services, Inc., Mariner Post-Acute Care Network, Inc., Sun Healthcare Group, Inc., and Vencor, Inc. Documentary evidence used in analyzing the effect of the BBA included both financial information provided by the companies and their corporate filings from the United States Security and Exchange Commission, which contain material financial and business information on publicly traded companies.

Extendicare Disposes of 15 Florida Facilities for Initial Cash Proceeds of US $30.0 Million
Business Wire September 20, 2000, Wednesday

Extendicare Inc. announced the disposition of 15 nursing homes and assisted living centres in Florida to affiliates of Greystone Tribeca Acquisition, L.L.C. of New York, New York for initial cash of US $30.0 million and contingent consideration of up to US $30.0 million over the next 3.5 years.

The transaction closed on September 19, 2000. Upon determination of the final consideration for each facility, the Corporation will record any resulting loss or gain on disposal.
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"This transaction indicates that the Corporation is successfully pursuing its objective of reducing debt by divesting assets, especially in Florida, that do not meet our performance criteria or are not strategic to the achievement of our goals," said Mel Rhinelander, President and Chief Executive Officer.

COMMENT:- Nursing homes employ staff who have violent criminal records. It is not surprising they ignore patients with violent records.

Suit says home put resident in danger Woman, 83, died after she was thrown against a wall by a man with history of violence.
THE INDIANAPOLIS STAR September 22, 2000

Relatives of an elderly woman who died after she was thrown against a wall by another nursing home resident filed a lawsuit Wednesday alleging that the Evansville facility knew of the attacker's violent background but failed to protect residents from him.
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At one point, they almost moved her to another facility after they noticed conditions slipping. But they changed their mind because his mother had become close to her roommate.
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According to police records, Moore physically assaulted numerous individuals and shot at least four people between 1960 and 1985, according to the lawsuit filed by H. Kennard Bennett of Indianapolis in Vanderburgh Circuit Court.

And the violence continued after his admission to Westpark in 1993, the lawsuit claimed. Between 1993 and August 1999, Moore was involved in 48 incidents in which he demonstrated physical and verbal aggression toward staff members and residents.
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His fear is that it's all too common for people with a violent background to wind up in a nursing home where other residents are at their mercy.

"We just want to bring this issue up to the public and put it out in the open," he said.

Family awarded $ 3-million in suit against nursing home
St. Petersburg Times September 27, 2000

A Pinellas County jury decided Tuesday that a Kenneth City nursing home had neglected an Alzheimer's patient who eventually died and that the home's parent company should pay his family nearly $ 3-million in compensation.

Today, jurors will consider how much in punitive damages the corporation should pay.
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McCorkle's aunt sued the nursing home giant Extendicare Inc., which owns Colonial Care and nearly 300 other retirement homes and assisted living facilities in the United States and Canada.

The lawsuit alleged that McCorkle's health went into a downward spiral at Colonial Care because he became malnourished and dehydrated and suffered a bedsore that opened to the bone.
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McCorkle's aunt, Mary Weldon, who helped pay for his care, moved him out of the home in May 1998. He died in August 1998.

Weldon's lawyer, Bennie Lazzara, told jurors that McCorkle rapidly lost weight at Colonial Care, that his bedsore became gangrenous and that he was left to lie in his own waste.

COMMENT:- Note that what the jury awarded US $17 million of the US $20 million for deliberately understaffing.

Jury to nursing home: Pay $ 20-million
St. Petersburg Times September 28, 2000, Thursday

The verdict is the largest against a nursing home in Florida history. Nursing home giant Extendicare Inc. plans to appeal.

LARGO - The family of Charles McCorkle Jr. painted a vivid picture.

They told a jury that a giant, greedy nursing home corporation didn't have enough staffers at its home in Kenneth City, so McCorkle was left helpless, hungry and dehydrated, with bedsores that cut to the bone.

On Wednesday, Pinellas County jurors returned the largest verdict against a nursing home in Florida history.

They decided that the nursing home's parent company should pay McCorkle's survivors $ 17-million in punitive damages on top of nearly $ 3-million in compensation that the jury awarded to the family Tuesday.
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But the lawsuit's central argument was that Colonial Care was understaffed.

Weldon's attorney, Bennie Lazzara Jr., told jurors that the home didn't have enough nursing assistants to feed McCorkle, give him water or keep him from getting bedsores. McCorkle rapidly lost weight and was left to lie in his own waste, Lazzara said.

"Short staffing was the key issue," Lazzara said after the jury reached a verdict Wednesday. "This jury determined that this corporation set a policy of understaffing these facilities, and they didn't want that to go on.

"It's a simple proposition: You have to have enough people there, and they have to have enough time to do what they need to do."
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The industry is raising the specter of mass nursing home closings as homes are no longer able to afford insurance.

"You cannot continue to sue and sue and sue and expect nursing homes to be around tomorrow," said Ed Towey, who heads the industry's association in Tallahassee.

Trial lawyers scoff. "They're always saying that," Lazzara said.

Trial lawyers say big verdicts send a message that poor care is unacceptable. They also say nursing home companies make plenty of money. "If they'd put a small percentage of that back into staffing ... ," Lazzara said. "They never want to listen."

Mining Florida's seniors for gold: Negligence, fraud, serial bankruptcies, billion-dollar criminal and civil fines. It's the seamy side of nursing home care in the U.S. And, as Paul McKay discovers, it has disturbing links to Ontario. . . . (2003 update)
Ottawa Citizen April 28, 2003

The jury got it right, says Mr. Lazzara (lawyer).

"It was our position at the McCorkle trial that Extendicare was trying to set the bar of care very, very low. They defended the case on the basis this was acceptable care. They never said, 'We messed up here. It was an isolated incident. We're sorry.' Instead, they called experts to say the care they gave was fine."

