Nurses are being pushed to engage in “fraudulent” activities, staff levels are half what they should be, and our whistleblower reports of systemic neglect are “100% correct”. It’s not costing taxpayers $75,000 a resident, however. It’s $90,000. And all funnelled through a South Pacific tax haven. The Toowoomba nurses of aged care giant TriCare are exhausted. They’re deeply concerned. And now they’re fighting back. Anthony Klan reports.
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EXCLUSIVE
Nurses and care workers at a Queensland aged care home at the centre of an elder abuse scandal blew the whistle on serious problems at the facility – including allegations of serious mistreatment of residents – over six weeks ago but were completely ignored by management.
Staff at the TriCare Toowoomba Aged Care Residence wrote to senior TriCare management in June warning that vast understaffing meant a “very poor quality of care” was being provided, that laws were being systemically broken, and that residents were being put in danger.
TriCare, one of the nation’s biggest private aged care operators, is owned by Queensland’s ultra-wealthy O’Shea family but is legally “based” in Norfolk Island, a tax haven and “secrecy jurisdiction”.
The nurses and carers said concerns exposed by resident Kylie Kilroy and reported by The Klaxon on Monday (Nursing Home Hell) – including that dire understaffing meant residents were missing medications, hurting themselves and being left in soiled sanitary pads – were entirely accurate.
Whistleblower Kylie Kilroy: “Nobody bullies me and gets away with it”. Pic: Kylie Kilroy
“As staff we can confirm that what Kylie Kilroy stated is 100% correct,” the group of TriCare Toowoomba employees said.
“We are all extremely disgusted and angry at the way the residents and staff have been treated”.
The group of nurses and carers have provided The Klaxon with a copy of a highly-detailed, nine-page letter they sent to TriCare senior management on June 24.
“Just so you know, we as staff have advocated for those in our care,” the staffers told us.
“In fact, we wrote a nine-page letter to the TriCare Aged Care Manager and…to director John O’Shea.
“Their interest in the quality of care of the residents was zero, and their response was nil.”
TriCare and John O’Shea have repeatedly declined to comment when contacted by The Klaxon.
The letter from TriCare staff contains includes solid data, many examples of alleged abuse, and an entire page of references supporting the claims.
It makes for highly disturbing reading.
“We are extremely disgusted and angry at the way the residents and staff have been treated” — TriCare Toowoomba nurses
The Toowoomba facility – which received over $6 million from the Federal Government last year – is allegedly employing just half the nurses it should; forcing insufficiency trained staff to help administer drugs against the law; and pressuring staff to “fraudulently” record patient care that hadn’t been provided, the staffers allege in the letter.
The facility also had a policy of not replacing staff members when they were off sick.
The revelations are particularly disturbing given the Coronavirus pandemic and the possibility the virus could be spread by contagious workers who felt pressure to work even if unwell.
“The current practice of not replacing a sick staff member not only reduces the staffing levels in an already under-resourced environment, but has no basis and reduces the quality of care,” the letter states.
The staff said they had a legal and ethical responsibility to report their serious concerns, but responsibility for the dire situation fell squarely with TriCare management.
“Due to the nature of the current policies and procedures, and the corresponding staffing levels, there is strong evidence that the quality of care is not, and will not, be adequate,” the letter states.
“This is out of the control of staff, and it is therefore TriCare management that have to take full responsibility for residents having a diminished quality of care because of staffing allocation.
“It is our responsibility to let you know this, and this letter does so.”
The group said “all of the staff and many of the residents are very unhappy” but they were unwilling to provide their names for fear of retribution.
“We do not trust the current management, and so will not use, or give the names of those in the group,” the letter states.
The facts “speak for themselves”.
(Staff told The Klaxon they “have families to support and fear retribution”.)
“Current management do not…carry through with efforts that are discussed in meetings,” the staff wrote.
“We therefore believe that our views and concerns will not be registered unless they are in the form of writing.”
Staffing v profit
The June 24 letter says that for a typical day “calculated on 24 June 2020”, there were 67 residents, with registered nurses employed for a total of 38 hours in that 24 hour period.
(The Toowoomba home has received $6.08m from the Federal Government in the 2019 financial year. It has total capacity for 81 residents, which would equal about $75,000 a head. But with just 67 residents that’s $90,746 a head from taxpayers.)
Based on the minimum staffing levels the Queensland Government mandates for the homes it manages – considered “best practice”- the Toowoomba facility should have had nurses working for a combined total of 73.4 hours during that day.
The 38 hours actually worked was just 52% of that government minimum.
Data sent to TriCare management by nurses: “completely ignored”. Source: Supplied
The number of “carers” working – those employees directly involved in caring for residents but who are not registered nurses – also fell deep within “unacceptable” range, when set against the government standards.
For the same 24-hour period nurses and carers were rostered on for a total of 167 hours, just 67% of the 245 hours that would be legally required at Queensland Government-owned homes.
Those homes were required to have nurses and carers working 3.65 hours per resident per day.
“TriCare’s staffing levels are unacceptable by both measures and the calculations show that TriCare needs to increase its care and nursing staff levels significantly,” the letter says.
“On most days it is just not physically possible for the staff to complete everything on their shift, and response times are very much delayed,” the letter says.
