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Mariner Reference Pages
Origins . . . . The Market . . . . Care Before . . . . Care After . . . . Fraud . . . . Politics . . . . Culture
The many extracts on this page are from copyright material. 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 all of the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of the allegations made.

Mariner in the Marketplace

The extracts on this page describe the market fortunes of Mariner Post-Acute Network after its formation in July 1998 - its slippery slide into Bankruptcy.

The Extent of Mariner's Operations

Mariner Post-Acute Network was a vast integrated empire built on the principles of integration and market dominance - the idea that bigger is best. It survived for only 18 months before entering Chapter 11 bankruptcy. It lived out the ideological beliefs of the marketplace - the recipes for success were in place but not surprisingly success did not come. The introductory extracts are from later articles. They give some idea of this empire.

Mariner Post-Acute Network Announces 1998 Fiscal Year Results
PR Newswire December 29, 1998

Prism Rehab Systems, the Company's contract therapy provider, provides therapy and rehabilitation staffing services to more than 1,200 long-term care facilities. Rehability operates more than 200 outpatient clinics and hospital therapy departments. 

COMMENT:- An outline of Mariners integrated system of care. By April 1999 when this article was published times were hard. It had been forced to sell Rehability, its outpatient rehabilitation clinics and hospital rehabilitation management contract business. Rehability was a subgroup of Prism (see above). This cog in the integrated machine was under pressure from the new Medicare funding.

Mariner Post-Acute Network Announces Asset Sales
PR Newswire April 28, 1999

Mariner Post-Acute Network, Inc., headquartered in Atlanta, Georgia, operates 421 skilled nursing, sub-acute and assisted living facilities with more than 50,000 beds. American Pharmaceutical Services, the Company's institutional pharmacy group, operates 41 institutional pharmacies, serving more than 1,000 facilities, comprising approximately 125,000 beds.

In addition, the Company's Specialty Hospital group operates 11 LTAC hospitals in key markets. Mariner Specialty Services manages more than 100 programs for long-term care providers and acute-care hospitals, provides physician management services and operates 30 branches that provide home health, hospice and private duty nursing services.

Nursing Home ChainTo Lay Off 7,300 - - - (Mariner)
AP Online May 18, 1999

The bulk of its operations are in Texas, California, Florida and North Carolina.

Mariner's rapid decent into bankruptcy

Mariner Post-Acute Network's history in the marketplace is the story of a rapid descent into bankruptcy. Within 4 months Standard and Poor had started downgrading the company. Within 6 months it was renegotiating the terms and conditions of its loans.

Mariner was forced to rapidly unbundle its empire, selling into a buyers market. Its share prices toppled. Apollo one of the original backers, which might have bailed it out sold its entire holding in Mariner. Mariner's shares were delisted from the stock exchange and within eighteen months of its foundation it was in chapter 11 bankruptcy. It continued to close and sell off facilities.

COMMENT:- Within four months of mariner's birth cracks are appearing. Even the marketplace sounds a warning.

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


Mariner Post-Acute Network

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

Mariner Health Group, Inc.

Corporate credit rating . . . . . B+
Subordinated debt . . . . . . . . . . B-

COMMENT:- Home health when integrated into a network had promised profits and nursing home referrals. Most nursing home chains set up home health services. With the new Medicare system home health was not performing well. Companies feeling the squeeze started selling. How the community would be best served was never a consideration. The newly formed Mariner Post-Acute Network was soon in trouble and sold its home health business. 

Modern Healthcare November 09, 1998

Other long-term-care companies, including Atlanta-based Mariner Post-Acute Network, are paring their home-care holdings as well, he said. ''But there is no other publicly traded company that has as much exposure in home health as IHS.''
Standard & Poor's said they are worried that debt-laden companies might not have the financial flexibility to weather the drop-off in reimbursement.

The designation, which affects more than $8 billion in rated debt, indicates that Standard & Poor's could lower credit ratings for the companies.

Included in the listing were Kennett Square, Pa.-based Genesis Health Ventures; Owings Mills, Md.-based Integrated Health Services; Atlanta-based Mariner Post-Acute Network; and Louisville, Ky.-based Vencor.

COMMENT:- It is clear from the following that Mariner targeted Medicare rather than Medicaid. At one time it could have charged for all of the ancillary services which it provided -- but no more!

Businesses react to cuts in Medicare
The Tampa Tribune November 15, 1998

Phelan complains Medicaid pays only about $ 90 per day per poor resident, and that doesn't even cover basic care costs.

But he and others say little about the money they get from residents paying privately and from Medicare, which provides 10 percent to 25 percent of most nursing home revenue.

In a quarterly statement in May, Mariner Health Group reported company-wide revenues averaging $ 60,000 per year per resident. That's $ 164 a day.

COMMENT:- Only 6 months after it raised the loans to fund its expansion Mariner is going to its creditors cap in hand.

Bank Letter 12/21/98

Healthcare companies are flocking back to the bank market to loosen covenants on their credit agreements as they wrestle with Medicare's prospective pay system, bankers said.
Companies currently seeking amendments to the credit agreements reportedly include Mariner Post-Acute Network and Integrated Health Services. Sun Healthcare and Genesis Health Ventures are among companies that have already altered leverage covenants.

According to a banker close to Mariner, the company needs to loosen covenants concerning leverage on a credit led by Chase Manhattan Bank that finances the merger between Mariner Health Group and Paragon Health Network.

The company has submitted a proposal to its lenders, offering as compensation a 1/4 point amendment fee and increased pricing on the facility.

COMMENT:- The sharemarket has the message and is selling Mariner's shares.

Bed News: The Business Potential Of Nursing Homes Is Elusive, Vencor Finds: Bid for High-Paying Patients Brings Firm Headaches, And It Has to Regroup: Medicaid Is Welcome Now
The Wall Street Journal 12/24/98
By Chris Adams and Michael Moss

Stock values reflect the problems. A nursing-home company assembled by financier Leon Black, Mariner Post-Acute Network Inc., has seen its share price fall nearly 75% since spring.