"The jury (members) were outraged by what they heard. The company cared more about revenues than Mr. McCorkle. The evidence was that Extendicare neglected him so badly that he could never recover. Later, they back-charted treatment for him (for dates) when he wasn't even there."

Extendicare cuts loss
The Gazette (Montreal, Quebec) August 15, 2000

Nursing-home operator Extendicare Inc., which has said it plans to sell $100 million U.S. worth of assets in the wake of cuts to U.S. Medicare funding for long-term care, has trimmed its second-quarter loss to $6.8 million.

Extendicare Expects To Recover US $10-US $12 Million In Workers' Compensation Case Ruling
Business Wire September 28, 2000, Thursday

Extendicare Inc. announced today that its wholly owned United States subsidiary, Extendicare Health Services, Inc., received notification on September 27, 2000 of a favourable ruling in its Workers' Compensation case from the Provider Reimbursement Review Board (PRRB), which indicates the Corporation will be successful in this matter.

Upon final ruling, the Corporation anticipates recovering and taking into income US $10-US $12 million.

Service Employees International Union - Local 204
Canada NewsWire September 28, 2000, Thursday

A determined effort by the Service Employees International Union to settle a new contract for 9,000 nursing home workers at 65 nursing homes in Ontario came to an abrupt end today, when nursing home operators walked out of the negotiations.

"Four days of intensive effort went down the drain because Ontario nursing home operators want to remove the existing contract provisions that restrict the employers' right to contract out bargaining unit work," Mark Ortlieb, President of Local 204 in Toronto, said.
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The SEIU negotiating team included member representatives from 5 local unions and each nursing home in the Extendicare, Central Park Lodges and Versa Care chains plus many independent nursing home operators.
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Because nursing home workers do not have the right to strike, SEIU is demanding an arbitration panel be established immediately to resolve all issues in dispute.

EXTENDICARE APPEALING $ 20-MILLION US PATIENT SUIT
The London Free Press September 29, 2000

Extendicare Inc. is appealing a $ 20-million US jury award in a lawsuit arising from the death of a former resident of a Florida nursing home.

The Toronto-based international nursing home operator also said yesterday its American subsidiary, Extendicare Health Services Inc., has won a Workers' Compensation case worth $ 10 million US to $ 12 million US.

Nurse's aide files sex harassment suit
The Associated Press State & Local Wire October 12, 2000

A former nursing home aide has filed a lawsuit accusing a colleague of sexual harassment, and also blaming her employer for failing to take appropriate action.

Jewel Marie Stoll's complaint names LaCrosse Health and Rehabilitation Center and its owner, Extendicare Homes, Inc., in the case against a co-worker.
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LaCrosse Health and Rehabilitation Center earlier this year faced a $5,000 fine and a ban on accepting some new patients after an 87-year-old woman with Alzheimer's repeatedly attacked other patients in her ward.

COMMENT:- The views of the jury as expressed in the verdict are very revealing. Extendicare was under financial pressure. The allegations suggest that it put its own survival ahead of its patients. The $20 million reveals that the jury were persuaded of this. Corporate bankruptcy creates a great splash. The death of an Alzheimer's patients seldom does.

$20M award in negligence case
The National Law Journal October 16, 2000
MARGARET CRONIN FISK, SPECIAL TO THE NATIONAL LAW JOURNAL

A FLORIDA JURY has ordered the owners of a Tampa nursing home to pay $20 million to the estate of an Alzheimer's patient who died after receiving allegedly substandard care.

The jury rejected the plaintiff's claim that this care brought on the death of Charles McCorkle, but it awarded $3 million in compensatory damages and $17 million in punitives in finding that subsidiaries of the nursing home chain Extendicare Inc. had been negligent and had acted with "reckless disregard" for the needs and rights of patients "by setting a policy of understaffing" in the companies' homes, said plaintiff's attorney Bennie Lazzara Jr. of Tampa's Wilkes & McHugh.
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"For the first 35 days of his residency at Colonial, the staffing was below minimum standards 80% of the time," Mr. Lazzara said. This understaffing led to the substandard treatment, he alleged, "and this understaffing was negligence."

Mr. Lazzara said that "[we] sued the corporation. This was a corporate policy. . . . [They] were putting profits over people."

The plaintiff's team called as witnesses seven of the Colonial staff members who were working at the time Mr. McCorkle was a resident. These witnesses, he said, "testified that they never had enough time to feed the patients; there was never enough manpower."
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On Sept. 26, the St. Petersburg jury awarded $3 million in compensatories, then added $17 million in punitives the following day. "The jury found that the defendants violated his rights, but that they didn't contribute to his death," Mr. Lazzara said.

But, he added, the jury found the Colonial owners responsible for the negligent care Mr. McCorkle received at the nursing home and found that Extendicare's actions were "willful and wanton."

COMMENT;- California, Florida and Texas are the three states where citizens have decided to take the problems in care out of the hands of state officials and do something about it themselves. In these states regulators failed their citizens and links between politicians and corporations were particularly strong.

Bankrupt, and without a plan; As nursing home industry continues to founder, most ailing chains still seek funding
Modern Healthcare November 6, 2000, Monday

It's been more than a year since the first of five of the country's largest for-profit nursing home chains filed for bankruptcy protection, but only one has come up with a plan to right its financial ship.
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On top of all that, skilled-nursing providers are being hard hit by patient liability lawsuits in California, Florida and Texas, which account for 19% of the 1.8 million nursing home beds in the U.S., according to the American Association of Homes and Services for the Aging.

The suits and judgments, including a $20 million award handed down by a Pinellas County, Fla., jury in September against Milwaukee-based Extendicare Health Services, are fueling skyrocketing liability insurance premiums in Florida. The company was sued by the survivors of a man who died three months after he was pulled from an Extendicare home. The survivors allege that he was neglected at the home, resulting in dehydration, malnutrition and bedsores. Extendicare plans to appeal the verdict.