“The staff are so busy that there is not enough time to have a meal break or even stop to have a drink or a toilet break.”
Despite handing billions of dollars a year to private aged care providers, the Federal Government does not stipulate any minimum staff-to-resident ratios.
Of government aged care home funding, 98 per cent comes from the Commonwealth, which is primarily responsible for the private aged care sector.
The Queensland Government has called on Canberra to set minimum staff-to-resident ratios, but it has failed to do so.
Aged care operators (including TriCare) are among major LNP donors.
Despite Queensland’s strong public stance, the Palaszczuk government failed to mandate minimum staff ratios when it implemented new aged care legislation late last year.
TriCare Aged Care Residence, Toowoomba Queensland. Pic: Kath Turner
While the vast majority of aged care funding comes from the Federal Government, the states are responsible for registering facilities, given them a degree of control over the sector.
Queensland has legislated for a new reporting system, under which aged care home operators will be asked to report their average daily resident care hours each quarter, data the government hopes to publish on a new website.
However providers can “opt-out”, and they face zero penalties for failing to provide information.
The aged care sector, rich with taxpayer funds, aggressively lobbied against mandated staff ratios for private facilities and also pushed against the planned new reporting regime.
The Queensland Government told us it planned to have the new website – legislated last December – up by the end of this year.
It was unclear why it would take an entire year to launch the website.
Ghost massages
Despite all the existing serious problems, conditions at the Toowoomba facility were becoming “even worse”, staff said.
“To compensate for a lack of staff, management have instructed the RN’s (registered nurses) to give a resident a ‘pat’, but document the massage as taking 20 minutes,” the letter states.
“This is fraudulent and the excuse that TriCare do not have an adequate number of registered nursing staff on each shift would not be accepted by the authorities.”
On July 1 – a week after staff sent the letter to TriCare management – TriCare further slashed nursing hours.
And at the end of July it allegedly pushed ahead with more improper practices.
“The TriCare procedure to be implemented at the end of July for care workers that do not have adequate medication competency qualifications to work alongside an RN when delivering dangerous drugs is against regulatory requirements,” the letter says.
“This should never be implemented”.
Some staff were also allegedly not paid to attend mandatory meetings, which was against the law.
“We ask that staff be back-paid where mandatory meetings were held and staff were not paid,” the letter says.
Staff said the source of the problems was clear.
TriCare was profiteering and abusing taxpayer funds.
“It’s a lucrative business…it’s our opinion that the managers get paid large salaries and bonuses to cut costs and increase shareholder returns but do not consider the effect on residents,” the staff said.
“I could be a lot different if they just redirected some of the funds towards the care of the residents.”
Tax haven
TriCare was founded 1968 by Queensland accountant John O’Shea and in the five decades since it has delivered his family vast wealth, much of it from taxpayers.
(In the 2018 financial year TriCare received $77.7m in federal funds).
At the same time, the company appears to be operating – and to have long operated – a sophisticated tax avoidance scheme on the money it makes.
TriCare is currently run by John’s sons, John, Peter and Damien (all of which live in Queensland) and it is based in Brisbane.
Yet despite this, the “ultimate holding company” of the entire group – Tricare Group Pty Ltd – is based, legally at least, on Norfolk Island, a known tax haven and “secrecy jurisdiction”.
TriCare – operating from a tax haven for 50 years. Pic:Supplied
In May last year a detailed report by the Tax Justice Network Australia and the Centre for International Corporate Tax Accountability & Research found TriCare appeared to be using Norfolk Island to engage in “financial engineering” to “reduce any income liability”.
“A key objective appears to be to shift profits, equity and debt to minimise tax payments,” the report says.
Because it is based on Norfolk Island – and so files no financial statements – there was “no way of knowing what tax payments, if any, are made by TriCare Group Pty Ltd.”
Company documents obtained by The Klaxon show that despite having zero actual operations on Norfolk Island, TriCare has been operating shelf companies there since 1971 – almost the company’s entire existence.
TriCare has two companies registered on Norfolk Island, TriCare Group Pty Ltd (the current parent company) and TriCare (Queensland) Pty Ltd.
TriCare (Queensland) Pty Ltd was created on Norfolk Island in June 1971.
TriCare Group Pty Ltd was created on Norfolk Island in February 1997.
TriCare Group Pty Ltd became the overall parent company when it was created, in 1997.
Despite having a turnover of hundreds of millions of dollars, the official head office of TriCare Group is a small accountancy called Norfolk Island Business Solutions.
Norfolk Island accountant Belinda Grube – TriCare Group Pty Ltd “company secretary”. Source: Supplied
According to Google Maps, Norfolk Island Business Solutions is situated near the middle of the island on Taylors Road – a few doors up from petrol station Paw Paws Pump Shed.
Norfolk Island Business Solutions is run and owned by accountant Belinda Grube.
By law, along with directors, registered companies must have a company secretary.
The Norfolk Island documents show Grube is a company secretary of both TriCare Group Pty Ltd and TriCare (Queensland) Pty Ltd.
Grube did not respond when approached for comment by The Klaxon.
According to its website, the services offered by Norfolk Island Business Solutions include “company formation”, providing companies with a “registered office” and “company secretarial services”.
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