COMMENT:- Like the other chains Mariner started off with the best of intentions. They believed that they could be competitive by doing the right things.

Wall street would however impose its own rules on the care patients would receive. As always there are many excuses but no acknowledgment that they made a terrible mistake and totally misjudged the situation.

Mariner Post-Acute Network Announces 1998 Fiscal Year Results
PR Newswire December 29, 1998

"The impact of the Balanced Budget Act of 1997, including the transition to the Prospective Payment System (PPS), combined with lower than expected census, higher than expected operating costs and external pressures from regulators, litigators, elected officials and the media, contributed to a difficult year for our company," commented Keith B. Pitts, Mariner Post-Acute Network's chairman of the board and chief executive officer.

"While external pressures and PPS will continue to present tremendous challenges to our industry, we have created a company that is prepared to meet those challenges. Today, Mariner has a strong operating platform of skilled nursing facilities with critical mass in strategic population centers, including leadership positions in key markets Houston, Northern California, Milwaukee, Baltimore/D.C., Phoenix, Milwaukee, Orlando and Denver."

"We have also made investments essential to creating a model organization, including: MarinerCare clinical programs, which provide facility staff with uniform guidelines and care maps focused on achieving each patient's optimal health, level of function and quality of life; a Washington D.C.-based independent Office of Ethics and Compliance, manned by registered nurses and headed by a former senior investigator from the United States Senate; a background check program designed to meet and often exceed regulatory requirements, attract the best employees and reduce employee turnover; and, Mariner University, which provides PPS and other key training for clinical and administrative staff. Put simply, we are committed to providing high quality care to our patients, treating our employees with dignity and respect, and enhancing shareholder value," said Pitts.

COMMENT:- The following extract reveals the way these corporations think about patient care. Everything except actual care needed by patients plays a part in determining care. Most patients require individualised care but that is not what they will get. They will get the standardised care, which is most profitable. Results are measured in census not in the care provided. These chains generate profits by adopting a factory approach to individuals and their individuality. This is the "advantage" of size.

Incentivising management to focus on the business from a cash flow perspective will inevitably result in staffing and equipment cuts.

Cutting salaries and increasing throughput in therapies produces resentment and also compromises care, unless there was excess in the system which was unlikely.

The thinking and the emphasis here resembles Tenet/NME and Columbia/HCA.

In addition, the company has identified six key areas of operational focus for 1999, including:

Modern Healthcare March 01, 1999

* Mariner Post-Acute Network, formed last year in a giant long-term-care merger, announced a $39 million loss, or 53 cents per share, in its first quarter ended Dec. 31, 1998.

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

The ratings for these companies - Genesis Health Ventures Inc., Integrated Health Services Inc., Mariner Post-Acute Network Inc., NovaCare Inc., and Sun Healthcare Group Inc. - remain on CreditWatch with negative implications, S&P said.


Mariner Post-Acute Network Inc.-- To - - - From

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

Mariner Health Group Inc.

Corporate credit rating . . . . . . . . . . . . . . . B- . . . . . . B+
Subordinated debt . . . . . . . . . . . . . . . . . . . CCC. . . . . . . B-

Modern Healthcare March 08, 1999

The nursing home industry continued to nosedive last week, as rating agency Standard & Poor's downgraded debt held by several companies. One of them, Sun Healthcare Group, said its assets were overvalued.

The rating agency lowered corporate debt ratings to reflect ''significant near-term liquidity issues'' for Genesis Health Ventures, Kennett Square, Pa.; Integrated Health Services, Owings Mills, Md.; Mariner Post-Acute Network, Atlanta; and Albuquerque-based Sun, according to Standard & Poor's analyst Elie Radinsky.
This indicates ''serious financial difficulties,'' Radinsky said. These companies may need to sell parts of their businesses to meet their debt obligations.

Bank Loan Report March 15, 1999

OTHER LENDERS: Bank Austria, Mellon Bank, Toronto-Dominion, BT Alex. Brown, Credit Lyonnais, Amsouth Bank, Bank of Tokyo-Mitsubishi, J.P. Morgan, SunTrust Bank, Bank One, Fleet Bank, Comerica Bank, First Chicago NBD, Industrial Bank of Japan, Long-Term Credit Bank, Riggs Bank

AMOUNT: $210 mil.
TYPE: Term loan
MATURITY: 01/03/00

Outcry Grows Over Nursing Home PPS Losses, But Some Are Doing Fine.
Medicine & Health April 26, 1999

Perhaps the most dramatic evidence of the new straightened circumstances in which nursing home owners find themselves was the decision last month by Standard & Poor's to lower the debt ratings on five major operators: Genesis Health Ventures, Integrated Health Services, Mariner Post-Acute Network, NovaCare, and Sun Healthcare Group. Those five were singled out because they are highly leveraged and S&P said it had worries about "the increasing impact of PPS on corporations laden with substantial debt."

COMMENT:- Eight months after the merger Mariner is in serious trouble. It is forced to start selling into a buyers market. Bankers have stopped lending to potential buyers. Rehabilitation services were previously paid per item of service. They are now dispensable.

Mariner Post-Acute Network Announces Asset Sales
PR Newswire April 28, 1999

Mariner Post-Acute Network (NYSE: MPN), a leading long-term care provider, today announced it has entered into definitive agreements to sell Rehability, its outpatient rehabilitation clinics and hospital rehabilitation management contract business. Rehability's outpatient rehabilitation clinics will be sold to HealthSouth, the nation's largest provider of outpatient surgery centers and rehabilitative healthcare services, based in Birmingham, Alabama. In addition, Rehability's hospital rehabilitation management contracts will be sold to National Rehab Partners, Inc., based in Brentwood, Tennessee.

Modern Healthcare May 03, 1999

One man's hot potato is another man's meal.

That's nowhere more obvious than in the long-term-care industry, where some companies drop businesses like so many hot potatoes and others just as eagerly snap them up.

