LINKS CORPORATE MEDICINE WEB SITE Disclaimer The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made. Any comments made are based on the belief that there is some substance at least to so many allegations. Links to Site Maps Central Initial USA Australian International Corporate Practices (to print) Path to this page Home Australia Markets & aging Nursing homes The Companies overview Health care Hospital Corporatisation   Entry to Privatisation   Privatisation Background   Australian states Pathology & Radiology Gen. Pract. Corporatisation Aged Care Story of corporatisation   Nonprofit dilemma Aging bonanza Banks Nursing homes Home Care Breadth health corporat. Retirement Villages Nursing Homes Government    1985 to 1998    Correspondence    1998 to 2001    2002 to 2005    2006 Accreditation Nurses    People farming Residents & Relatives The Companies Not for profit homes Nursing Hm Comp The Companies overview Listed Companies Milstern DCA    Audit problem Ramsay Hlth Care Aevum Retirement Care Aus. Bigger unlisted Comp. Moran Hlth Care Tricare Regis Grp Unlisted Comp. Vic. A Illawaong Saitta/Neviskia CIS Holdings Unlisted Comp. Vic. B Eildon McKenzie SRS & Marnotta Enhance Peel Street Muskjest Lasalto & Easyplan etc Ellis & Elfam Dampier Bay Hastings Regional Navatha & Locksley Unlisted Comp. Other Aegis Sauve/Craigcare Kennedy Thompson Alchera Park Trans Dominion/Farad Gonzales Bresant Tolega & Karoona Peninsula Introductory page This corporate web site addresses the issues of corporate health care within a broad framework. A web page describing this broad context should be considered as an introduction to each page on the web site. If you have not yet read it then CLICK HERE to open it in another tab or web page. Content of this page This web page looks at the different understandings of care, the economic pressures, the problems for nurses and whistleblowers, as well as the impact of nursing home size on the service in the home. It is illustrated by looking at this small Victorian family owned nursing home which closed in 2006.  Australian section    Hastings Regional Nursing Home Pty Ltd

This was another small Victorian nursing home group owned by a man and his wife. It owned only one nursing home.

It was supported by the government with an allocation of 30 new beds in 2002.

The home provides further insight into the plight of small operators encouraged to buy into the privatised nursing home industry in Victoria. Several small homes in the area were struggling largely due to under funding. They simply could not survive in a marketplace where size gives advantages and the benefits of community are not recognised.

In 2002 the government helped by allocating 30 new beds to the home which might have made it more viable. Without enough money to operate the facility there was little prospect of building. In spite of a government subsidy the extra beds were never built.

In the meantime the financial situation continued to deteriorate and with it the standard of care of the residents. Staff were reduced, bills were not paid and essential supplies did not arrive. Key staff resigned and were not replaced. It is clear from the residents comments that the staff were indeed very caring and that the cause of the problems was primarily commercial. The nurses comments suggest that standards had deteriorated rapidly as economic failure loomed.

The accreditation agency found major deficiencies and imposed financial sanctions. These put further pressure on the home so that it did not have the resources to improve. The financial situation continued to get worse until the tax office put the business into liquidation.

As I see it there are a number of important issues here.

1. The meaning of care:- As happened in Riverside in 2000 there is a glaring disconnection between the understanding of the situation by the agency and by residents and their families. To the relatives the staff were caring and the care was good. They were traumatised and angry at the closure. To the agency residents were at risk and had to be protected.

There is a fundamental lesson to be learned here. That is the difference between care and standards, between what the community wants and what the government and its agencies want. They live in different worlds. Caring has to do with people and the way they relate to one another. Standards, efficiency, productivity, risk and adverse events have to do with another impersonal world which threatens and intrudes into the world where people who care live. This bureaucratised world of markets and agencies with its web of complexly defined realities is meaningless to them.

Both worlds have validity but there is no shared consciousness. Government have not learned from Riverside.

2. The primary driving force:- The second issue is inherent in markets. Money is the dominant determinant of what happens and, because financial failure comes suddenly and is not cushioned in any way, the closure and relocation of residents is sudden and life wrenching for all parties. In a more sensible world where care is a consideration, change, relocation and employment are all managed more sensitively and less hurriedly. Staff would move with residents.

