"It's criminal"
September 9, 2022 7:08 PM Subscribe
Private equity investment in nursing homes has grown to $500 billion in the US. Data shows that when for profit companies take over the homes, deaths rise and care falls. After an investment firm bought St. Joseph’s Home for the Aged, in Richmond, Virginia, the company reduced staff, removed amenities, and set the stage for a deadly outbreak of COVID-19.
The US is also plagued with Private Equity hospices. There's no conflict of interests here at all! We can trust our Capitalist overlords all the way to our death beds.
posted by monotreme at 9:21 PM on September 9, 2022 [16 favorites]
posted by monotreme at 9:21 PM on September 9, 2022 [16 favorites]
There are some things that private equity firms do that can only be explained as pure evil (and yes, in this case greed is the driving force. That does not make their actions any less evil).
posted by eye of newt at 10:04 PM on September 9, 2022 [3 favorites]
posted by eye of newt at 10:04 PM on September 9, 2022 [3 favorites]
& here in Australia some of the religiously-run nursing homes had high COVID death rates because they were busy funneling Government money that was supposed to be used to keep nursing home residents safe into the coffers of the religious arm of the church instead :(
posted by carriage pulled by cassowaries at 12:53 AM on September 10, 2022 [14 favorites]
posted by carriage pulled by cassowaries at 12:53 AM on September 10, 2022 [14 favorites]
So, since, in the US, corporations are people, charge them with elder abuse, neglect, and murder, then jail the boards and management layers.
posted by GenjiandProust at 2:56 AM on September 10, 2022 [14 favorites]
posted by GenjiandProust at 2:56 AM on September 10, 2022 [14 favorites]
The hell of it is, too, that senior living facilities of any kind are usuriously expensive. They drain you of every last penny before letting you die.
posted by Thorzdad at 5:20 AM on September 10, 2022 [17 favorites]
posted by Thorzdad at 5:20 AM on September 10, 2022 [17 favorites]
It is $criminal$ but no one is going to do time for it.
posted by DJZouke at 5:20 AM on September 10, 2022 [2 favorites]
posted by DJZouke at 5:20 AM on September 10, 2022 [2 favorites]
It is $criminal$ but no one is going to do time for it.
Unfortunately true, but the next time a government official muses about privatizing something, their underlings (of which I am one) will produce clippings like this and ask them if that is *really* how they want to get on the front page of the paper.
And one more regulated service *stays* regulated.
I'm Eastern Canadian, so ymmv.
posted by Mogur at 6:26 AM on September 10, 2022 [5 favorites]
Unfortunately true, but the next time a government official muses about privatizing something, their underlings (of which I am one) will produce clippings like this and ask them if that is *really* how they want to get on the front page of the paper.
And one more regulated service *stays* regulated.
I'm Eastern Canadian, so ymmv.
posted by Mogur at 6:26 AM on September 10, 2022 [5 favorites]
Thorzdad: The hell of it is, too, that senior living facilities of any kind are usuriously expensive. They drain you of every last penny before letting you die.
I had two great-aunts in nursing homes in the late 90s-early 00s and they were north of 6-7k USD/month. They both just happened to die right when their own funding was going to run out and the far less reimbursable Medicare was going to kick in. I’m not conspiracy minded, but the timing is suspicious to say the least.
posted by dr_dank at 6:33 AM on September 10, 2022 [7 favorites]
I had two great-aunts in nursing homes in the late 90s-early 00s and they were north of 6-7k USD/month. They both just happened to die right when their own funding was going to run out and the far less reimbursable Medicare was going to kick in. I’m not conspiracy minded, but the timing is suspicious to say the least.
posted by dr_dank at 6:33 AM on September 10, 2022 [7 favorites]
Are you sure you don’t mean Medicaid? Medicare, as far as I know, doesn’t pay for nursing homes, only rehab. Medicaid requires you to spend down all your assets before it kicks-in, so that definitely tracks with your aunts’ experiences. I had to do this for my own mom.