Last week, Atlanta-based Mariner Post-Acute Network said it would sell about 170 outpatient rehabilitation clinics in 18 states to Birmingham, Ala.-based HealthSouth Corp. Although both companies are publicly traded, terms of the cash transaction were not disclosed.
Long-term-care chains are trying to stem staggering losses with strategic changes, paring operations to core competencies and selling or closing everything else.

Mariner lost $39 million on revenues of $672.7 million for the first quarter ended Dec. 31, 1998, after a loss of $209.7 million on revenues of $2 billion for the year ended Sept. 30, 1998.

Mariner blames much of its poor showing on losses in Medicare revenues because of the PPS. The sale to HealthSouth is part of the company's hasty exit from the rehabilitation business.

Earlier this month, Mariner's contract therapy division, Prism Rehab Systems, told its 900 unaffiliated nursing home customers that it was shutting down operations by May 31.

Mariner Post-Acute Network Announces Second Quarter Results
PR Newswire May 17, 1999,

For the six months ended March 31, 1999, after adjustment for certain unusual items, the Company recorded net revenue of $1,287 million, EBITDA of $99 million, a net loss of $57 million and a net loss per basic and diluted share of $0.77. On a comparable recurring basis, this compared with net revenue of $909 million, EBITDA of $97 million, net income of $3 million and earnings per basic and diluted share of $0.07 for Paragon Health Network, Inc. for the prior year six-month period.
Due to net losses resulting from these Medicare cuts, the Company was in violation of several covenants under both of its senior credit facilities. On May 12, 1999, the Company received a waiver from its lenders under the Paragon credit facility, and is actively pursuing a waiver from the Mariner Health credit facility lenders. The Paragon waiver and requested Mariner Health waiver result in a limitation on revolving credit availability, a tightening of financial covenants and an increase in pricing on borrowings.

On April 12, 1999, as a result of debilitating reductions in Part A and Part B reimbursements, the Company's rehabilitation subsidiary, Prism Rehab Systems, notified customers, including Mariner's long-term care facilities, of its intention to cancel its contracts to provide rehabilitation services effective May 31, 1999.

This discontinuation of services will effectively close Prism, the Company's contract therapy business. Prism was one of the leading contract therapy businesses in the country. To date, the Company has laid off more than 7,000 Prism employees due to cuts resulting from the 1997 Balanced Budget Act.
As part of the restructuring plan, over 300 corporate employees have left or will be leaving the Company.

Atlanta nursing home chain to cut 7,300 jobs
The Atlanta Journal and Constitution May 18, 1999

Atlanta-based Mariner Post-Acute Network, citing deep Medicare reimbursement cuts, announced Monday that it was laying off about 7,300 employees --- nearly 300 in Georgia --- because it is closing its rehabilitation business and restructuring.

Mariner, among the top three nursing home operators nationally, also reported a second-quarter loss of about $ 79 million. Mariner's shares fell 31 1/4 cents to $ 2.68 3/4.
Medicare also has capped the amount of physical, occupational and speech therapy a patient can receive in a year. Mariner cited those caps as a reason for closing its rehabilitation business.
"We were expecting a weak quarter; this is far weaker than we expected," said analyst Victor Seoane of Robinson-Humphrey.

The next six months are important for Mariner, Seoane added. "They have to improve their cash flow, and I would expect to see some asset sales."

Nursing Home Chain To Lay Off 7,300
AP Online May 18, 1999

Mariner, which has 400 nursing homes with 50,000 beds, plans to eliminate 11 percent of the jobs in its work force of 65,000.

''About 300 (layoffs) are corporate, the rest are rehabilitation therapists,'' company spokeswoman Kym Spell said Tuesday. ''We are not closing any homes.''

On the news, Mariner stock tumbled 20 percent Tuesday, or by 561/4 cents, to close at $2.121/2 a share on the New York Stock Exchange.

Nursing home operator hires executive to run Texas homes

Mariner Post-Acute Network, a leading national nursing home and assisted-living operator, said yesterday that it is appointing longtime industry executive Sandy Klein to direct its more than 100 homes in Texas.
Klein, who has been president of the Texas Health Care Association for two years, is entering a company in financial pain.

COMMENT:- Note that Mariner may have been charging Medicare more than it was entitled to.

Mariner Post-Acute Downgraded by S&P; Still on Watch
Business Wire June 11, 1999

Standard & Poor's CreditWire--June 11, 1999--Standard & Poor's ratings for Mariner Post-Acute Network and related entity, Mariner Health Group Inc., have been lowered and remain on CreditWatch with negative implications. (See list below). The ratings were originally placed on CreditWatch Nov. 3, 1998. Standard & Poor's now has heightened concern that there may not be sufficient liquidity in meeting near-term interest and principal obligations.

Key issues include:

COMMENT:- One can only wonder at what is going on behind the scenes. Are they dumping Pitts or is he leaving the sinking ship? Pitts is joining Vanguard which was founded in 1997 by Charles Martin Jr. the chairman of OrNda Healthcare with whom Pitts once worked. In 1997 OrNda paid a large settlement for fraud, which included paying kickbacks. Pitts was at the helm as Grancare started to gobble one company after another building up the debt which is now destroying it.

Mariner Post-Acute Network Announces Senior Management Change
PR Newswire June 11, 1999

Mariner Post-Acute Network, Inc. (NYSE: MPN) today announced the resignation of chairman and chief executive officer Keith B. Pitts. Mr. Pitts will leave the Company, effective immediately, to join Vanguard Health Systems, Inc. a privately held hospital corporation based in Nashville, Tennessee.
As a result of the impact of the BBA (1997 Balanced Budget Act ) and other factors, the Mariner board of directors formed a special committee to examine the Company's capital structure and restructuring alternatives. Bear, Stearns and Company has been retained as advisor to the special committee.

Bonds to run away from
FORBES June 14, 1999

Nursing home operators like Genesis Health Ventures, Integrated Health Services and Mariner Health have all been further downgraded.