3. The costs for staff:- There is the problem of large numbers of staff suddenly losing their salaries, their jobs and their superannuation entitlements, but expected to continue caring without pay for humanitarian reasons. These are people from the poorer sections of our community who live from week to week on their salaries. Government has been tardy and unfair in addressing this.

4. The cost of whistle blowing:- Once again, as in Riverside and in many other homes the ultimate cost of whistle blowing is severe trauma. They lose their jobs and their superannuation benefits. They must watch the stress of those for whom they care as their lives are torn apart. In a small community of 40 or fewer staff there is no way of hiding who the whistle blowers are. They are marked individuals when they want another job. In health and aged care almost all serious dysfunction and fraud is exposed by whistle blowers and not oversight. How many of us are noble enough to speak out when we know what the cost will be.

5. Size and Care:- This example illustrates another dilemma for aged care. Home is an intimate place where we know each other well and deal empathically with each other - we care. It may be a mess and hygiene sometimes slips a bit especially at the extremes of life. Small nursing homes if reasonably funded and staffed by motivated people provide this intimacy and the caring that goes with it. In a competitive marketplace these smaller homes are not economically viable when compared with larger homes.

Much more is required by the agencies, by government, by the market and by those who feel responsible for their elderly family. With larger facilities there can be more specialised staff, more facilities, more services, more activities and more efficiency. The elderly can be better managed, be cleaner and enjoy better health. The price is a more impersonal environment, less intimacy and less "care", as the residents experience it.

Larger groupings also have the capacity to harness greater resources, provide more services, give more support and introduce more uniform systems to ensure standards. The down side is the erosion of intimate units, flexibility and a failure to respond to individual quirks.

It seems important to recognise the problem and to strike a happy medium in size and in the structure of larger homes. Providing an intimate and caring environment requires more and different staff who have plenty of time to talk to and interact with residents. This is not profitable, efficient or economically productive. Hogan and his Productivity Commission would not approve.

These issues are illustrated almost every time a nursing home is forced to close because of commercial failure, commercial disputes, or government intervention. Other examples include Riverside, Blackburn Aged Care Facility, and St Lawrence Nursing Home

Dec 2002 Extra beds allocated

HASTINGS will get an extra 45 aged-care beds in the new year, thanks to a $1.8 million funding boost by the Federal Government.

Flinders Federal Liberal MP Greg Hunt said the windfall was the biggest single allocation since the Commonwealth started funding aged-care beds.

Hastings Regional Nursing Home will receive 30 new beds, while the Bays Nursing Home will get 15.
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Hastings Regional Nursing Home proprietor Ann O'Brien said the funding would greatly benefit Hastings and surrounding areas.

The high-care nursing home, which has operated since 1992, has 30 residents, and has a waiting list of about 100.
Aged-care boost. Frankston Standard December 9, 2002

Jun 2004 Gets subsidy to upgrade bed numbers

A CASH injection of more than $100,000 of federal funding may have saved Hastings Regional Nursing Home from closure.

The home is one of six aged care providers in Westernport to get more than $100,000 in Commonwealth funding to help with building upgrades.

A one-off payment of $3500 a resident will be delivered this year to providers of care for the aged.

In addition, each high-care bed will get an increase in annual funding of more than $1000 from July 1. This will rise to almost $5000 a bed by 2007.

But some providers say it will not be enough to keep their businesses viable.

Hastings Regional Nursing Home spokeswoman Michelle Paine said the funding had been a lifesaver for the facility.
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"We may have been forced to close without the injection of the funds we are now receiving," she said. "It's a lifesaver because with 30 beds the profit margin is marginal."

The 10-year-old home hopes to increase its capacity from 30 to 60 beds within the next 12 months and has submitted plans for the expansion to Mornington Peninsula Council.
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Another industry member from Hastings, who also asked not to be named, said that while the funding was welcome it was merely a Band-Aid.
Federal cash injection a lifesaver, says nursing home Frankston Standard/Hastings Leader June 7, 2004

Mar 2006 Dreadful standards - sanctions imposed

Meanwhile, a Victorian nursing home where faeces were found in a dryer with a load of tea towels is still open for business despite a damning report that recommended it be shut down.

