REACTION D‘ORPEA FOLLOWING THE FINAL REPORT OF THE MISSION D‘IGAS JOINT INSPECTION – IGF
Puteaux, March 26, 2022 (8:00 p.m. CET)
Orpea takes note of the announcement by Mrs Brigitte Burgundian, Minister Delegate to the Minister of Solidarity and Health, in charge of Autonomy of his decision to send the public prosecutor the report of the control mission carried out by the‘Inspection general of social affairs (IGAS) and the General Inspectorate of Finance (IGF). This transmission will allow us to explain ourselves in serenity, assert our rights and of course collaborate with Justice whenever necessary.
We regret that rapport of the inspection mission, as well as the 177 pages (excluding documents supporting documents) of very detailed answers that we have provided, are not made publicnor made available to all parties-taking. The only elements that have been disclosed are indeed a pre-report presented in an overwhelming way for Orpea and not taking into account our answers.
However, if the final report which was sent to us on the night of March 25 to 26, 2022 does indeed highlight certainns dysfunctions, it allows to conclude that there is no “ system” organized which would lead to widespread abuse and denies several allegations particularly serious leveled against us in the book The Gravediggers.
Philip Charrier, CEO of Orpea, specifies:
“We have taken full measure of the legitimate emotion aroused by these dysfunctions, many of which stem from the shortage of care and support professionals. which affects us strongly as it affects the entire EHPAD sector.
We deeply regret them. We would like to renew our sincere apologies to the residents and their families. We take all necessary measures to implement actions relating to all of the elements provided by the IGF-IGAS report. We will also apply as soon as possible the recommendations made following all the expected reports”.
Justice being seized, we cannot today enter into the bottom of all the subjects on which we are implicated. At this stage, however, we would like to make the following clarifications:
1. The inspection mission enabled us to identify room for improvement and we we are already committing to actions correctors:
We are going to change our organization to give more autonomy and resources to our facility directors.which are the lifeblood of the Group.
We must ensure systematic implementation of our school projects and quality processes that are not always applied uniformly in all our establishments.
We need to be more open to our stakeholders. We are going to do this in particular by instituting family mediators, by bringing together the ethics committees from the field, improving the operation and promoting our alert platform.
We are going to change our procedure for declaring adverse events and raise awareness among the teams on the subject to shorten the time for these declarations.
We are going to work on simplifying quality processes in order to allow better appropriation by field teams.
We are going to act with more vigor and determination on the problem of the chronic lack of personnel which affects the whole sector and to do this, improve the attractiveness of Orpea and better retain our employees even if our turnover rate is at same level as that of all French nursing homes.
We will improve social relations and attention to the exercise of rights union by negotiating agreements with all the trade unions present in the company.
2. The mission report leads to the conclusion that there is no organized “system” which would culminate in widespread abuse and clearly debunks some of the most shocking allegations in The Gravediggers book.
Regarding alleged rationing of incontinence padsthe mission “ did not uncover any major anomaly in the supply of incontinence pads and specifies that “Recent feedback from the Regional Health Agencies does not reveal any organized system of rationing food products.‘incontinence “.
The rapport refutes accusation of poor pressure ulcer management and notes that “ the cutaneous monitoring of pressure points and the prevention of bedsores is not a critical point “. The mission estimates that the percentage of residents wearing one or more dressings‘bedsore (3.42%)” does not seem excessive “.
The number of coordinating physicians in Orpea nursing homes is much higher than the sector average: they are present in 82% of our establishments compared to 67% in the whole sector1
3. Grievances in the report call for comments from Orpea
AT. Regarding quality and care
Orpea denies that the management rate in its establishments is lower than the industry average. Between 2017 and 2021, the managerial ratio calculated by Orpea on the care, dependency and accommodation staff increased continuously, from 0.621 to 0.704. Moreover, the staff-to-staff ratio alone cannot define the quality of care and it would be advisable at least to correct this one of factors likely to explain the variation according to the establishments (state of dependence and pathology of the residents, number of beds, age of the real estate and character functional residences)2.
The nutritional policy put in place by Orpea fully meets the protein needsenergy consumption of residents and meets the standards of the National Agency for Food Safety (Anses) and the High Authority for Health (HAS). Ihe mission of IGAS has establishedli his assessment on nutrition from of a tool of orders which are passed in kg, whereas these are the contributions protein-energy nutrients that matter3. The food plan developed
1 See Medical care for the elderly in nursing homes – Court of Auditors February 2022
2 see DREES files No. 68 • December 2020 – The supervision rate in the EHPAD: its determinants and its alternatives
3 See latest opinion from the Haut Conseil de la Santé Publique (May 18, 2021, updated on August 24, 2021)
by the Medical Department, the Nutrition Manager and the Catering Department of Orpea, over 5 weeks, aims to guarantee the nutritional balance of residents and makes it possible to verify that all nutritional intakes are guaranteed and fully in line with official intake recommendations in proteins, calories, lipids, and carbohydrates.
The average weekly energy intake of Orpea menus is between 2037 kcal / day and 2147 kcal / day, versus 1950 kcal to 2275 kcal / day recommended. The nutrition policy also includes monthly weight monitoring and controls albumin and BMI as needed.
The Group has implemented a dental protocol integrated into the care plan, with an assessment by the coordinating doctor during his Standard Geriatric Assessmentinput (EGS), then once a year.
B.
Regarding the use of public funds
Orpea formally denies the existence of a system aimed at optimizing the use of grants public:
The surpluses recorded in the establishments over the period 2017 – 2020 were for essentially formed in 2019 and 2020, and are explained by the combination of :
– Tariff convergence which, by granting private establishments an additional allocation, generated budget surpluses not foreseen by the establishments. Each year, as these allocations are only validated in the middle of the year, the directors do not commit them during the first part of the year.
– And the health crisis which, having led to both a reduction in the number of residents entering nursing homes and the number of helpers– caregivers available during this period, resulted in a reduction in planned expenditure over the period.
Faced with this situation of shortage of aid– caregivers and to continue to support residents as well as possible, the establishments have called on carers who act as‘caregiver, general practice in the sector4. We have therefore imputed these wage costs corresponding to the increased care needs to the public allocations for the care part.
The cost of these allocations has always been declared to the ARS in charge of controlling the establishments concerned.
The €20 million in surpluses mechanically generated during this period gave rise to the recognition of a charge aimed at neutralizing the favorable impact on the accounts of the group.
Far from the sums advanced by the inspection mission, out of the four years studied, €4.6 million could come from non-compliant allocations to care allocations and dependency, i.e. 0.3% of grants received between 2017 and 2020.
The mission considers that the services are imprecisely described in the contracts or inherent in the contractual service. This assessment is, in our view, debatable.
VSthis being so, to avoid any difficulty in the future, ORPEA has decided to exclude henceforth, from the basis for calculating fees due for servicesons of services, the amount of orders for products in the care and dependency sector. No more royalties
4 See Medical care for the elderly in nursing homes – Court of Auditors February 2022
will henceforth be calculated and collected on the basis of the amount of products financed by public allocations.
As she s‘committed to it, the company will communicate the results of the independent external investigations that the Board of‘administration has launched, as well as, in May 2022, its transformation plan to better serve residents and their families.
About ORPEA (www.orpea-corp.com)
Founded in 1989, the ORPEA group is one of the world’s leading players in comprehensive dependency care (retirement homes, assisted living facilities, medium-stay and mental health clinics, home support).
ORPEA is listed on Euronext Paris (ISIN: FR0000184798) and a member of the SBF 120, STOXX 600 Europe, MSCI Small Cap Europe and CAC Mid 60 indices.