Nursing Home Industry's Financial Crisis Threatens Patient Care
The Washington Post June 19, 1999

Whatever the cause may be, the industry's vital statistics paint a bleak picture. Take, for example, losses reported for the quarter that ended March 31, which include some one-time charges:
$ 78.8 million at Atlanta-based Mariner Post-Acute Network Inc., compared with a loss of $ 4.5 million a year earlier;

The stock of both Sun Healthcare Group and Mariner Post-Acute have lost nearly all of their value.

Index of change, weekly, June 12, 1998 = 100
S&P 500 index: Up 22%
Sun Healthcare Group: Down 98 %
Mariner Post-Acute: Down 96 %

COMMENT:- One wonders how one can lay off 7,300 staff without compromising care. The information available suggests that the Grancare - Paragon - Mariner lineage did not provide good care with the staff it already had!

Mariner's layoffs

For Mariner, Medicare cuts led to its May announcement of a layoff of 7,300 employees, or 11 percent of its 65,000member work force. "No patient-care staff has been laid off or cut back," Watson said. "So far, no one has cut quality of care."' He said he doesn't expect that nursing homes will close, but if they do, patients will be moved to other facilities. In addition to the job cuts, Mariner is closing 20 offices and selling some of its rehabilitation business to HealthSouth Corp. in Birmingham, Ala, and National Rehab Partners Inc. in Brentwood, Tenn.

Mariner's latest distress came last month when its CEO and chairman, Keith Pitts, abruptly resigned to take a position at a private acute-care hospital in Nashville, Tenn.

Mariner lost $ 209.7 million last year, compared with its net gain of $ 43.9 million in 1997. Revenues increased from $ 1.1 billion in 1997 to $ 2 billion last year.

Modern Healthcare July 12, 1999

HealthSouth Corp., Birmingham, Ala., has completed its acquisition of Atlanta-based Mariner Post-Acute Network's approximately 170 outpatient clinics. - - - - HealthSouth disclosed the $55 million purchase price.

COMMENT:- The ship is clearly sinking and the rats know it!

HEADLINE: NATION/WORLD ::: Compaq names Napier CIO in restructuring

Compaq Computer Corp., the world's largest personal computer maker, named Robert Napier chief information officer - - - - who was chief information officer for Mariner Post-Acute Network Inc.

Los Angeles Times July 15, 1999

John B. Evans has joined Costa Mesa-based ARV Assisted Living Inc. as vice president, operations - - - -was previously regional vice president of operations for Mariner Post Acute Network in Hayward.

Rehability closing HQ after sale
Nashville Business Journal July 23, 1999

Brentwood-based Rehability Corp.'s 165 local employees are looking for new jobs now that two health care companies have acquired the company's assets.

By November, the Nashville headquarters of Rehability Corp. will be shut down, spurred by the purchase of separate segments of Rehability's operations by Birmingham-based HealthSouth Corp. (NYSE: HRC) and Brentwood-based National Rehab Partners Inc.

Modern Healthcare July 26, 1999

Atlanta-based Mariner Post-Acute Network is similarly discussing repayment terms with its lenders, and its stock price has been below $1 per share since June, compared with $16 per share a year ago.
Before the PPS, companies such as Mariner, Sun and Vencor borrowed heavily to pay for acquisitions and other expansions. They also had historically high per-day Medicare revenues because they actively sought patients who were more difficult to treat and who could generate higher reimbursement, and they contracted to provide plenty of therapy to outside nursing homes. As long as Medicare revenues stayed high and contract therapy remained profitable, those companies could make good on their steep loan repayments.

But the PPS cut Medicare payments sharply and brought contract therapy to a near standstill. These companies can look forward to several more years of cuts as PPS rates are phased in.

Crain's New York Business August 09, 1999
Jon Birger

Russell Ray's biggest deal last year turned out to be a doozy.

Mr. Ray, then head of health care investment banking at BT Alex. Brown, helped negotiate the $1.2 billion sale of Mariner Health Group to Paragon Health Network. The combination was supposed to create a powerhouse in the U.S. nursing home business, but within five months the company's stock had lost three-quarters of its market value.

Today, Mariner is trading at under $1 per share -- which is ironic considering that Mr. Ray's own stock has never been higher.

In May, he and 40 members of his department bolted for Credit Suisse First Boston, and headhunters put the value of Mr. Ray's new contract at an eye-popping $2.5 million a year.

Loan Market Week August 16, 1999

Bids for Paragon Health Network bank debt dived more than 20 points last week, after Mariner Post-Acute Network, which owns the Paragon debt, had an Aug. 5 conference call with lenders about Paragon's recent performance. The company has been under observation by the lenders since it violated its covenants in early June, a trader noted. "Operationally things got worse when people thought they would be getting better," he said, nothing the bid-offer spread for the paper two weeks ago stood at about 66-70, but slumped to about 45-55 after the conference call. Chase Manhattan Bank and Bank of America lead the $ 990 million Paragon deal. Officials at the company did not return repeated calls.
The Mariner-Paragon bank deal has been sliding since the middle of June, when ratings agencies Standard & Poor's and Moody's Investers Services noted the company was in violation of its covenants and downgraded the credit facility to CCC and Caa2, respectively.
An analyst is the lack of news coming out of the company is disturbing. "It's not surprising. You always want to leave the worst news until the last possible moment," he commented, noting the firm's best hope lay with principal equity investor Apollo Management, which might inject more cash into the firm in order to ensure its survival. Officials at Apollo did not return calls.

Mariner Post-Acute Network Announces Third Quarter Results
PR Newswire August 17, 1999, Tuesday

Mariner Post-Acute Network, Inc. (NYSE: MPN) today announced operating results for its third fiscal quarter which ended June 30, 1999. For the third fiscal quarter, the Company recorded net revenue of $365.3 million, a net loss of $405.7 million and a net loss per basic and diluted share of $5.51. These results include $351.0 million in unusual charges to earnings which are further explained in this release. This compared with net revenue of $494.1 million, a net loss of $0.2 million and a not loss per basic and diluted share of $0.01 for the 1998 third fiscal quarter for Paragon Health Network, Inc.
To achieve the Company's objective of reducing annual corporate overhead by at least $50 million, and eliminating the distraction of non-core businesses, the following milestones have been achieved:

Mariner posts big loss for quarter;
The Atlanta Journal and Constitution August 18, 1999

Nursing home operator struggles to stem losses blamed on Medicare changes that cut its reimbursement.