Either way, it’s an appalling situation for seniors in this country.
posted by Thorzdad at 6:42 AM on September 10, 2022 [4 favorites]
Either way, it’s an appalling situation for seniors in this country.
posted by Thorzdad at 6:42 AM on September 10, 2022 [4 favorites]
Thorzdad: an appalling situation for seniors in this country.
Maybe 5 years ago, a friend of my mother's regularly visited their elderly, demented father in a swanky private nursing-home on the outskirts of Bath [home to England's second most expensive properties]. One morning there was nobody at reception, indeed there were no staff at all and the ambulatory clients were wandering the corridors looking for breakfast. The place had been sold as a going concern so all the staff were terminated the evening before but not replaced.
posted by BobTheScientist at 7:36 AM on September 10, 2022 [13 favorites]
Maybe 5 years ago, a friend of my mother's regularly visited their elderly, demented father in a swanky private nursing-home on the outskirts of Bath [home to England's second most expensive properties]. One morning there was nobody at reception, indeed there were no staff at all and the ambulatory clients were wandering the corridors looking for breakfast. The place had been sold as a going concern so all the staff were terminated the evening before but not replaced.
posted by BobTheScientist at 7:36 AM on September 10, 2022 [13 favorites]
Things are looking bad here in the UK. Retirement homes have long been seen as an investment opportunity in one of the few growing markets, providing a way to channel state funding and people's pensions into returns for shareholders. With the cost of energy to businesses looking to spiral out of control here, many of them will be cutting back on staff or even closing altogether.
posted by pipeski at 8:17 AM on September 10, 2022 [1 favorite]
posted by pipeski at 8:17 AM on September 10, 2022 [1 favorite]
7 things to know about the aging U.S. population, Advisory Board [*], Elysia Culver, April 5, 2022:
The problems will continue after most boomers (born 1946 to 1964) die off:
posted by cenoxo at 8:40 AM on September 10, 2022 [5 favorites]
- The overall adult population is becoming increasingly older, predominantly female, and less white.
- Life expectancy is on the rise, impacting the prevalence of chronic disease and disability.
- Older adults are in a precarious financial situation given increased costs of care with fewer dollars saved.
- The future demand for paid and unpaid caregivers will outpace current supply expectations.
- Older adults have made it clear that they prefer to age in place—however, this isn't feasible for many.
- Medicare Advantage continues to grow nationally and will likely outpace traditional Medicare by 2030.
- Covid-19 disproportionately impacted older adults and worsened existing problems around caring for them.
The problems will continue after most boomers (born 1946 to 1964) die off:
Demographic Turning Points for the United StatesPart of the answer may not be how to make life longer, but how to end it more easily (and legally) at one’s own choosing when the time comes.
Population Projections for 2020 to 2060 (PDF)
U.S. Census Bureau > Population Estimates and Projections > Current Population Reports
Jonathan Vespa, Lauren Medina, David M. Armstrong
Issued March 2018, Revised February 2020
posted by cenoxo at 8:40 AM on September 10, 2022 [5 favorites]
Unfortunately true, but the next time a government official muses about privatizing something, their underlings (of which I am one) will produce clippings like this and ask them if that is *really* how they want to get on the front page of the paper.
This isn't working at all in Ontario, as far as I can tell. The stories about the differences between profit-driven and non-for homes in terms of Covid outcomes are plentiful, but Ford is still committed to privatizing whatever the fuck they can.
posted by jacquilynne at 9:05 AM on September 10, 2022 [2 favorites]
This isn't working at all in Ontario, as far as I can tell. The stories about the differences between profit-driven and non-for homes in terms of Covid outcomes are plentiful, but Ford is still committed to privatizing whatever the fuck they can.
posted by jacquilynne at 9:05 AM on September 10, 2022 [2 favorites]
Life expectancy is on the rise, impacting the prevalence of chronic disease and disability.
Actually, we've lost something like a year to COVID in the latest numbers. Remains to be seen whether it's a blip or not.
Some of this data has been available for a while. It's all exhausting.
posted by praemunire at 9:15 AM on September 10, 2022 [2 favorites]
Actually, we've lost something like a year to COVID in the latest numbers. Remains to be seen whether it's a blip or not.
