‘Secret’ bonus scheme at nursing homes revealed

Swedish health care provider Carema has received another blow as a "secret" bonus program for managers was revealed just days after staff told how high-savings initiatives have led to neglect of the elderly in their care.

'Secret' bonus scheme at nursing homes revealed

The bonus programs reportedly reward managers of elderly care facilities who keep tight control on their division’s economy and perform under budget, according to Swedish Television (SVT) documentary, Dokument inifrån, which airs Sunday evening.

An anonymous director described how departments are pitted against each other in competition.

The managers who maintain the best budgets receive one or more months’ salary in bonuses, according to reports by daily newspaper Dagens Nyheter (DN).

“The bonus is something you talk quietly about and is not spread about within the company or to the public,” the manager told SVT.

In addition, the documentary episode reveals that a large number of managers are also enticed to become shareholders in the business, giving them an added stake in cost savings.

Last week employees from a Carema elderly care facility in Stockholm disclosed how major cut backs have meant staff shortages, broken equipment and sometimes no toilet paper.

According to the employees, management solved staff shortages by making personnel from other departments fill in 20 minutes here and there over the course of a day.

Reports from staff and ex-employees of Carema also included situations where toilets couldn’t be sat on due to their filthy state, the questioning of every prescription that would cost the company money, and a failure to address patient concerns.

For example, the DN reported how a patient’s broken bed led to the requisition of that of another patient’s, who in turn was forced to sleep on the floor for several months.

Carema has thus far chosen not to comment on its bonus programs or allegations of suspected neglect at both Koppargården and Tallbohov elderly care facilities in Järfälla, outside Stockholm.

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Police probe mystery death at Swedish care home after spate of overdoses

Police are investigating one case of murder and two attempted murders at a care home in the west of Sweden, after a doctor raised the alarm about suspicious insulin overdoses.

Police probe mystery death at Swedish care home after spate of overdoses
At least of the women did not normally receive insulin injections. Photo: Claudio Bresciani/TT
“There is one man who died in connection to the events,” Stina Lundqvist, the prosecutor in the case, told the local Göteborgs Tidning newspaper.
“All of these three people who received a medication which they were not supposed to have, according to what they were prescribed,” she added in an interview with Swedish state radio broadcaster SR
“We are investigating the events as attempted murder,” she told Sweden's TT newswire, which reported that it could be a case of active euthanasia, which is illegal in Sweden, although the prosecutor did not comment.
The doctor reported his suspicions to the police after two women from the same section of the care home were admitted to the hospital, both suffering from extremely low blood sugar. 
“Through giving the plaintiff insulin, someone has caused her to lose consciousness and stop breathing,” a senior doctor at the hospital wrote in a police report.
The doctor added that the woman would not have been capable of administering the insulin herself. 
In January this year, a third resident from the same section of the same care home, was also admitted to the hospital suffering from low blood sugar. It was then that police put a prosecutor on the case. 
“It's unlikely to be a coincidence because it is all from the same section and is the same type of event,” Lundqvist told TT.
“But it's a slightly special case. We can't say with confidence that this is an attempted murder. That's something we hope the investigation will shed some light on.” 
“There are certain elements which suggest a crime has been committed, although exactly what evidence this is, I cannot go into at present.” 
At least one of the women did not normally take insulin, and another was admitted with a type of insulin in her body different from that which she was prescribed. 
According to a report in a local newspaper, a police search of the home found two empty insulin pens containing fast-acting insulin which were not registered in the home's records. 
Lundqvist said it was a “complicated investigation”, as many of the staff who worked at the home at the time had already moved on. 
“We have no one at present we could reasonably call a suspect, but of course there are people we are looking closely at,” she said. “It's of course a natural part of our investigation to look at who has been working at the home when all the events took place.” 
The prosecutor in the case, Stina Lundqvist, says there is not yet a suspect. Photo: Adam Ihse/Exponera