Mariner Post-Acute Network, one of the nation's top three nursing home operators, Tuesday posted a fiscal third-quarter loss of $405.7 million, including a charge of $351 million.
The company also said Tuesday it sold its three corporate aircraft and its part- ownership of a fourth.
Mariner's shares rose 6 1/4 cents to close at 56 1/4 cents on the New York Stock Exchange. The company, which employs about 55,000 people, now has a market value of about $ 41.4 million.

Modern Healthcare August 30, 1999

National Rehab Partners has completed its purchase of Atlanta-based Mariner Post-Acute Network's hospital rehabilitation management contracts.

Perennial insists loss is part of smart shift in its strategy
The Courier-Journal (Louisville, KY.) September 4, 1999

The same problem has been cited as a major factor in the near bankrupt condition of national nursing home chains Sun Healthcare, Mariner Post-Acute Network and Louisvillebased Vencor Inc.

COMMENT:- Could this be another group which like Beverly Healthcare sees franchising as the future of nursing home care?

Troubled Mariner names hotel exec to three top posts; Varied career: New head of nursing home company also has background in health care.
The Atlanta Journal and Constitution, September 9, 1999

Mariner Post-Acute Network, staggered by large financial losses, Wednesday announced the appointment of Francis W. ''Butch'' Cash as chairman, chief executive and president.
For the past four years, Cash, 57, has been chairman, president and CEO of Red Roof Inns, an economy hotel chain. At Ohio-based Red Roof, Cash presided over a growth spurt that was aided by a franchise initiative, said Mark Woodworth of PKF Consulting in Atlanta. "Prior to (Cash's tenure) all Red Roof Inns were owned and operated by the company,'' Woodworth said.
Cash also has health care experience. From 1992 to 1995, he was president and chief operating officer of NovaCare, a rehabilitation management services company.

PRISM REHAB SYSTEM TO CLOSE BRENTWOOD SITE; Therapy management company still in Atlanta, Texas
The Tennessean September 17, 1999

The Brentwood office of Prism Rehab Systems will close this fall, two years after Prism was purchased by an Atlanta-based health-care company.

The closure comes as Mariner Post-Acute Network Inc. which paid more than $ 92 million in cash and assumed debt for Boston-based Prism in late 1997 disassembles Prism's physical therapy and rehabilitation management operations nationwide, blaming cutbacks in Medicare reimbursements.

About 7,000 employees around the country are losing their jobs.

As part of the divestiture, Mariner has also sold off Prism's corporate sibling, Rehability outpatient physical rehabilitation clinics and hospital rehabilitation management contract business.

Mariner Post-Acute Network to Suspend Certain Interest Payments and be Delisted from NYSE
PR Newswire October 1, 1999, Friday

Mariner Post-Acute Network (NYSE: MPN) announced today that its subsidiary, Mariner Health Group, Inc., has not made the interest payments now due on its bank credit facility and 9-1/2% senior subordinated notes due 2006. In addition, Mariner Post-Acute Network will not make the interest payment due November 1st on its 9-1/2% senior subordinated notes due 2007. The Company also announced that it has been notified by the New York Stock Exchange (NYSE) that it has fallen below its continued listing criteria. Management is working with the NYSE to effect a smooth transition to allow the stock to trade on the over-the-counter market subsequent to the delisting which is expected to occur in October.

The Atlanta Journal and Constitution October 2, 1999

The company said it plans to trade on the over-the-counter market after the delisting, expected to occur in October

St. Petersburg Times October 05, 1999

The state Agency for Health Care Administration is monitoring the 28 Florida nursing homes owned by Mariner Post-Acute Network Inc.

LTC Healthcare Inc. Announces the Commencement of Nursing Home Operations
Business Wire October 14, 1999, Thursday

Oct. 14, 1999--LTC Healthcare Inc. (PCX:LTI) announced that it has completed a series of transactions resulting in the commencement of nursing home operations.

As a result of these transactions, LTI is the operator of 27 skilled nursing facilities, one assisted living facility and one hospital. Effective Sept. 1, 1999, the company entered into long-term leases with LTC Properties Inc. (NYSE:LTC) and began operating six skilled nursing facilities that were previously operated by Mariner Post-Acute Networks Inc.

The Wall Street Transcript Publishes Long Term Care Stocks Report
PR Newswire October 21, 1999
SOURCE The Wall Street Transcript

Basically PPS, in my view, made several of the strategies employed by companies somewhat obsolete, Capek states, "And exacerbating that obsolescence was constraining or very high debt levels. I would put Vencor (OTC Bulletin Board: VCRI), Sun (OTC Bulletin Board: SHGE), Mariner (NYSE: MPN), to a certain extent Integrated (NYSE: IHS), and even Genesis (NYSE: GHV) in that category.

Change and Crisis in Nursing Homes
The New York Times December 13, 1999

Two others, Mariner and Integrated Health Services, are trading at pennies a share.

Long-Term Health Despair
The Motley Fool (Dec. 21, 1999)

As the year draws to a close, many operators are in critical condition financially, with several already having slipped into full-out bankruptcy comas.

