four questions about the report behind the state complaint against the world leader in nursing homes

After six weeks of investigation in ten Ehpad Orpea, it is time to take stock. Ihe General Inspectorate of Finance (IGF) and that of Social Affairs (Igas) submitted the conclusions of their mission on Saturday 26 March. In the aftermath, theState has announced that it is filing a complaint against the group of private nursing homes. A request for reimbursement of public grants will also be made. France info rsummarizes in four questions what you need to know about this report.

1What does this report contain?

The double administrative investigation into the operation of the Orpea group was entrusted by the government to theIGF and Igas February 1 to shed light on the facts denounced by the journalist Victor Castanet in his book-investigation The Gravediggers. The conclusions, which are not made public, mention “significant dysfunctions in the organization of the group, to the detriment of the care of residents”, summarizes the ministry delegate in charge of the Autonomy of the elderly, in a statement released on Saturday. The Orpea group, contacted by franceinfo, has not yet reacted to this announcement.

On the financial side, the report has “brought to light presumed irregular practices, in particular the absence of accounting monitoring of surpluses on public funding and non-compliant charging of expenditure to the care and dependency sections financed by public grants”specifies the ministry. The sums involved are of the order of “few millions” euros, has figured the Minister Delegate for the Autonomy of the Elderly, Brigitte Burgundy, Saturday on France Inter. The Orpea group is notably suspected of having increased its profit by hiring fewer staff than allowed by the public grants paid for this purpose, and by keeping the unspent funds.

March 21th, The world published un detailed summary of the preliminary report of the General Inspectorates of Finance and Social Affairs. In particular, the savings made by the group with the help of public money are pointed out. The preliminary report establishes an under-consumption of public credits of 20 million euros paid by the regional health agencies (ARS) and the departmental councils between 2017 and 2020. Orpea is also accused of “artificially increase the cost of purchases financed by public money”via a system of “end of year discounts” granted by its suppliers.

The Minister Delegate for the Autonomy of the Elderly, Brigitte Bourguignon, also specified “that there were insufficient supervisionants and frames that were not up to scratch”. She also mentions “problems on nutritional quality” dishes offered.

2Have reports already been made?

These practices were revealed by the independent journalist Victor Castanet in his book “The Gravediggers”, published the 26th January 2022. The book, the result of three years of investigation and 250 interviews, describes a system where hygiene care, medical care and meals for residents are sometimes “rationed”due to a “cost reduction policy” aimed at improving the group’s profitability. Orpea is there accused of having set up “a system that mistreats our elders”. An accusation totally denied by the group, which denounces a “manifest intention to harm”.

Alerts had already been launched before this investigation. In 2019, after several reports for suspicion of abuse, the regional health agency of Île-de-France had submitted a report on the Ehpad Résidence Les Bords de Seine in Neuilly-sur-Seine, near Paris, managed by Orpea. The report already deplored that the recommendations of the HAS on the nutritional monitoring of residents “are not respected for all residents.”

3Why is the report not made public?

The report, commissioned by the government, cannot be made public, confirmed the office of the Minister Delegate for Autonomy at franceinfo “due to business secrecy”since the document “will become a play” in possible legal proceedings. The government must therefore follow the law (available on the Legifrance website). The state complaint will be filed “a.s.a.p“this Saturday, specifies the cabinet of Brigitte Bourguignon to franceinfo.

The Minister of Health, Olivier Véran, had nevertheless declared on March 11 that he wanted to publish “the totality” report,”except for what is covered by business secrecy”. “This notion of business secrecy is done to the detriment of the general interest and at the service of a private group”, comments Victor Castanet, le journalist behind the revelations, for franceinfo.

4What follow-up is given to this report?

“In view of serious malfunctions, we are able to tell you that the State is filing a complaint and seizing the public prosecutor” and “we demand restitution” of public grants presumed to have been diverted from their purposes, said the Minister Delegate for the Autonomy of the Elderly on France Inter. The idea is therefore to “report” to justice the “financial practices” from Orpea, “so that legal proceedings can, if necessary, be instituted against the group”, adds the ministry in its press release. A decision welcomed by Victor Castanet. “Justice will have the means to investigate, to know exactly the extent of these practices, the amounts that will have been captured from public money”, he commented for franceinfo.

On March 8, in response to these revelations, Brigitte Bourguignon and the Minister of Health, Olivier Véran, had already announced a plan to strengthen controls and transparency in nursing homes. These checks must be carried out by the ARS, in the 7,500 Ehpad “within two years”said the ministry in its press release.


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