Undernourished residents, lack of care, untrained staff… On Tuesday, April 5, the government published an administrative investigation that it commissioned in February on the management of nursing homes within the private group Orpea. More than 500 damning pages, written jointly by the General Inspectorate of Social Affairs (Igas) and the General Inspectorate of Finance (IGF).
→ MAINTENANCE. Isabelle Dumoussaud: “The nursing home becomes a foil, this must raise questions”
On March 26, the government announced that it was going to take legal action on the basis of the conclusions of this report, in order to require Orpea to reimburse public grants presumed to have been diverted from their purposes. Orpea has around 14,000 employees and 228 nursing homes in France, which last year housed 27,392 residents.
Pure accounting management
“It is a very comprehensive and informative report. It demonstrates many operating anomalies, at all levels,” greets Senator Bernard Bonne (LR), co-rapporteur of the committee of inquiry into the control of nursing homes in the Senate, who is preparing to hear the inspectors.
→ READ. The government wants more transparency in nursing homes
Main dysfunction: the dominant weight of financial indicators in the management of establishments. “Orpea’s extremely centralized management is entirely dictated by a financial performance objective”, thus note the inspectors. Each nursing home manager is, for example, subject to a “daily budget reporting” for “meet the objectives set for it in terms of payroll, net income or occupancy rate”.
Irregular budgetary practices
The report also scrutinizes Orpea’s budgetary practices: by spending less than what was planned in its estimated revenue, the group thus “reserved” part of the grants from the Regional Health Agencies (ARS) and departmental councils. A maneuver that has enabled Orpea to generate a surplus of 20 million euros, intended to support the care and dependency of its elderly residents.
Added to this is the irregular use of the public allocation of 50 million euros over the period 2017-2020, to recruit “non-qualified carers”, according to the authors of the report. Recourse to untrained personnel which alters the accompaniment of dependency. With, as direct victims, the residents of the nursing homes of Orpea.
Serious consequences for residents
The report points out that “the residents’ day is dictated by the pace of the staff” or that “Bedtimes can occur at very early or too late times”. A nurse’s aide confirmed to inspectors that she put residents to bed in their beds from 5 p.m. or after midnight, for lack of sufficient staff.
This organization, based on profitability, “implies a lower capacity to monitor residents, especially the most dependent, and therefore increases the risk of adverse events”, like falls, still denounce the inspectors. They thus report ” 29 Orpea residents hospitalized per day » on average in February, of which “85% urgent”. Accidents most of the time absent from the medical records of residents.
In terms of food, the figures are also clear: in the month of February, nearly 53% of Orpea residents were undernourished. “severe to moderate”. In question, the « grammages » meals served to seniors, who are “significantly and systematically insufficient”.
→ READ. Abuse in nursing homes, a lasting electroshock?
So many shortcomings that had already been highlighted in the book-investigation The Gravediggers, written by journalist Victor Castanet. And which echo the complaints filed by 80 families against the Orpea group, Monday April 4, for “endangering the lives of others”, ” manslaughter “ and “negligent abuse”.