I have argued that most of the charismatic entrepreneurs who founded the corporate health and aged care chains show some of the personality features which I have called extreme closed minded or even successful sociopaths. I have described these features on a separate web page and have suggested that because of the nature of health and aged care, the market system in health and aged care selects for people like this.
These are the least suitable people one could possibly find to look after citizens who are trusting, vulnerable and dependent on the Samaritanism of their fellows. Examine the material about Genesis on the Genesis pages and try to imagine the sort of person Walker is. Here is my assessment but decide for yourself.
Michael Walker is chairman and CEO of Genesis Health Ventures and it is clear that he is the driving force behind the company. On one occasion he even uses the terms "I" and "my" when talking about corporate policy. He is clearly supremely confident.
I have very little information about Walker the man except for the glimpses provided by quotes from interviews and corporate reports in SEIU documents. The assessment of Walker can only be made on the basis of Genesis policy and his role in implementing that policy. It is likely that he was the architect and driving force. There are no reasons to doubt his sincerity, his single mindedness or his drive.
We are therefore confronted with a man who is probably the driving force behind Genesis. He is certainly enthusiastic in implementing its policies. While there is every indication that he is genuinely interested in providing good care he nevertheless pursues policies which are incompatible with that objective. He seems unable to actually confront evidence, which indicates that he has failed in this regard.
Walker's vision was essentially market based and success in the marketplace would have been the ultimate measure of his personal performance. It is clear that he was ambitious. He developed a market strategy, which was clearly incompatible with his commitment to care.
He pursued his unrealistic vision of marketplace dominance with a single mindedness, which flew in the face of economic sense. He failed to heed clear warning signs, which showed that government intended to curtail the exploitation of Medicare on which his vision was built. The company found itself with massive debts and an income stream that could not service these debts.
When the nurses who provide the care in Genesis facilities produce clear evidence that Genesis policies had seriously compromised care Genesis responded by attacking the accuracy of the evidence and the motives of the critics. Genesis did not counter with alternative figures or an alternative explanation. The response was wordy and sounds sincere. It seems that they genuinely believe what they are saying.
The information on which my comments are based is scattered across the Genesis web pages describing market practices, patient care, and whistle blowing by the SEIU. I include here only a few extracts in order to highlight the issues.
Walker resigned as CEO of Genesis in May 2002 soon after Genesis emerged from bankruptcy. His vision of good care and the ideas behind "Eldercare" became a victim of the market.
House of Cards
Service Employees International Union
-- September 1998
Mike Walker, CEO talks about regional domination. In the Northeast:
"Ask the question, 'How many of the long-term care companies are in this geographical marketplace?' Not a lot." In Massachusetts : ". . . we are the most substantive provider of long-term care services throughout the entire state, but with real dominance in three cities-Springfield, Worcester and Boston."In New Hampshire : ". . . we're the dominant provider in New Hampshire, in Manchester and Concord ."
In Maryland: "Basically, in Baltimore, we'll cover the whole state.
House of Cards
Service Employees International Union -- September
1998
These networks are so pervasive and so substantive that we will capture the managed care marketplace because there will be no place else to go."
("Genesis Health Ventures, Inc. :Company Report ," August 18, 1997 , Wall Street Transcript Corporation.)
Rolling The Dice
Service Employees International Union --1998
"The near-term strategy is to take my knowledge to the managed care companies in this country, especially in my markets, and say ‘I can bring your medical loss ratio down to 75 percent or 65 percent; I want you to share those savings when I do that.’ And they will do that."
(Mike Walker’s quote is drawn from "Genesis Health Ventures Company Report," Wall Street Transcript Corporation, Aug. 18, 1997.)
Rolling the Dice
Service Employees International Union -- 1998
- - - - Genesis Health Ventures, is positioning itself to win the managed care race by specializing in providing low -cost long-term care services. The Genesis strategy is to accomplish two goals simultaneously. By aggressively seeking exclusive contracts with managed care organizations, Genesis promises to lower managed care costs . At the same time, Genesis has launched a branding strategy, the "Genesis ElderCare Network," that promises health care consumers a consistently high level of quality care in all of their facilities.
House of Cards
Service Employees International Union -- September
1998
"..they (McKerley facilities in New Hampshire) were overstaffed, not at the corporate structure but at the facility level ; they didn’t have subacute units ; they didn’t have distinct part units; they just basically provided intermediate care. We changed that , and we reduced staffing and we got greater productivity. There were a few complaints, but overall the transaction has been successful and we’ve moved ahead."
(-Genesis CEO Michael Walker, Wall Street Transcript Corporation ,Company Report - August 18, 1997)
House of
Cards -
Quote from Nursing Home Inspection
Report
Service Employees International Union -- September
1998
"The facility has failed to provide staff who are aware of the residents’ needs . Over 50 percent of CNAs delivering care were agency staff who had not received orientation to the facility or residents’ needs ." On one day of the survey, eight of 10 staff members were agency staff. Nursing home residents told inspectors : "staff are overwhelmed and exhausted" " we ring and they do not come because they are busy " "when they do come sometimes it is too late" "not having enough staff is frustrating and it makes for a debilitating atmosphere " " there are a lot of agency staff and they do not know what we need" "staffing is always short and we know about what we speak"
House of Cards - Quote from Nursing Home
Inspection Report
Service Employees International Union -- September
1998
Group and family interviews revealed : "Residents were not ambulated as determined in their care plans due to a shortage of staff." " . . . not giving care as they used to" " Can’t find an aide to cut up meat." " . . . shortages of staff especially in an emergency."" Pool people don’t know residents ." " . . . nobody to ask questions of " " T hey are not toileting mother every two hours as they are supposed to." "Mother has been found with a soaked brief that disintegrated in the morning , as it had not been changed in a timely fashion ."
LIST OF GENESIS REFERENCE WEB
PAGES
(Click to go to)