The destruction has been startling, as the following chart shows:

Company . . . . . . . . . . . . . . . . . . .52-Week High . . . .12/10/99 . . . . Price % Decline

Beverly Enterprises (NYSE: BEV) . . . $8 3/16 . . . . . . . .$3 7/8 . . . . . . -52%

Manor Care (NYSE: HCR) . . . . . . . . . . $33 1/2 . . . . . . $16 1/16 . . . . -52%

Genesis Health Ventures (NYSE: GHV) . $9 1/2 . . . . . . . $2 3/8 . . . . . -75%

Centennial HealthCare (Nasdaq: CTEN) . $15 9/16 . . . . . $2 15/16 . . . -81%

Integrated Health (NYSE: IHS) . . . . . . . $14 11/16 . . . . $9/32 . . . . . . -98%

Vencor (OTC BB: VCRI) . . . . . . . . . . . $5 . . . . . . . . . . . . $0.085 . . . . . -98%

Mariner Post-Acute (OTC BB: MPAN) . $6 3/8 . . . . . . . . . $0.09 . . . . . . -99%

Sun Healthcare (OTC BB: SHGE) . . . . . $6 7/8 . . . . . . . . . $0.04 . . . . . . -99%

Meanwhile, heavily leveraged public operators such as Mariner Post-Acute Networks and Integrated Health are teetering on the brink of insolvency.

Mariner Post-Acute Network Announces Filing for Chapter 11 to Reorganize Debt; Normal Operations to Continue in all Mariner Facilities
Company Press Release Tuesday January 18, 11:25 am Eastern Time

ATLANTA, Jan. 18 /PRNewswire/ -- Mariner Post-Acute Network, Inc. (OTC Bulletin Board: MPAN - news) and Mariner Health Group, Inc., and certain of their respective subsidiaries (``Mariner'') have filed separate voluntary petitions under Chapter 11 of the U.S. Bankruptcy Code with the U.S. Bankruptcy Court for the District of Delaware.
In addition to the Chapter 11 filing, Mariner announced that Apollo Management, LP and its affiliates sold on December 20, 1999 substantially all the Mariner equity owned by Apollo and its affiliates. As a result, all Apollo board of directors designees resigned from the Mariner board effective January 2, 2000.

Second-largest nursing home chain seeks bankruptcy protection
The Associated Press January 18, 2000, Tuesday, PM cycle

Atlanta-based Mariner Post-Acute Network, which runs more than 400 nursing homes nationwide, said it had secured $150 million in debt financing from Chase Manhattan Bank and PNC Bank.

COMMENT:- Industry always says what it wants to believe regardless of the accuracy and improbability of the statements. The truth is obvious and simple - care costs money - the less money the less care. The chains have displayed their willingness to understaffing when making a profit. What do we expect when they face bankruptcy?

Another nursing chain goes bankrupt Mariner joins Sun Healthcare
The Courier-Journal (Louisville, KY.) January 19, 2000

For the third time in four months, a major nursing-home company has filed for Chapter 11 bankruptcy protection.
But does the financial devastation and the restructuring to follow among some of the country's largest nursing-home providers mean trouble for patients and residents as well?

Industry analysts say mostly no.
They lost that wager with the enactment of the Balanced Budget Act. Ransom said that ''it just completely eviscerated the . . . Medicare business model'' the companies bet on.

Mariner Post-Acute Network Lists Largest Creditors
Business Wire January 21, 2000, Friday (, an Internet site providing in-depth information on major bankruptcies, announced that the lists of creditors holding the 40 largest unsecured claims against Mariner Post-Acute Network, Inc. (OTC BB:MPAN) and Mariner Health Group, Inc. are now available on the website.
(Note:- The following was constructed from article)

Mariner Post-Acute

  • IBJ Schroder & Company, which serves as indenture trustee on Mariner Post-Acute's $275 million of 9.5% Senior Notes due 2007 and its $294 million of 10.5% Discount Notes due 2007
  • U.S. Department of Human Services Health Care Financing Administration with an undetermined amount of Medicare Program Liabilities.
  • Third is Neighborcare Pharmacy with trade debt of $13.2 million.

Mariner Health Group

  • State Street Bank & Trust Company which serves as indenture trustee for Mariner Health's $150 million of Senior Subordinated Notes due 2006
  • Second on the list is the U.S. Department of Human Services Health Care Financing Administration with $5.1 million of Extended Repayment Plan claims.
  • Third is Aetna/U.S. Healthcare/Prudential with $956,124 of trade debt.

COMMENT:- The REITs lease the nursing homes to the corporate chains. The REITS raised loans to buy them. When the chains can't pay the leases then the REITS are in trouble too.

Omega Announces 1999 Financial Results and Establishes the First Quarter Dividend
Business Wire January 21, 2000, Friday

The company also reported that on Jan. 18, Mariner Post-Acute Network Inc. (Nasdaq:MPAN) ("Mariner"), a customer of the company, filed for bankruptcy reorganization in Federal Bankruptcy Court in Wilmington, Del. Mariner owns and operates through a subsidiary 16 properties which are subject to an existing $64 million first mortgage lien to the company.

Domestic News: Health Care Chain Gets DIP Loan
Bank Loan Report January 24, 2000

Bankrupt Mariner Post-Acute Network Inc. (formerly known as Paragon Health Network Inc.), the nation's second largest nursing home operator, has obtained $100 million in debtor-in-possession financing from Chase Manhattan.

At the same time, Mariner Health Group Inc., which Paragon acquired in July 1998, has also received a $50 million DIP from PNC Bank.
During the fiscal year ended June 30, 1999, the company experienced losses totaling $7.73 per share. Its stock value also fell by 96.2% in the past 52 weeks to close at $0.17 per share on Jan. 14. The company defaulted on its bank loans in March 1999.

As of June 30, 1999, Mariner Post-Acute Network had outstanding bank facilities that included a $166.4 million revolver, a $292.9 million A-term loan, a $248.5 million B-term loan and a $248.5 million C-term loan.

Loan Market Week January 24, 2000

An original lender last week sold about $ 10 million of Mariner Health Group's bank debt, on the heels of a Jan. 18 Chapter 11 bankruptcy filing by parent company Mariner Post-Acute Network. Traders noted this was the first time the paper has traded, and said it fetched around 25 in a retail sale.

COMMENT:- Many chains lease their facilities from REITS. The REITS also borrow to buy. When the companies cant pay their leases then the REITS are in trouble too.