Some of this data has been available for a while. It's all exhausting.
posted by praemunire at 9:15 AM on September 10, 2022 [2 favorites]
Actually, we've lost something like a year to COVID in the latest numbers. Remains to be seen whether it's a blip or not.
A drop of 2.7 years to the end of 2021, for the US. Hard to see how 2022 isn't going to be even worse.
posted by ssg at 9:52 AM on September 10, 2022 [6 favorites]
A drop of 2.7 years to the end of 2021, for the US. Hard to see how 2022 isn't going to be even worse.
posted by ssg at 9:52 AM on September 10, 2022 [6 favorites]
A drop of 2.7 years to the end of 2021, for the US. Hard to see how 2022 isn't going to be even worse.
The mortality numbers are going to be really very weird for the next little because there will be a lot of displaced or misplaced mortality going forward. It's going to difficult work for actuaries to figure out because huge number of covid-19 deaths were people who were vulnerable and on trajectories to die of other causes.
Then there are a lot of other people who died of other causes like clots, heart attacks and degenerative diseases that were accelerated by survived acute covid-19 infections.
So you can anticipated future articles talking excitedly about the drops in certain types of mortality as if they were improvements in something when the sad reality will be that we just already killed off the people who would have died of the now lower rate mortality conditions.
posted by srboisvert at 4:40 AM on September 15, 2022
The mortality numbers are going to be really very weird for the next little because there will be a lot of displaced or misplaced mortality going forward. It's going to difficult work for actuaries to figure out because huge number of covid-19 deaths were people who were vulnerable and on trajectories to die of other causes.
Then there are a lot of other people who died of other causes like clots, heart attacks and degenerative diseases that were accelerated by survived acute covid-19 infections.
So you can anticipated future articles talking excitedly about the drops in certain types of mortality as if they were improvements in something when the sad reality will be that we just already killed off the people who would have died of the now lower rate mortality conditions.
posted by srboisvert at 4:40 AM on September 15, 2022
Just this link from my brother: Ontario patients to pay $400/day to stay in hospital instead of moving to LTC.
Basically, they are forcing people into distant LTC placements and removing choice with the threat of bankrupting them with excessive fees rather than increasing the available local LTC beds.
I got to see how bad the situation was in 2020/2021 when we needed to get my father into care. The projected waits were longer than he probably would live. I'm glad my father got his emergency placement in the facility our family's choice in August 2021 in Ontario. Unfortunately it took my older brother's sudden death, my father's rapid mental decline in 2021 and my mother dying of breast cancer coupled with the absence of any other local family support to trigger the expediting of it. Even then he only got moved from the much more expensive Assisted Living facility to the adjacent subsidized LTC because of repeated falls (Parkinsons). My parents got great end of life care and support from the local health agencies but I recognize it was part luck and part the advantage of living in an affluent area with a political powerful elderly population.
Vote "progressive" conservative if you want your end of life situation to resemble punitively distant prison placements. Though it does sit uncomfortably in the back of my mind, living here in Chicago, that what Ontarians get, even under the Tories, is still far better than I can expect here.
posted by srboisvert at 9:18 AM on September 15, 2022 [1 favorite]
Basically, they are forcing people into distant LTC placements and removing choice with the threat of bankrupting them with excessive fees rather than increasing the available local LTC beds.
I got to see how bad the situation was in 2020/2021 when we needed to get my father into care. The projected waits were longer than he probably would live. I'm glad my father got his emergency placement in the facility our family's choice in August 2021 in Ontario. Unfortunately it took my older brother's sudden death, my father's rapid mental decline in 2021 and my mother dying of breast cancer coupled with the absence of any other local family support to trigger the expediting of it. Even then he only got moved from the much more expensive Assisted Living facility to the adjacent subsidized LTC because of repeated falls (Parkinsons). My parents got great end of life care and support from the local health agencies but I recognize it was part luck and part the advantage of living in an affluent area with a political powerful elderly population.