The litigation climate has even financially healthy providers, including Extendicare, looking to exit the state, further depressing the prices that the bankrupt chains may hope to fetch for their properties there.

The litigation and labor issues both relate to the same point--quality of care concerns are driving up costs, said S&P's Kaplan.

Extendicare Inc. Announces Normal Course Issuer Bid
Business Wire November 23, 2000

Extendicare Inc. …. Extendicare Inc. announced that it has received the approval of The Toronto Stock Exchange (the "TSE") to make a normal course issuer bid (the "Bid") for up to 4,000,000 of its Subordinate Voting Shares (EXE.A) (one vote per share), representing approximately 10 percent of the public float of the Corporation's Subordinate Voting Shares. All Subordinate Voting Shares purchased under the Bid will be cancelled.
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The Board of Directors of the Corporation has authorized the Bid because it believes it is an appropriate use of the Corporation's funds to purchase Subordinate Voting Shares when, in the opinion of management, the value of such shares exceeds their trading price.

Extendicare Recovers Approximately US $11.5 Million In Workers' Compensation Case
Business Wire November 28, 2000, Tuesday

Extendicare Inc. announced today that it will recover and take into income approximately US $11.5 million, based on a successful appeal of a reimbursement case involving workers' compensation issues in the United States.

Nursing home hopes fade on liability
The Florida Times-Union (Jacksonville, FL) December 19, 2000

The nursing home industry saw its hope for lawsuit relief dim yesterday, when a state task force reviewing the issue couldn't agree on what to suggest the Legislature do.
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'The people of Florida have to decide if they're going to have nursing homes and assisted living facilities, or not,' said Joy Calkin, a task force member and chief executive officer of Wisconsin-based Extendicare Inc.

COMMENT:- As prospects in the USA dim, Extendicare is selling off large numbers of facilities (see following article). The next article shows that it is turning back to Canada where the political pressures to privatise and corporatise are very strong and where citizens have not yet recognised the dangers.

EXTENDICARE GETS FINANCING FOR NEW FACILITIES
The London Free Press January 3, 2001, Wednesday

The Canadian branch of long-term nursing home care operator Extendicare has formed an alliance with Ontario's municipal government pension plan to help finance construction of eight new Ontario centres.

Under a deal announced yesterday, Borealis Long-Term Care Facilities Inc. will provide the money to build and equip eight new long-term care centres that will be managed and operated by Extendicare (Canada) Inc. around the province.

Extendicare Ceases All Florida Nursing Home Operations And Reduces Liability Exposure
CCN Disclosure 01/09/2001

MARKHAM, ONTARIO--. Extendicare Inc. announced that it has ceased all nursing home operations in Florida, based on the completion of three transactions by subsidiaries of its wholly owned subsidiary, Extendicare Health Services, Inc. (EHSI), involving 1,738 beds and 16 facilities.

Tandem Health Care, Inc. has leased nine nursing homes, representing 1,033 beds, with an option to purchase these facilities for US$48.0 million. In December 1999, Tandem purchased six Florida facilities from EHSI.

Another transaction involved six facilities with 585 beds, which have been leased by subsidiaries of Senior Health Properties-South, Inc. Senior Health has an option to purchase these facilities for a cumulative value of US$10.7 million.

In addition, EHSI has sold a 120-bed facility in Tampa for proceeds of US$3.7 million, consisting of US$2.7 million in cash and a note receivable. The net book value was approximately US$6.0 million. As required by its bank agreement, EHSI applied US$1.6 million of the net cash proceeds to term bank debt reduction.
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"Since December 1999, as part of our very focused disposition program for non-core assets, Extendicare has sold or leased all 38 of its nursing and assisted living centres in Florida. This enabled us to lower our U.S. term debt by US$58.0 million in 2000, above and beyond scheduled debt repayments - and may allow us to make further unscheduled repayments," said Mel Rhinelander, President and Chief Executive Officer.
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"More than 80 percent of reserves for claims established by Extendicare in the first nine months of 2000 related to Florida, which has been the key to our divestiture strategy. The achievement of our objectives in the State - despite difficult market conditions there - illustrates management's ability to reposition the Corporation for success in a challenging long-term care environment."

Extendicare Inc. Declares Dividend Payment on its Preferred Shares
Business Wire January 15, 2001, Monday

Extendicare Inc. announced today the following details of the dividends on its Class I Preferred Shares, declared on December 14, 2000, and payable on February 15, 2001 to shareholders of record as at January 31, 2001

Pact trims jury award against nursing home;
The Tampa Tribune January 25, 2001

CLEARWATER - A Georgia man who knew nothing about a record-setting lawsuit now stands to inherit a substantial sum.

A record $ 20 million jury award in a lawsuit over nursing home care has been reduced, heading off appeals that could have dragged on for years.

The settlement amount is confidential, but it likely to be less than the $ 12 million that is the most the plaintiffs could have collected under state law.

"This is a satisfactory settlement for all the parties," said attorney Bennie Lazzara, who represented the estate of Charles McCorkle Jr.
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Lazzara said that both McCorkle's aunt, who filed the lawsuit, and his long-lost stepson, who surfaced recently, agreed to the settlement offer.
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Jurors in the trial over McCorkle's care said they wanted to send a strong message to the nursing home industry that it cannot neglect patients who, like McCorkle, are unable to complain because of the nature of their ailments.
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The stepson, Richard Charles McCorkle of Marietta, Ga., now stands to collect the entire settlement. His wife, Brandy McCorkle, said he was on the road with his trucking business Wednesday and could not be reached for comment.