Senior Housing Properties Trust Announces Record Date for Annual Meeting and the Timing of Expected Reporting of Year End 1999 Results
Business Wire February 18, 2000, Friday

Two of these tenants, Integrated Health Services, Inc. (NASDQ: IHSV) and Mariner Post Acute Network, Inc. (NASDQ: MPANE) filed for bankruptcy subsequent to year-end 1999 and the third tenant, Frontier Group, Inc. has been in bankruptcy and receivership since July 1999. Combined these three tenants are responsible for approximately 50% of SNH's revenues and represent 39% of SNH's investments at depreciated cost. The current negotiations include, but are not limited to, the possibilities that SNH will sell properties, that lease terms may be changed, that new tenants may begin operations of properties or that properties may be operated by SNH for its own account.

SNH Announces Agreement With Mariner and Sale of Three Nursing Homes
Business Wire March 22, 2000, Wednesday

Senior Housing Properties Trust (NYSE: SNH) today announced a conditional agreement with Mariner Post-Acute Network, Inc. and the sale of three nursing homes formerly leased to Frontier Group, Inc.

SNH currently leases 26 nursing homes (3,482 beds) to Mariner. The annual rent payable to SNH for these properties is approximately$16.7 million per year.

The terms of the conditional agreement between SNH and Mariner are as follows:

-- Mariner's lease obligation for all 26 properties will be terminated.

-- Approximately $24 million of cash and securities now held by SNH to secure the Mariner lease obligations and related guarantees will be retained by SNH.

-- SNH will assume operations for its own account at 17 of these 26 properties. Title to five of these 26 properties will be transferred to Mariner, which will continue those operations. The remaining four nursing homes are now subleased to two private companies; SNH expects to negotiate with these subtenants for their continued operations of these properties.

COMMENT:- When Pitts, the architect of Mariner's debt left suddenly Mariner ran with a committee until they found Cash. Now Cash has also left the sinking ship.

Meditrust Appoints Francis W. Cash as Chief Executive Officer
PR Newswire March 23, 2000

The Meditrust Companies (NYSE: MT) today announced the appointment of Francis W. ("Butch") Cash as chief executive officer of Meditrust. Mr. Cash joins Meditrust on April 17, 2000 and will be based in Dallas, Texas. Since September 1999, Mr. Cash has served as chief executive officer of Mariner Post-Acute Network, the nation's second-largest nursing home company, which operates more than 400 nursing homes nationwide.

Mariner Post-Acute Network Announces Executive Management Changes
Business Wire 03/23/2000

ATLANTA--(BW HealthWire)--March 23, 2000--Mariner Post Acute Network, Inc. today announced the appointments of C. Christian Winkle to the position of chief executive officer and Michael F. Gries chief restructuring officer, effective immediately. Francis W. ("Butch") Cash will leave the Company March 31, 2000.

COMMENT:- Another REITfeeling the pinch.

S&P Revises Outlook on Nationwide Health Properties to Negative
PR Newswire March 23, 2000, Thursday

Standard & Poor's today revised its outlook on Nationwide Health Properties Inc. to negative from stable. In addition, ratings were affirmed on the company and its US$747.9 million in outstanding securities (see list).

The outlook revision reflects Nationwide's exposure to weakened operators, including Beverly Enterprises Inc., Sun Healthcare Group Inc., Mariner Post-Acute Network, Inc., and Integrated Health Services Inc., in light of changes in the Medicare prospective payment system (PPS). Operator stress is now likely to lead to renegotiated lease terms and possible lower profitability and coverage measures for the company.

Mariner digging out of bankruptcy ; Nursing home company is rejecting unfavorable leases, selling unprofitable facilities
Modern Healthcare April 17, 2000, Monday

Bankrupt Mariner Post-Acute Network is shedding a few dozen of its 400 nursing homes across the country, and more almost certainly will follow.

The Atlanta-based company, which declared bankruptcy earlier this year (January 24, p.10), owns some but leases most of the buildings where it operates its long-term-care nursing businesses.

To both raise capital for creditors and focus operations, Mariner has petitioned the U.S. Bankruptcy Court in Wilmington, Del., for permission to reject leases on about 25 facilities it doesn't own and to sell about five facilities it does own.
The majority of Mariner's requests in bankruptcy court involve 26 buildings owned by Senior Housing Properties Trust, a company based in Newton, Mass.
Mariner is selling off other money-losing homes to raise cash.

In one deal, The Ensign Group, a private company based in San Juan Capistrano, Calif., is slated to buy a Mariner home in Phoenix, Ariz., for $1.3 million.

Mariner also plans to sell an 82-bed facility in Des Moines, Iowa, and three facilities in Rochelle, Ill., for a total of $4 million, according to court filings.

Medicare cuts hurt nursing facilities;
The Post and Courier (Charleston, SC) June 11, 2000

On the other hand, before 1997 Medicare's reimbursements were not predetermined, and there was no cap on what the government paid for care.

With hospitals transferring a growing number of patients to nursing homes to recover from difficult procedures, many companies were able to make a considerable amount of money from Medicare patients.

So while overall Medicare accounts for a small number of patients, some companies focused a larger part of their business on Medicare patients. At Mariner Post-Acute, 21 percent of company revenues in 1999 came from Medicare.

In 1997 Congress tightened its reimbursements considerably in the Balanced Budget Act, which reduced payments to nursing homes by $ 9.5 billion over five years. The act implemented a prospective payment system and placed a cap on what it spends per patient per day.
Mariner filed for bankruptcy in January, and IHS followed in February with its Chapter 11 filing. Between the two, they have 3,017 beds, or about 17 percent of the state's 17,531 skilled nursing beds, according to AHCA figures.

Both companies have grown fast. Mariner was formed through a series of mergers, one of which involved Atlanta-based GranCare, which owned two locations in Summerville and one in Simpsonville.

Mariner filed after seeing revenues fall 20 percent in the fourth quarter of 1999. The company blamed Medicare and said the problem was compounded with higher salaries and benefits for employees.

