"Short staffing was the key issue," Lazzara (patient's lawyer) 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.
(Jury to nursing home: Pay $ 20-million - - St. Petersburg Times September 28, 2000)
Extendicare is the 10th largest nursing home chain in the USA and operates about 300 facilities, mostly nursing homes.
In the Marketplace:- Extendicare is a Canadian company. It operates primarily in the USA. It joined the 1990's acquisition frenzy and used its income stream to buy and buy, so that it would remain competitive. Nearly a year after the government put an end to the exploitation of Medicare it went out and bought Arbor Healthcare for US $432 million.
Within 6 months of this its profits were slipping and it was soon making a loss. Extendicare survived by selling a large number of nursing homes in the USA and closing facilities and services, which were not profitable.
It has now turned to Canada where politicians have been infected with the privatisation and out-sourcing bug. In 2001 it started buying. Some analysts are enthusiastic about its commercial prospects but others have considerable reservation because of its massive debt.
Patient Care:- Complaints, state actions and litigation (e.g.. Florida) suggest that patient care has been a serious problem in a number of Extendicare facilities. It was targeted by litigants in Florida. It had difficulty in obtaining an insurer. It ultimately sold all of its Florida facilities.
Extendicare has the distinction of having a jury award an all time high US $20 million damages even though the patient did not die from the negligent care allegedly provided. Seven staff testified for the patient describing the staffing difficulties as "they never had enough time to feed the patients; there was never enough manpower". The jury concluded that Extendicare was deliberately understaffing and were putting "profits over people". They sent a clear message.
Nurses:- Extendicare has also been in conflict with nursing unions. It is one of the groups which an investigation suggested did not pass government money given specifically to boost nurses' salaries into the nurses' pay packets.
Political activity:- Extendicare has been active politically. It employed senior political figures to lobby for its interests in Florida and federally. It represented the corporate nursing home industry on a committee attempting to resolve nursing home problems in Florida. It is one of the few nursing home chains in Florida not accused of fraud.
Update August 2003
The concerns about care in Extendicare's facilities in the USA remain. It has survived the problems in the USA by selling its homes in Florida and expanding its operations in Canada where the government in Ontario is implementing a corporate model of care. It is once again making a profit.
Senator Kirby, a director of Extendicare has become the chairman of a senate committee inquiring into the future of health care in opposition to the Romanow Commission which recommended moving away from private for profit corporate care. Kirby's recommendations are very different and he has attacked Romanow's conclusions. The two reports represent an ideological divide.
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