Private equity-backed nursing company linked to serious safety lapses

Aveanna Healthcare, a home healthcare company owned by two large private-equity firms, has been cited for numerous safety violations, with at least seven children dying in its care over the past year in states where the company largely conducts business, Bloomberg News reports. 

Formed through a merger with PSA Healthcare and Epic Health Services, Aveanna Healthcare is owned by Bain Capital and J.H. Whitney Capital Partners. Aveanna aims to maximize profit while providing at-home nursing, mostly for children who need constant care.

Over 1,000 pages of publicly-released documents detail Aveanna safety violations, according to Bloomberg News, with seven deaths reported in Texas, Pennsylvania and Colorado over the past 12 months. Officials say Aveanna nurses failed to check vital signs, follow emergency protocol, show up for work or properly administer medication. Numerous cases of patients being burned from scalding hot bathwater have also been reported.

In Texas, the company's biggest market, Aveanna was responsible for 85 percent of violations by large pediatric home-health agencies from September 2016 to May 2019. The company only served 23 percent of those organizations’ patients, a Bloomberg analysis found.

Aveanna said injuries and deaths on its watch are unacceptable but rare, as it cares for more critically ill children than other companies. Company officials cited a survey of thousands of patient families that found 97 percent were satisfied with care, according to Bloomberg News.

Former Aveanna employees told Bloomberg News that company pressure to make a profit jeopardized the quality of care. According to a company document viewed by Bloomberg News, 90 percent of Aveanna bonuses are tied to earnings growth, patient care hours provided and cash collection, while patient satisfaction and clinical outcomes together make up 10 percent. Company leaders said its financial measures reflect quality of care.

Despite state documents reporting times Aveanna didn't conduct background checks, face-to-face interviews or verify references when hiring, the company dominates at-home pediatric care, and families told Bloomberg News that it's difficult to find nurses from other companies.

"I can't leave my daughter alone with these nurses," Jennifer Alvarado told Bloomberg News after going through almost 30 nurses mostly provided by Aveanna and its predecessor, PSA.

Aveanna is set to buy one of its largest rivals, Columbia, Maryland-based Maxim Healthcare Services, in a $1.25 billion deal.

Aveanna disputes the Oct. 22 Bloomberg News article about the company, its safety records and motivations, a company spokesperson told Becker's, adding that Aveanna repeatedly attempted to share information with Bloomberg.

"The resulting article does not paint an accurate picture of Aveanna and the high level of care we provide to tens of thousands of patients and families across the country. Satisfaction surveys, clinical data and any objective examination of the facts would conclude that we are leaders in providing quality care, a tribute to dedication and skill of thousands of highly skilled nurses proud to represent Aveanna," the spokesperson said.

Home healthcare backed by private-equity firms can reduce expensive hospital stays and generate revenue, making $63.1 billion in medical deals last year, a 50 percent increase from 2017.

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