The Hastings Regional Nursing Home on the Mornington Peninsula failed all but 18 of 44 mandatory standards when it was inspected last October.

An audit team from the Aged Care Standards and Accreditation Agency was scathing about the use of untrained and unsupervised staff, neglect of residents in pain, limited showers and a lack of stimulation and activities.

In a litany of problems found at the 30-bed high-care home, the team also sounded alarm bells that "breaches of infection control are not adequately managed. An incident report records that a staff member found faecal matter in the dryer with a load of tea towels."

But the team found no explanation of whether management had investigated or if there was any follow-up with staff.

The assessment team recommended that the agency revoke the accreditation of the home, but instead of closing it down, the Department of Health and Ageing decided to let it operate under sanctions.
Action on abuse of aged The Age March 30, 2006

Apr 2006 Major problems

A DAMNING report on the Hastings Regional Nursing Home has recommended its accreditation be revoked after it failed 18 of the 44 mandatory standards last year.

The 30-bed centre, which has 20 residents and is owned and run by Andrew O'Brien, will be re-assessed by the end of this month.

A Standards and Accreditation Agency report said the home was non-compliant in areas of nutrition and hydration, pain and continence management, infection control and occupational health and safety. - - - - - .

A staff member, who refused to be named, said faecal matter had been found in the dryer on more than one occasion.
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Residents experiencing pain were not assessed and residents with weight loss were not adequately monitored or referred to a dietitian, the report said. It also said residents were not able to make choices regarding their lifestyle and one method of restraining elderly clients a chair restraint was unsafe.
Nursing home in strife Frankston Standard/Hastings Leader April 17, 2006

Apr 2006 Staff entitlements lost

ENTITLEMENTS owed to former nursing staff at Hastings Regional Nursing Home are being pursued by the Australian Nurses Federation.
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The representative said the federation was seeking about $12,000 in superannuation entitlements.

Three former staff members told the Hastings Leader there had been problems getting vital supplies for the home.

They claimed continence aids were not provided because of payment difficulties.

The former staff members, who asked not to be named for fear of retribution, said the situation became critical during the past year, with both the director of nursing and the diversional therapist resigning.

One staff member said the matter had been brought to the attention of Flinders federal Liberal MP Greg Hunt last year.

Mr Hunt said he had contacted Minister for Ageing Julie Bishop's office last year to raise the concerns and was told an accreditation assessment would be occurring shortly to examine every aspect of the facility's activities.

"There was action, investigation and there were findings," he said.
Nurses fight for claims Frankston Standard/Hastings Leader April 24, 2006

May 2006 One of the worst

HASTINGS Regional Nursing Home is one of the three worst in Victoria, a report released last week says.
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The report by the Federal Government-appointed Aged Care Standards and Accreditation Agency says the home has again failed to achieve total compliance in accreditation. It met only 34 of the 44 expected outcomes.

The 30-bed home failed to meet minimum standards of clinical care; nutrition and hydration; behavioural management and leisure interest and activities. It also failed to demonstrate continuous improvement in health and care.
Hastings home one of worst Frankston Standard/Hastings Leader May 8, 2006

Jun 2006 Home to close

ELDERLY residents of the Hastings Regional Nursing Home are being forced to find somewhere new to live with the troubled home to close its doors within a fortnight.

Relatives of the 17 high-care residents most in their 80s and 90s must quickly find alternative accommodation.
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Shocked staff members said they were told it was not viable to continue and the 30-bed home would close in between "seven and 10 days".
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Some nurses who spoke to the Leader but wanted to remain anonymous said they would hold on "until the end" without pay to ensure the residents were cared for.

The 14-year-old home has twice failed to meet Federal Government Standards and Accreditation Agency requirements.
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"This is their home they're so settled here and despite the problems with sanctions, the care of the current staff is fantastic," she said.
Elderly people weep when told nursing home will close Residents Frankston Standard/Hastings Leader June 19, 2006

Jun 2006 Evacuation residents - staff praised

Mr O'Brien did not know if the 30 bed licences would remain in Hastings.
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The 14-year-old building and land, plus an adjoining block, are still owned by his parents, Ann and Tony O'Brien.

