“We scratch and we scratch every day! “: an Orpea executive thus addresses by email in 2018 to some directors of nursing homes in the private group. The watchword, quoted in the report of the General Inspectorates of Finance (IGF) and Social Affairs (IGAS) made public on Tuesday, April 5, by the Ministry of Autonomy, alone summarizes the document. A relentless 524-page indictment that demonstrates how the world-class, publicly traded company has become a money-saving and profit-making machine to the point of neglecting the well-being and health of the elderly who reside there .
The six chapters of the administrative inquiry commissioned by the government on 1er February, after the release of Victor Castanet’s book, The Gravediggers (Fayard, 400 pages, 22.90 euros), confirm the facts brought to light by the author of the book tending to demonstrate the existence of a “cost optimization system” at all levels. The IGF/IGAS report contains Orpea’s responses in an appendix. Despite the density of the objections made, they hardly changed – or marginally – the first provisional conclusions, which are almost as severe in the final report.
The ministry, in the name of business secrecy, obscured some figures and company names in the version published on Tuesday. But the document, even redacted, provides precise details on the “drifts” in the use of public money, the management of the 14,500 employees or the care of the 27,392 residents in the group’s 228 nursing homes.
Financial performance is a cardinal rule at Orpea. According to the report, it governs all floors. Starting with that of the directors, summoned to comply by their hierarchy but also encouraged to submit to it by bonuses. The more margins an Ehpad has on its budget, the greater the bonus for its manager. Between 2018 and 2021, some directors received a bonus of 250 euros, others 24,200 euros. “ The remuneration policy for executives as well as the management of their careers” incite “to overvalue financial objectives in relation to quality objectives”, points out the IGF/IGAS ratio.
It is also in the name of maximizing revenue that directors are encouraged to accommodate more residents than the number authorized by the supervisory authorities. The report establishes that 11% of nursing homes in 2019 had a “recurring overrun of their authorized reception capacity”, that is about twenty out of some 228 establishments. The IGF and IGAS cite internal memos from the group that encourage managers not to fill vacancies when their establishment is “at maximum occupancy”, even in “overcrowding”.
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