Deal ends record-setting nursing home case
St. Petersburg Times January 26, 2001, Friday

The settlement comes after a jury returned a $ 20-million verdict against the Pinellas home's former parent company.
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McCorkle's stepson, Richard McCorkle, will receive most of the money, said Bennie Lazzara, who represented McCorkle's estate. Marie Weldon, McCorkle's aunt, also will get some money for acting as McCorkle's personal representative, Lazzara said.

COMMENT:- The excuses and accusations made by the corporations below might be believable were it not the standard response of every health and aged care corporation found wanting by a formal investigation.

Audit says nursing homes didn't pass through wage increases
Milwaukee Business Journal February 2, 2001

A new state audit has concluded that 61 nursing homes in Wisconsin did not pass through any of the state dollars they received to boost wages for nursing home workers.

The preliminary audit by the state's Division of Health Care Financing reveals that $1.9 million of state money, out of an available $8.3 million, was not used by nursing homes for its intended purpose of increasing the wages of certified nurse's aides (CNAs). The nursing home industry had requested assistance to pay higher wages to recruit and retain workers in a tight labor force.
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"To me, this represents a real break of faith," said Sen. Brian Burke (D-Milwaukee), co-chairman of the Joint Committee on Finance. "I had representatives of the nursing home industry sit in my office and promise to use these funds for wage increases. I think the audit shows that did not happen often enough."

"This is an industry screaming that it can't retain workers," said Robert Kraig, political director of the Service Employees International (SEIU), which represents 4,500 workers in 51 Wisconsin nursing homes. "It's very disappointing that they did not use the money to increase wages when they said that's what they needed it for."
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"That (audit) is not the end-all, be-all," said John Sauer, executive director of the Wisconsin Association of Homes & Services for the Aging Inc., Madison, which represents mostly nonprofit nursing homes in the state.
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An official from Extendicare Inc., a national operator of long-term care facilities, including nursing homes in Wisconsin, agreed with Sauer's assessment that flawed calculations were used in determining whether wage pass-throughs actually took place.

Randy Krentz, regional director of operations for Extendicare, points to three homes in the Sheboygan area, two of which were found to have properly used allocated funds for wage pass-through. A third was found to have used only half of the $21,569 for wage pass-through. However, more than $23,000 has been spent on wage increases at that facility, according to Krentz.

"We did not misuse these dollars," Krentz said.

If the state money was not used for wage increases at nursing homes, it could have been used for a variety of purposes, including the expansions of nursing homes or corporate profits, Kraig said.

Extendicare Announces Fourth-Quarter News Release and Conference Call Dates
Business Wire February 6, 2001, Tuesday

Extendicare Inc. will release its 2000 fourth-quarter financial results on the afternoon of Wednesday, February 21, 2001.

The Corporation will hold a conference call on Thursday, February 22, 2001 at 10:00 a.m. Eastern Standard Time to discuss its results for the fourth quarter and year.

EX-POLICE CHIEF SUES NURSING HOME
The Ledger (Lakeland, FL) April 11, 2001, Wednesday
JOY MURPHY The Ledger

BARTOW -- Former Fort Meade police chief Andrew Kovschak is suing Arbor Health Care Company for failing to provide proper care while he was a patient in The Arbors at Winter Haven nursing home facility.
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On Monday a lawsuit was filed by Neal O'Toole, an attorney representing Kovschak and his wife, Alice Kovschak, claims that while still a patient at the facility, Kovschak suffered a stroke in late December and was admitted to Winter Haven Hospital. It was there that doctors discovered Kovschak was suffering from dehydration and that his left hip had been reinjured.
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"As a direct and proximate result of (Arbor Health Care's) acts or omissions which resulted in injury to Andrew Kovschak, he reinjured his hip, suffered acute (kidney) failure, weight loss and dehydration and subsequently suffered a debilitating stroke," the lawsuit asserts.

In a second count, this one for negligence, the lawsuit maintains that the facility "failed to appropriately treat Kovschak for hydration and nutrition, failed to administer necessary medications, failed to prevent a re-injury to the patient's hip and failed to confer with physicians when necessary and appropriate."

Extendicare Inc. Declares Dividend Payment on its Preferred Shares -- TSE:EXE.PR.B, EXE.PR.C, EXE.PR.D and EXE.PR.E
Business Wire April 16, 2001, Monday

A monthly dividend of $0.113 per share on the Corporation's Class II Preferred Shares, Series 1 (EXE.PR.E) was declared today, payable on May 15, 2001 to shareholders of record on April 30, 2001.

Extendicare Announces First-Quarter News Release and Conference Call Dates
Business Wire April 19, 2001, Thursday

Extendicare Sells Two Leased Nursing Homes for Proceeds of US $11.4 million
Business Wire April 19, 2001, Thursday

Extendicare Inc. (NYSE:EXE)(TSE:EXE.)(TSE:EXE.A.) announced that its wholly owned U.S. subsidiary, Extendicare Health Services, Inc. (EHSI), has sold two leased nursing homes in Florida for proceeds of US $11.4 million.

The sale to Tandem Health Care, Inc., which has operated the facilities under a lease agreement with a purchase option, was completed on April 18, 2001.

Extendicare Inc. Announces Normal Course Issuer Bid And Declares Preferred Share Dividend
Business Wire April 25, 2001, Wednesday

Extendicare Inc.(TSE:EXE.) (TSE:EXE.A.) (NYSE:EXE.A) announced that subject to the approval of The Toronto Stock Exchange (the "TSE"), it intends to make a normal course issuer bid (the "Bid") for up to 375,000 of its Multiple Voting Shares (EXE) (10 votes per share), representing 2.8% of the outstanding Multiple Voting Shares.

