The managing director of Esperi Care nursing home, Marja Aarnio-Isohanni, has stepped down, according to a press release issued by the company.
Her resignation is just the latest turn in recent media reports of ongoing difficulties that have plagued private nursing homes in Finland and come to light this week.
On Friday, Valvira, the National Supervisory Authority for Welfare and Health, announced that it would suspend operations at Esperi's nursing home in Kristinestad, western Finland when an elderly resident’s death was suspected to be caused by negligence.
According to an Yle investigation, officials have in recent years been repeatedly looking into problems at Esperi Care nursing homes around Finland.
In 14 cities and 16 nursing homes, the Regional State Administrative Authorities (Avi) has demanded that Esperi remedy serious shortcomings in its operations.
For example, Avi gave Esperi a warning at the end of last year about the Paatela nursing home in central Finland and workers lack of qualifications, which resulted in a 70,000 euro fine.
Almost all of Esperi’s nursing homes where authorities have intervened have had too few workers. There have also been problems reported about medication handling and storage, human resources and a lack of staff qualified to handle medications.
Esperi has, according to its website, about 130 nursing homes around Finland. Its turnover for 2018 was 270 million euros.
Esperi not alone
Meanwhile, Yle has also been looking into another chain of nursing homes, the health care giant Attendo, where reports have surfaced of elderly patients being underfed, rarely taken outdoors, and sleeping in dirty diapers.
The problems appear to stem from a lack of healthcare personnel.
Avi uncovered grievances around the country. Between 2016 and 2018, there were 16 instances were Avi demanded that Attendo nursing homes correct problems.
Attendo’s operations have been under the magnifying glass, especially in Espoo, where the city fined the company several times for recurring breaches of contract since 2015.
Though the City of Espoo uses several private healthcare providers, it has had to scale back use of three of Attendo’s nursing homes: Harmaaniitty in 2018, Mikevan Helmi (now Attendo Helmi) in 2017 and Laaksolahti in 2016.
According to information received by Yle, the Laaksolahti and Harmaaniitty cases relate to a shortage of workers. In the case of Mikevan Helmi, the reason was customer feedback, poor hygiene and problems regarding medication.
In the end, the city terminated its agreement with Mikevan Helmi in November 2017, when it was unable to resolve the outstanding issues.
Problems were also reportedly discovered by Avi and the city at Attendo’s Vuoripirtti and Olarinpuisto homes, and some issues have been ongoing at Attendo’s Laaksolahti nursing home.
According to the city and Avi, inspection and supervision documents tell their own tale of Attendo Laaksolahti’s problems. There have been 17 seniors whose body mass index has been so low that their risk of premature death has increased according to Avi. (There are currently 65 care places at Attendo Laaksolahti.)
Personnel shortages at Laaksolahti have been repeatedly been ignored. Espoo has fined Attendo twice because of it – for a total of 55,000 euros.
Prescription drugs without a prescription
In 2018 Avi ordered Laaksolahti to remove unlawful medicine cabinets. The cabinets had been used to store leftover, opioid prescription drugs.
According to Avi, the drugs were to be destroyed as medical waste, but they were instead handed out to the nursing home's other patients without doctor’s orders. Avi says the situation jeopardised patient safety.
Attendo and Espoo are currently having a more peaceful time according to Matti Lyytikäinen, director of elderly services for the city of Espoo, there are currently no "non-normal control measures underway."
However, in Laaksolahti there are still problems.
In 2018, city documents reveal that the nursing home was still receiving a lot of negative customer feedback. This ranged from a lack of interesting activities to complaints about the flow of information. A scarcity of auxiliary personnel has been reported as well as a shortage of trained and qualified personnel. In addition, the city has expressed concerns about the lack of up-to-date medical certificates for staff.
Attendo is the largest company in the Finnish care market. It has about 250 nursing homes.
In 2017, the company's net sales of care services amounted to approximately EUR 300 million.