The Orpea case casts doubt on the economic model of commercial nursing homes


Posted on January 27, 2022 at 18:37Updated at 8:11 am on January 31, 2022.

The publication of “Gravedigger” causes a shock wave. Named after this French group of European retirement home leaders, a report by journalist Victor Castanet, who blames the Orpea system, arouses the resentment of political leaders during the presidential elections. ..

Home Affairs Minister Bridget Bourguignon summoned Orpea’s CEO next Tuesday. Parliamentary Speaker Richard Ferrand estimated at the French Inter this Thursday: »»

Valérie Pécresse, an LR candidate for Elysée, called for “a radical change in the model of nursing homes.” Socialist agents have called for “the real law of autonomy and old age” and “the parliamentary investigative commission” as part of them-RN candidate Marine Le Pen also wants.

Occupancy rate and labor management

To read Victor Castanets, the economic model of private commercial groups is going in the wrong direction. Journalists point out three mechanisms by which Orpea can benefit some of the publicly funded services (care and addiction) and should be offered at a cost price.


For example, some facilities accept more occupants than the number of beds approved by the local health agency. Even if that means getting the doctor on duty out of bed! It is very beneficial without increasing the salary.

“In rare cases, it is theoretically not allowed to exceed 100% occupancy,” recalls Jean-François Vitoux, Managing Director of the Arpavie CDC (Private Nonprofit Organization). In Germany, he emphasizes experts in this field, “it doesn’t happen because we first need to prove that we have enough staff who have the right to welcome additional residents.”

video. Ehpad Orpea suspected of abuse

Adapt salary in real time

Orpea has also developed software that can use fixed-term contracts and temporary work to adjust salaries in real time as occupancy rates fluctuate. why ? This is because the assignments given to nursing homes vary from tranche to tranche. For example, occupancy can drop slightly below 90%, but is stable up to 95%. It is possible to fit directly under the ceiling without increasing the number of staff.

An isolated example? “In reality, the problem with our office today is rather to find and stabilize our staff,” Jean-François Vitoux predicts. But he realizes that without optimization, the fiscal equation is tense. If I don’t find anything, I get, “he explains.

Juicy retreat system

Third lever, year-end discount. Victor Castanets discovered that Orpea had “industrialized” this system. The group has negotiated favorable contracts with manufacturers of wheelchairs and other medical devices (funded by Medicare) or diapers (funded by the department). In exchange for large orders, they agree to set back 10%, even up to 28% of the market. In the case of the Hartmann Incontinence Pad, the face value paid with public funds will increase year by year, but the amount earned by the supplier will decrease. So he started delivering diapers that were too small to leak, without rubber bands.

Jean-François Vitoux, who also chaired the commercial organization Domus Vi from 2010 to 2015, explains that year-end discounts are “not illegal” and “optimization of public funds”. He put an end to this practice at Domus Vi. No doubt, according to him, local accounting offices should be more interested in managing commercial facilities.

If the lucrative private sector developments since 2002 made it possible to open beds and modernize retirement homes, the unlimited growth of these groups would create new risks. You can’t just drive profit. »»