SNH Announces Approval of its Agreements with Mariner and Integrated
Business Wire July 13, 2000, Thursday

Senior Housing Properties Trust (NYSE:SNH) today announced that its agreements with Mariner Post-Acute Networks, Inc. (OTC:MPANE) and Integrated Health Services, Inc. (OTC:IHSV) were approved by the Bankruptcy Courts supervising the Chapter 11 proceedings by Mariner and Integrated.

Mariner turns over eight Wisconsin nursing homes
The Business Journal July 14, 2000

A Massachusetts long-term care company is taking over eight Wisconsin nursing homes owned by Mariner Post Acute Network Inc.

Five Star Quality Care Inc., of Newton, Mass., took over management of the eight ursing homes July 1, according to Evrett Benton, the firm's president and chief executive.
SNH received approval from Bankruptcy Court in late June to repossess the Mariner properties. Since then, Five Star officials have been in contact with Wisconsin nursing home regulators to seek state approval in the transfer of the nursing homes' licenses.
Meanwhile, Five Star has begun correcting many of the patient-care deficiencies and problems cited by state regulators in surveys of Mariner's Wisconsin nursing homes. In April, the state fined one of the homes, River Hills West in Pewaukee, in a case involving a 92-yearold who died of complications of gangrene.

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

Ranked by number of beds as of January 1999

1 Beverly Enterprises Fort Smith, Ark. 62,293

2 Mariner Post -Acute Network Atlanta 49,656

3 HCR Manor Care Toledo, Ohio 47,138

The Stuart News/Port St. Lucie News (Stuart,FL) September 3, 2000

WASHINGTON - One of every four people who live in nursing homes in Florida is being cared for by a company in bankruptcy proceedings.

That's potentially more than 18,500 patients in 145 facilities - 23 percent of the state's total, according to the Florida Health Care Associa-tion, an industry group for nursing homes and assisted-living facilities. Nationwide, the figure is only 10 percent.

These five of the nation's top 10 nursing home chains are in Chapter 11 bankruptcy, meaning they continue to operate their nursing homes while they reorganize:

Mariner Post-Acute Network, Atlanta.

Federal News Service September 5, 2000, Tuesday

So Where are We Now? REITS and commercial banks have written off or taken reserves against billions in nursing home investments: Sun, Integrated, Vencor, Genesis, and Mariner account for the lion's share of the exposure. Approximately 13% of all industry nursing home beds are operating in bankruptcy. Beverly and HCR remain the only viable public companies. Market cap: less than $2 billion vs. a market value exceeding $10 trillion. The industry persists in a state of shock and demoralization with extreme difficulty attracting labor and capital.


Three companies, which run 49 of Colorado's 58 bankrupt homes, are being investigated for defrauding Medicare of hundreds of millions of dollars. They are Vencor, Sun Healthcare, Mariner Post -Acute Network and Integrated Health Services (IHS).
But a recent GAO study found most Medicare fees to nursing homes are fair. It's only the chains' high debt payments that caused the string of bankruptcies, the GAO concluded. They are in trouble because they "took advantage of Medicare's previous payment policies to finance inefficient and unnecessary care delivery . . ."

Standard & Poor's Assigns 'BB+' Rating to Senior Housing Properties
PR Newswire June 12, 2001

In response to tenant bankruptcies that plagued the skilled nursing industry, Senior Housing terminated leases with its two largest financially troubled operators, Integrated Health Services and Mariner Post -Acute, which combined represented over one-third of the company's real estate investments and nearly half of its revenues prior to the 2000 bankruptcy filings by these operators. The company successfully negotiated settlements with these operators and took control of 57 facilities.

The New York Times December 7, 2001

Omnicare Inc., a leading provider of pharmacy services to nursing homes, agreed to buy most of the assets of American Pharmaceutical Services Inc. from Mariner Post-Acute Network Inc. for $97 million.

Mariner parent, unit ready with restructuring plan
Daily Deal (New York, NY) January 16, 2002 Wednesday

The parent company and its health group unit went through 18 debtor-in-possession amendments and stayed in Chapter 11 for 24 months, and now await a bankruptcy judge's ruling on whether their restructuring plan can go to creditors for a vote.
Ultimately, Mariner Post-Acute didn't tap its DIP because management reduced overhead by closing 85 underperforming healthcare facilities. The result: a $240 million boost in cash flow. Another shot in the arm has been the recent completion of the sale of Mariner Post-Acute's pharmaceutical assets to Omnicare Inc., which resulted in $97 million in proceeds upfront, plus $18 million in deferred payments.

Mariner Post-Acute gets reorg plan approved
Daily Deal (New York, NY) March 25, 2002

The reorganization plan calls for creditors of both Mariner Post-Acute and the Mariner Health Group to receive equity, cash and debt in the reorganized company.

The secured lenders of Mariner Post-Acute are slated to receive 96% of the equity of the newly reorganized company, and the unsecured creditors will get the remaining 4%.
In the nine months ending on June 30, 2001, Mariner Post-Acute turned a profit of $49.57 million compared with a loss of $9.9 million in 2000. Assets were listed as $1.28 billion and liabilities at $2.7 billion.

GEORGIA STOCKS: Influential analyst's increase in rating perks up Coca-Cola
The Atlanta Journal and Constitution March 26, 2002

Some 20 million shares of Mariner Post-Acute new common stock will be issued on the date the plan takes effect. All existing Mariner Post-Acute and Mariner Health stock will be canceled, and holders of equity interests will receive no distribution under the plan.

Comment:- Mariner comes out of bankruptcy under the name Mariner Health Care Inc. in May 2002 and I don't have information about its economic performance since then.

Daily Briefing : HEALTH CARE: Facilities operators cleared to combine
The Atlanta Journal and Constitution April 11, 2002

* Atlanta-based Mariner Post-Acute Network and Mariner Health Group will combine into one company under a Chapter 11 reorganization confirmed by a Delaware Bankruptcy Court judge. Mariner Post-Acute, an operator of in-patient and assisted-living centers, said it will combine with its affiliate under the name Mariner Health Care Inc. upon emergence from Chapter 11.

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