Extendicare Inc. Continues to Strengthen Operations
Business Wire May 8, 2001, Tuesday

Extendicare Inc. (NYSE:EXE.A) (TSE: EXE and EXE.A.) reported a loss in the first quarter of 2001 of $5.3 million ($0.08 loss per share) compared to a loss of $11.9 million ($0.16 loss per share) in the same period last year.
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"The changes we have made in our U.S. operations are improving Extendicare's performance. Our strategy includes the divestiture of assets that do not perform to our expectations, represent undue risk to the Company, or are not strategic to our long-term plans. We have accomplished our primary divestiture objective by exiting Florida and we have benefited through a significant reduction in resident care liability costs. We may dispose of other assets as we intensify our efforts to enhance the performance of our portfolio overall," said Mr. Rhinelander.
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"In Canada, we are preparing for the opening later this year of five new nursing homes in Ontario, with another three due to open in 2002. These facilities, representing 1,100 beds, will increase our resident capacity in the Province by 23%," he added.
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Extendicare is one of the largest operators of long-term care facilities in North America. On March 31, 2001, Extendicare operated 275 facilities in the United States and Canada, with capacity for 27,300 residents. Extendicare also provides medical specialty services in the United States, including subacute care and rehabilitative therapy services, as well as home health care and rehabilitative therapy services in Canada.

Extendicare comes off the critical list: Up 143% since November: But analyst warns of 'uncertain' prospect for profit in 2002
National Post (formerly The Financial Post) May 17, 2001
Jason Chow;chow@nationalpost.com

Extendicare Inc. shares (EXEa/TSE) have been on a slow and steady recovery from their price low, making them one of the hotter performers on the Toronto Stock Exchange this year.

However, analysts and investors are unsure whether the patient is in good health again.
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After years of losses, the red ink is fading and management says it expects a return to profitability by the fourth quarter. Could Extendicare be the TSE's feel-good story of the year? Not so quick, according to Rossa O'Reilly, an analyst at CIBC who has an 'underperform' rating on the stock.

'Owing to the company's large debt and uncertain prospects for generating profit growth in its remaining U.S. operation, we regard the prospects for achieving substantial overall earnings in 2002 as uncertain,' Mr. O'Reilly writes in a research note released last week.
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Last year, Extendicare had to set aside a US$9-million reserve to settle a case out of court in Florida and was appealing a US$20-million bill that was given to the company by a Florida jury. Extendicare has since pulled out of those states that have proved to be legal battlefields.
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Extendicare owns 274 long-term care facilities in Canada, the United States, and Britain, with a capacity for 27,000 residents. The company also has a 32.3% stake in Crown Life Insurance Co.
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The portfolio manager added the company's whopping $817.7-million in long-term debt was under control, pointing to its ability to pay during the bad times.
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Susannah Gray, a bond analyst with Merrill Lynch in New York, isn't so enthusiastic and still thinks the company is swimming in red ink.
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However, equity analyst Ihor Danyliuk, also of Merrill Lynch, was bullish on the stock and upgraded it to a long-term 'buy' rating from a long-term 'accumulate' last week.

Nursing homes forge new way; Florida measure would cap awards, increase staffing and boost Medicaid
Modern Healthcare May 14, 2001, Monday
Vince Galloro

Florida's nursing home industry would get some relief from the resident-liability lawsuits that it claims are putting nursing homes across the state perilously close to bankruptcy under a bill approved earlier this month by the Republican-dominated state Legislature.
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For national chains, which claim to have been a particular target of aggressive plaintiffs' lawyers, the relief may have come too late. Citing liability concerns, Extendicare Health Services, Milwaukee, and National HealthCare Corp. , Murfreesboro, Tenn., have exited the state (See story below).

Extendicare Announces Senior Executive Appointment
Business Wire May 31, 2001, Thursday

The Board of Directors of Extendicare Inc. (NYSE:EXE.A)(TSE:EXE.)(TSE:EXE.A.) is pleased to announce the appointment of Philip Small as Senior Vice-President Strategic Planning and Development, Extendicare Inc, effective June 1, 2001.

Mr. Small comes to Extendicare from a 15-year career at Beverly Enterprises Corporation, Fort Smith, Arkansas.

Extendicare Inc. Declares Preferred Share Dividend Payment
Business Wire June 13, 2001, Wednesday

Extendicare Inc. (NYSE:EXE.A) (TSE:EXE.) (TSE:EXE.A.) announced today that a monthly dividend of $0.104 per share on the Corporation's Class II Preferred Shares, Series 1 (EXE.PR. E) has been declared payable on July 16, 2001 to shareholders of record on June 29, 2001.

No charges will be filed over patient's beating death
The Associated Press State & Local Wire June 25, 2001

The death of a patient beaten by another resident of Westpark Rehabilitation Center will not result in criminal charges against the nursing home or its former administrator, a prosecutor said.
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"If ever there was a case in the state where the evidence was all there, this was the one," Becker (patient's daughter in law) said.
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Becker is also pursing a wrongful-death lawsuit against the nursing home's corporate owner, Extendicare, and the home's former administrator.

Manager says it's time to buy
Globe & Mail -- June 26, 2001
SHIRLEY WON

Fund manager David Picton says the Canadian market could test its lows over the next couple of months, but "this will prove to be a fantastic buying opportunity" for those with up to a two-year outlook.

"You may see the ultimate rally start three or six months from now," says the momentum manager at Toronto-based Synergy Asset Management Inc.
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Extendicare Inc. (EXE.A-TSE). The Markham, Ont., operator of nursing homes, which closed yesterday at $6.41, traded at a 52-week low of $1.65 last July and a 52-week high of $6.85 this month. Extendicare was a money loser in recent years, but management has been divesting risky businesses, such as its Florida nursing homes hurt by onerous insurance claims and litigation. Extendicare has gone from being a "basket case" to "a reasonable company that is undervalued" and possibly a longer-term growth play as aging boomers require nursing care, he says. The stock could hit $9 to $10 over 12 to 18 months, he estimates.