Andrew O'Brien said the nursing home would be demolished soon and replaced with housing units.
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The home's 42 sacked staff are now looking for jobs and waiting for their full entitlements, including superannuation.

The 17 high-care residents, most with dementia, were moved to other nursing homes, the last resident leaving at 2.30pm last Monday.

Angry and upset staff and relatives met the Leader last week to air their grievances. Staff were worried about their superannuation entitlements, finding new jobs and the fate of residents. "They didn't want to go," said a spokeswoman, who did not want to be named. "We had emotional bonds with these residents, too, so it was distressing for all of the staff as well. Fortunately relocating them was a well-planned, organised and dignified process for residents and their families."

All relatives who spoke to the Leader praised the efforts of nurses and carers.
Shut nursing home sold No guarantee that beds will stay in Frankston Standard/Hastings Leader June 26, 2006

Jun 2006 Staff praised

On June 13, she was given a month's notice that her 81-year-old mother, Jean Lowry, who has severe dementia, was to leave Hastings Regional Nursing Home.

Mrs Lowry moved out three days later, leaving her home of three years.

"Despite all the problems with sanctions and management, the staff were wonderful worth their weight in gold," Mrs Nathan said.

"It's just an absolute shame that it has come to this: 42 people have lost their jobs, 17 mentally and physically disabled people thrown out. All for what?

"Why couldn't the Government have stepped in and kept the home going? Where have the watchdogs been all this time?"
Family saddened by loss of home Frankston Standard/Hastings Leader June 26, 2006

Jun 2006 Sanctions the final straw

He said the sanctions, imposed by the Department of Health and Ageing in March, banned him from taking in new residents for six months.

He said he had hoped to restructure his company's finances and expand the licence to 60 beds, building on neighbouring land owned by his parents, to attract an equity partner.

"But the sanctions made the business an unattractive proposition," he said.

He said the accreditation agency had visited the home 30 times since October. In March, a Commonwealth-approved nursing adviser was sent in to improve conditions and a new head of nursing appointed.
Sanctions pushed business to brink Frankston Standard/Hastings Leader June 26, 2006

Jun 2006 The blame game

HASTINGS Labor MP Rosy Buchanan said the closure of the Hastings Regional Nursing Home was another example of health in crisis on the Mornington Peninsula.

"The families of residents are devastated by the home's closure and the abrupt way it happened," Ms Buchanan said.

"They want to know how this could have been allowed to happen. I have put this to the Flinders MP Greg Hunt: why doesn't the Federal Government have safeguards to prevent this from happening?"

Flinders federal Liberal MP Greg Hunt said he was hopeful the 30 high-care beds would remain in the area.
Call for safeguards Frankston Standard/Hastings Leader June 26, 2006

Jun 2006 Problems for nurses

This is the second aged care facility this month to close without paying their nurses and personal carers their superannuation wages and entitlements. ANF (Vic Branch) is pursing legal avenues to secure thousands of dollars owed to nurses and personal carers at Hastings Regional Nursing Home which closed its doors earlier this month prior to resolving a matter with the Australian Taxation Office.
Media Release: Australian Nursing Federation Media Release: Australian Nursing Federation June 30, 2006

Jul 2006 Political promises

FLINDERS federal Liberal MP Greg Hunt says he will be "relentless" in pursuing all entitlements owed to sacked staff of the now closed Hastings Regional Nursing Home.
MP to fight for nursing staff dues Frankston Standard/Hastings Leader July 3, 2006

Jul 2006 Tax department winds up the business

THE Hastings Regional Nursing Home Pty Ltd has been wound up. The Federal Court ordered on June 29 that the company be wound up and a provisional liquidator appointed at the request of Deputy Commissioner of Taxation.
Home wound up Frankston Standard/Hastings Leader July 10 2006

For Updates:- A good way to check for recent developments in aged care is to go to the aged care crisis group's search page and enter the name of the company, nursing home or key words relating to any other matter in the search box. Most significant press reports are flagged there. The aged care crisis web site has recently been restructured and some of the older links used from this site may not work.

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Web Page History This page created Sept 2006 by Michael Wynne