Profit over people

​We’ve been talking a lot lately about Berks Heim-both to our group and to our elected officials. At this point we can safely say that our efforts (phone calls, emails, postcards, attending meetings) have moved the needle. Last week the County Commissioners said the sale of the Heim has been tabled-at least for the next five years. Major players in the debate have been the two unions, Service Employees International Union (SEIU) and United Food and Commercial Workers (UFCW), who made extensive contract concessions in order to advance the discussion to the point we find ourselves at now. 

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illustration by Anna Parini (The New Yorker, 2017)

One argument we’ve stressed in our fight to save the Heim, is that along with privatization comes a serious risk of decline in quality of care and accountability. This isn’t just speculation on our part. We need to look no farther than a neighboring county to the north for a case in point, namely Schuylkill County.
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In 2015, citing a $4.6 million revenue deficit, Schuylkill County Commissioners agreed to sell the county nursing facility known as Rest Haven to Nationwide Healthcare Services, a for-profit, private company based in New Jersey. Rest Haven was once noted as one of the best nursing homes in Pennsylvania. At the time of the sale, 84% of Rest Haven residents relied on Medicaid to pay to stay at the facility. But Medicaid reimbursement was not keeping up with increasing operating costs - thus the budget shortfall. The sale to Nationwide Healthcare Services eventually fell through. Due to its favorable reputation, there were a number of private operators interested in Rest Haven, and in September 2015 a sale was finalized to Investment 360°, also of New Jersey. The deal with Investment 360° promised physical improvements to the building and first shot at positions for former county workers.

But before the sale to Investment 360° was even finalized, trouble started to surface. Employees were told their insurance premiums were going from $80 per month with a $1,000 deductible to $700 with an $11,000 deductible for family coverage. They were also told hours would be cut and weren’t even certain if their jobs would continue to exist. And though the sales agreement was approved by the Schuylkill County commissioners, employees hadn’t received their severance contract paperwork.

It wasn’t only the county home that suffered in Schuylkill County. When the private-equity firm, the Carlyle Group, bought up the Manor Care chain of homes, Manor Care ended up in bankruptcy, even though the investors made millions. Conditions at the facilities were reportedly horrific with violations increasing after the Carlyle Group took over.

According to the Washington Post:
​"The number of health-code violations found at the chain each year rose 26 percent between 2013 and 2017, according to a Post review of 230 of the chain's retirement homes. Over that period, the yearly number of health-code violations at company nursing homes rose from 1,584 to almost 2,000. The number of citations increased for, among other things, neither preventing nor treating bedsores; medication errors; not providing proper care for people who need special services such as injections, colostomies and prostheses; and not assisting patients with eating and personal hygiene.

Counting only the more serious violations, those categorized as "potential for more than minimal harm," "immediate jeopardy" and "actual harm," The Post found the number of HCR ManorCare violations rose 29 percent in the years before the bankruptcy filing." 

Apart from violations, nurses complained of being constantly short-staffed.            "The short-staffing was to the extent that it was very dangerous for the residents," said Lisa Kay Wasnowic, who worked off and on at the Allentown ManorCare from 2004 to 2014. "At times, it was just one aide for 60 patients. And it just kept on getting worse." (Click here to read the complete article.)

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​If you worked in public education in the last decade, you no doubt heard “The Blueberry Story”. In short, it’s about an ice cream company executive who in presentations to school teachers went around saying his company produced the best blueberry ice cream and public schools would benefit by being run on a more business-like model. Then a teacher stood up and asked him what he would do if he received a shipment of inferior blueberries. Would they be rejected? Would he send them back? As an ice cream producer, yes he could. But school teachers can’t pick and choose their students. The comparison may be simplistic, but you get the point. People aren’t a commodity, and we shouldn’t be treating them like one. The analogy used with school students is equally applicable when it comes to nursing home residents. Shortcuts in care in order to pad the bottom line are simply unethical and, in this case, can even be deadly.

So we should be asking our county commissioners a question-Is privatization of county-held assets like the Heim and also the prison worth the human cost? ​Yes-when the commissioners sold Rest Haven, Schuylkill County received a large influx of cash-but this was a one-time windfall. In Berks as in Schuylkill County, the cost of running the Heim that is pushing the budget into the red is a tiny percentage of overall expenses. Selling isn’t a long-term solution. And how many more sacrifices can we ask of the dedicated workers caring for our loved ones? A better solution would be to pressure Pennsylvania’s elected officials to stop cuts to the Medicaid benefits which many Heim residents depend upon. This is yet another reason why an accurate 2020 Census count is so crucial. If our state and county populations are undercounted, it will result in fewer federal dollars for programs like Medicaid.  

The fight for the Heim isn't over. We've weathered this first storm and deserve a pat on the back for our efforts, but let's not get complacent. And let's remind our county commissioners-unlike the teachers in the story, we can send our "blueberries" back in November.