Patient Care Issues

WITNESSES RECOUNT NURSING HOME ABUSE
Pittsburgh Post-Gazette (Pennsylvania) March 5, 2002

Senators heard emotional testimony yesterday about nightmarish cases of abuse in nursing homes and the failure of government safeguards to protect patients.

An Indiana woman told lawmakers that her mother-in-law died after she was slammed into a wall by an unstable patient. She has sued the Indiana nursing home, owned by Milwaukee-based Extendicare Health Services.
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In both cases, family members raised the issue not only of abuse but also of the poor response they felt they got from nursing home officials and state and local agencies.

In a report released yesterday, the General Accounting Office found that cases of abuse in nursing homes are rarely prosecuted and sporadically reported.

Barbara Becker, whose 83-year-old mother-in-law, Helen Becker Straukamp, died in the Indiana facility, complained that assaults in nursing homes are treated far more lightly than they are elsewhere.

"The biggest insult of the whole experience has been that had this happened in my own house, I would have been investigated. I would have been prosecuted, and I probably would have been put in prison," she told senators. "That's why I can't let it go."

Death costs Westpark $2,500 fine
Courier & Press July 24, 2002

Westpark Rehabilitation Center has been fined $2,500 by the state for deficiencies linked to a death that was ruled a homicide by the Vanderburgh County coroner.
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The nursing home is owned by Extendicare, a Milwaukee-based nursing home corporation with more than 250 facilities in the United States and Canada.
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A forensic pathology report indicated Mynatt had been without fluids for at least two days before she died.

A survey by the state, conducted after Mynatt's death, found numerous "severe deficiencies," including the failure by Westpark staff to keep adequate records on Mynatt's condition and whether she was receiving enough fluids.

Grand jury gets nursing home death
Courier & Press August 1, 2002

A grand jury will be asked to decide whether criminal charges should be filed in connection with the death of a local nursing home patient that was ruled a homicide by the Vanderburgh County coroner.
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Mynatt's granddaughter, Angela Mynatt, said she is "impressed" prosecutors have taken the case this far.

Indiana pursues ex-nursing home boss
Courier & Press January 5, 2003

The Indiana attorney general's office wants to make sure the former administrator of Westpark Rehabilitation Center never oversees another nursing home in Indiana again. A hearing to revoke or suspend the administrator license of Angela Werner is scheduled for Jan. 29-31 before an administrative law judge in Indianapolis.

"We're focusing on Angela Werner as administrator from 1996 to 2000," said Indiana Deputy Attorney General Renee Gallagher. "In this case, we just need to lay the facts out and I think it will speak for itself. I believe we will meet the burden."
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Complaints alleging poor conditions and violations of nursing home regulations were filed against Werner and Extendicare Inc., the nursing home's owner, while Werner was the administrator at Westpark. In 1999, 66-year-old Helen Straukamp was living at Westpark when she was fatally injured by another resident. Extendicare eventually was fined more than $30,000 by the state for violations related to Straukamp's death.

The allegations against Werner were among a backlog of complaints that languished for years at the Indiana Health Professions Bureau. Many of the complaints were filed by Straukamp's daughter-in-law, Barbara Becker. Becker has met with Attorney General Steve Carter asking him not to settle this case behind closed doors.

"I told him the decisions he makes affect real people," Becker said. Becker was told she would be the state's key witness.

State reviews facility's quality of care; Maggots in a resident's wounds prompted visit.
Fort Wayne News Sentinel August 6, 2003

Patient neglect, undocumented or missed medications, improper releasing of a resident and resident-to-resident abuse are among the findings of a state report on Applewood Health and Rehabilitation Center.

The Indiana State Department of Health investigated whether maggots formed in one resident's bedsores while she was at the center or with family. The July 15 report states a resident with multiple bedsores was admitted to Applewood, 3811 Parnell Ave., on June 5. The care plan called for daily dressings and treatment of wounds, which included open sores on both feet.
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Applewood is owned by Milwaukee-based Extendicare. In a written statement to The News-Sentinel, Applewood Administrator Edward Fodrea said dressing changes were done as required, but they weren't documented.

Extendicare's cost cutting and closures

Nursing homes barely hang on; Low Medicaid rates, sicker residents lead to closings and a troubling future
Milwaukee Journal Sentinel (Wisconsin) August 28, 2001

Less than two weeks ago, Extendicare announced it would close the Plymouth Manor Nursing and Rehabilitation Center in mid-January, forcing 90 residents at the central city home to relocate. And last week, Milwaukee Care Center, a small, northwest side nursing home, said it will close this fall, displacing 30 residents. Both homes primarily serve patients relying on public funds.

Canadian nursing home operator leaving state
Fort Worth Star-Telegram (Texas) October 11, 2001

A Canadian nursing home operator with facilities in Tarrant County is bailing out of Texas, citing financial losses and the high cost of liability insurance.
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In the first six months of 2001, Extendicare's 17 nursing homes in Texas posted a loss of $4.4 million. Key to the losses was a $5.4 million bill for liability insurance.

Texas nursing homes pay the second-highest rates in the nation for liability coverage, trailing only Florida, according to a recent study by the Texas Health Care Association, a trade group representing for-profit nursing homes.

COMMENT:- The following has everything to do with profit and nothing to do with responsibility or care for the needy. What a way to care for seniors when they can no longer care for themselves.

Texas lawsuit settlements prompt exit by Extendicare: 'Undue risk exposure'
FINANCIAL POST: CANADA October 11, 2001

Extendicare's continuing strategy for achieving ongoing performance improvements involves divestiture of assets that impede growth or create undue risk exposure,' said Mel Rhinelander, president and chief executive of Extendicare, in a statement. 'For some time, Florida and Texas have been problem states in terms of exposure to litigation. 

Longtime nursing home in city closing; Money woes cited in loss of St. Mary's
Milwaukee Journal Sentinel (Wisconsin) December 1, 2001

After 100 years of serving the elderly, St. Mary's Nursing Home announced Friday that it is closing for good and will relocate its 84 elderly and disabled residents by March 20.

The closure will also affect about 150 full- and part-time employees, many of whom live in the immediate area of the home at 3515 W. Hadley St. (the home's owner/operator, Extendicare Health Services Inc)
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Of the 22 nursing home closures in the past two years, eight have been in the Milwaukee area, she said.

Health staff strike for wage parity
The Edmonton Journal February 12, 2002

"These folks have been paid substantially less than the hospital workers for years," said Dan MacLennan, president of the Alberta Union of Provincial Employees, which represents the workers.

"Both facilities are funded by the Aspen Regional Health Authority. So the conclusion is Extendicare, a private company, is grinding out profits on their employees' lower wages."

ATHABASCA STRIKERS COME TO EDMONTON
Edmonton Sun (Alberta, Canada) February 16, 2002

"We have wondered if (Extendicare) have imagined their activities will not be seen by the public because they are taking place in a small northern Alberta community," said Dan MacLennan, president of the Alberta Union of Public Employees. "From the start, this company has taken an unfair, hardball attitude with this small group of women."

EXTENDICARE WORKERS SETTLE
Edmonton Sun (Alberta, Canada) April 9, 2002

Striking members of the Alberta Union of Provincial Employees ended a 56-day walkout yesterday by ratifying a new contract with Extendicare Canada.

Extendicare's improving financial performance

As Extendicare abandons markets where citizens have learned to bite back it increases its profits and expands in Canada where they have not learned yet.

Nursing home operator shrinks quarterly losses
Toronto Star August 11, 2001

Extendicare Inc., one of the largest operators of long-term care homes in North America, is continuing to shrink its quarterly losses after exiting Florida following a costly lawsuit.

The Markham-based company's loss in the second quarter was $4.1 million, or 6 cents a share, compared with a loss of $5.3 million, or 8 cents per share, a year earlier.

Extendicare Health Services, Inc. Reports Third Quarter Results: Strong 2002 Performance Turnaround Continues
BUSINESS WIRE Nov. 7, 2002

Extendicare Health Services, Inc. reported net earnings of $2.0 million in the 2002 third quarter compared to a loss of $14.1 million in the quarter ended September 30, 2001, demonstrating a strong performance turnaround this year and the fourth consecutive quarter of positive results.

Extendicare Inc. Reports Fourth Quarter 2002 Results; Delivers First Profitable Year Since 1999
Business Wire February 20, 2003

Extendicare Inc. reported its first profitable year since the implementation of the U.S. Medicare Prospective Payment System in 1999. Net earnings rose to $18.9 million ($0.26 per share) in 2002 from a loss of $36.4 million ($0.52 loss per share) in 2001.
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"We are increasing our nursing home portfolio in Ontario by more than 1,300 beds over a four-year period ending in 2004, as part of the Province's plan to improve access to long-term care. We maintained Canadian occupancy levels of better than 98% in 2002, excluding newly opened buildings.

Extendicare's Political Influence in Canada

Canadian Senator Kirby is a director of Extendicare. In spite of this he became chairman of a senate committee advising on the future of Health Care in Canada. This was run in opposition to the Royal Commission into the future of health care in Canada chaired by Mr. Romanow. Not surprisingly Romanow carefully documented the problems in corporate for profit medicine and advised moving away from it. Kirby's committee advised the opposite and attacked Romanow! The company is expanding its nursing home operations in Canada particularly in Ontario where the government is rapidly privatising.

Grit senator asked to step aside; Health coalition says chairman of medicare review forum is in conflict of interest
The Ottawa Citizen February 24, 2000

The Liberal senator who heads a parliamentary committee studying medicare is being urged to step aside over concerns his directorship of a private nursing-home firm places him in a conflict of interest.

Since 1987, Kirby has sat on the board of directors of Extendicare Inc., the Markham-based firm which operates a network of more than 300 nursing and retirement homes throughout Canada and the U.S. The company is now also involved in the home-care sector, which is viewed by experts as one of the burgeoning fields of health-care delivery in coming years.

Crack the Medicare mould: Kirby Senator warns against 'knee-jerk' rejection of change
National Post (Canada) July 3, 2001

A Liberal Senator heading a study of the future of medicare is encouraging Canadians to consider user fees, an annual health care insurance premium and private services Michael Kirby, chairman of the Senate committee that has been looking at health care for 18 months, says more money will be needed to sustain the system as a result of an aging population and expensive new technologies.
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Other senators on the committee have criticized Mr. Romanow's health care probe as a waste of money and said it might in fact delay needed reforms to the medicare system.

Senator should quit committee
The Gazette (Montreal, Quebec) December 14, 2001

A conflict of interest, according to the Random House dictionary, is "the circumstance of a public officeholder, business executive, or the like, whose personal interests might benefit from his or her official actions or influence."
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The committee has yet to offer any evidence that this approach would benefit the average Canadian, though there's plenty of evidence to suggest those who could only afford second-class treatment would suffer. Nonetheless, such a system would be guaranteed to personally benefit Michael Kirby.

Sits on board

As the Canadian Health Coalition details in a report this week, Kirby sits on the board of directors of Extendicare Inc., based in Markham, Ont., which owns hundreds of nursing homes and other health-care facilities throughout North America. That fact is fairly well known in the closed confines of Ottawa, where many of the groups and individuals who testify before Kirby's committee have bitterly complained about the apparent conflict. But barely a peep about it has been raised in the media.
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Unfortunately, the experience of Extendicare in the United States doesn't portend much good for our health-care system if we go down the road Kirby is likely to recommend. As the health coalition found in its research of the U.S. nursing-home industry, Extendicare is beset by a series of liability lawsuits in Florida and Texas. The lawsuits have prompted the company to withdraw from both markets in order to lessen its "exposure to litigation."
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Ignores U.S.

This is one aspect of the private health-care system that ideological boosters never talk about. Kirby's committee likewise doesn't look at how that system actually operates in the U.S. It favours tax credits that benefit for-profit home-care industries. It relies on political positions advanced by private lobbyists at the Fraser Institute to support user fees and Medical Savings Accounts. And, as the coalition report emphasizes, the Kirby committee report argues that problems in the health-care system are related to the five principles of the Canada Health Act and that they must be substantially modified, without supplying evidence.

Kirby might not have the direct power to benefit his own interests. But as fawning media coverage of his committee's work has demonstrated, he certainly does have influence over the direction the Liberal government might take on public health care. The simple fact he stands to personally gain

Kirby fuels private-public spat over health
The Vancouver Province October 27, 2002

The ideological divide splitting Canada's health-care debate came into sharp focus with the release of the Kirby report.

Those groups opposed to an increased private-sector role in health-care delivery portrayed it as a disaster.

Those in favour of increased privatization generally had kind words, although they fretted about Sen. Michael Kirby's call for a national health premium to cover increasing costs.

The divide won't go away, even after Roy Romanow presents his Royal Commission report on health-care next month.
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"If Canada accepts Kirby's competitive bidding model, we will be forced to open our doors to American corporations who will use NAFTA to dismantle medicare," warned Maude Barlow of the Council of Canadians.

On the neo-conservative side of the political spectrum, the message was a polar opposite.

The Canadian Chamber of Commerce is "disappointed that the report did not encourage more opportunites for private sector delivery within the publicly-funded system."

Extendicare expands in Canada with government support

EXTENDICARE GETS FINANCING FOR NEW FACILITIES
London Free Press (Ontario, Canada) January 3, 2001

The Canadian branch of long-term nursing home care operator Extendicare has formed an alliance with Ontario's municipal government pension plan to help finance construction of eight new Ontario centres.

Under a deal announced yesterday, Borealis Long-Term Care Facilities Inc. will provide the money to build and equip eight new long-term care centres that will be managed and operated by Extendicare (Canada) Inc. around the province.

The combined total of 1,100 beds includes those awarded to Extendicare by the Ontario Health Ministry in a 1998 competition.

HOW TO STOP THE CARE CRISIS FROM GETTING WORSE?
The Toronto Sun June 10, 2001

Current trends indicate we'll likely be warehoused in large institutions run by for-profit conglomerates, predicts Ernie Lightman, a University of Toronto professor of economics in the social work department.

Most of the new 20,000 new long-term care beds promised by the government have been awarded to private operators such as CPL (Central Park Lodges), Leisureworld and Extendicare.

Lightman says Extendicare's success at winning more long term beds comes on the heels of their settling an American lawsuit and exiting all their homes in Florida. "They got nailed in Florida," he says. "There they enforce their standards and people sue and when they sue they get lots of money."
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"We're going to get bigger and bigger nursing homes because that's the kind of places CPL and Extendicare run," Lightman adds, "so they're going to be more like warehouses for the elderly."

Nursing home operator shrinks quarterly losses
Toronto Star August 11, 2001

"We are proceeding on time and on budget with the opening of five new Canadian nursing homes this year," Rhinelander said. "A further three homes are scheduled to open next year. These eight facilities represent 1,100 beds and will increase Extendicare's resident capacity by 23 per cent in Ontario, our largest Canadian market."

On June 30, Extendicare operated 276 care homes in the United States and Canada.

Extendicare extends Ontario presence; :: Extendicare flees lawsuit-prone U.S.
Toronto Star August 28, 2001

Seven months after bailing out of the litigious Florida market, nursing-home giant Extendicare Inc. has kicked off a $125 million plan to increase the company's Ontario presence with yesterday's opening of a 64-bed facility in Lindsay.
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Next year, new nursing homes will open in Toronto, Mississauga and Hamilton, boosting the Markham-based company's capacity in the province by 23 per cent to almost 6,300 residents.
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"In Canada, the issues in Florida around general liability and tort law don't exist," said Philip Small, senior vice-president of planning and investor relations at Extendicare.

"The rationale around exiting Florida was related to the risk of general liability exposure . . . The opportunity in Ontario presented itself and Extendicare was aggressive in pursuing that opportunity," said Small.
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Shelly Jamieson, president of Extendicare Inc.'s Canadian division, said the eight new Ontario facilities grew out of a 1998 move by the Ontario Ministry of Health to encourage the expansion of long-term care facilities.

The province will pay Extendicare $10.35 per resident per day for 20 years, or about $4 million annually, to offset the cost of the new facilities.

Extendicare estimates the 1,105 new beds will each cost about $112,000 to develop, or about $123 million in total.

Ontario gives federal health money to private clinics
The Standard (St. Catharines) April 8, 2002

More than $60 million in federal funding earmarked to buy much-needed medical diagnostic equipment has been used by the Ontario government for grants to privately owned radiology clinics and to purchase bathtubs, beds and mattresses in for-profit long-term care homes.
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The grants to the private, long-term care companies included:

- $1.7 million to 24 long-term care homes operated by Extendicare (Canada) Inc., a publicly traded company and one of the largest operators of long-term care centres in North America. After nearly three years of losses brought about by troubles in its American nursing home operations, Extendicare earned a net profit of $6.9 million in the last quarter of 2001.

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This page created Feb 2001, last updated Aug 2001 and Aug 2003 by Michael Wynne