Vote "progressive" conservative if you want your end of life situation to resemble punitively distant prison placements. Though it does sit uncomfortably in the back of my mind, living here in Chicago, that what Ontarians get, even under the Tories, is still far better than I can expect here.
posted by srboisvert at 9:18 AM on September 15, 2022 [1 favorite]
Exactly, srboisvert. There’s a debate on how much mortality improvement we will get from the survivor effect vs how much increased mortality do we see from Covid (and long Covid) and indirect Covid, which would be impacts from people not receiving preventative care or treatments or not catching cancers before it’s too late. After the 1918 flu pandemic, there was a general decrease in mortality because the remaining population had less people with serious health issues, so the average health of the remaining population was better than before the flu pandemic. Super interesting times to be an actuary for sure!
posted by LizBoBiz at 2:46 PM on September 17, 2022
posted by LizBoBiz at 2:46 PM on September 17, 2022
The mortality numbers are going to be really very weird for the next little because there will be a lot of displaced or misplaced mortality going forward. It's going to difficult work for actuaries to figure out because huge number of covid-19 deaths were people who were vulnerable and on trajectories to die of other causes.
I think there's quite a bit of wishful thinking in this line of thought. Excess mortality continues to be high and there's no sign of that changing. We're seeing significant excess mortality not just in older age cohorts, but also in the middle-aged. Covid and post-Covid issues do not just kill those who "would have died anyways", despite what many would like to tell you. We may well be in for a sustained period of excess mortality over the pre-Covid baseline.
Time will tell, but those who have been talking about dry tinder and so on for nearly 2.5 years now have been shown quite wrong thus far.
posted by ssg at 7:55 PM on September 17, 2022
I think there's quite a bit of wishful thinking in this line of thought. Excess mortality continues to be high and there's no sign of that changing. We're seeing significant excess mortality not just in older age cohorts, but also in the middle-aged. Covid and post-Covid issues do not just kill those who "would have died anyways", despite what many would like to tell you. We may well be in for a sustained period of excess mortality over the pre-Covid baseline.
Time will tell, but those who have been talking about dry tinder and so on for nearly 2.5 years now have been shown quite wrong thus far.
posted by ssg at 7:55 PM on September 17, 2022
I think there's quite a bit of wishful thinking in this line of thought
Sorry, maybe its your phrasing but it is not wishful thinking that mortality will be weird for a bit going forward?
As for the rest of your point: Speaking as a life insurance actuary who of course has been following the pandemic very closely, every age group (except young children, I think) had increased mortality specifically from Covid, but the older ages and those with pre-existing conditions were hit the hardest. We've seen a big shock to mortality in the last couple of years, there will be a little bit of survivors benefit.
in addition, we have seen every age group have increased mortality from non-Covid causes of death as well. There are many theories, but it will be years before we figure this out. The cause of death studies will be very interesting. I think the flu may be the only cause of death that probably saw a decrease. We have gotten incredibly good at treating heart conditions, but much of that is preventative. What happens when people miss those preventative care appointments? What about long-term mental health effects from lockdowns and living in a pandemic?
Essentially we have
1) a general increase in the healthiness of the population because of the loss of unhealthy people, and yes some healthy people died but they were just such a small portion of deaths compared to those who were older or had pre-existing conditions (just mathematically that's what happens with averages)
2) general decrease in healthiness of population due to delayed healthcare or other indirect impacts from Covid and also impacts from long-Covid
Anyone who thinks they know how this is going to play out is kidding themselves at this point.
posted by LizBoBiz at 12:33 AM on September 19, 2022 [1 favorite]
Sorry, maybe its your phrasing but it is not wishful thinking that mortality will be weird for a bit going forward?
As for the rest of your point: Speaking as a life insurance actuary who of course has been following the pandemic very closely, every age group (except young children, I think) had increased mortality specifically from Covid, but the older ages and those with pre-existing conditions were hit the hardest. We've seen a big shock to mortality in the last couple of years, there will be a little bit of survivors benefit.
in addition, we have seen every age group have increased mortality from non-Covid causes of death as well. There are many theories, but it will be years before we figure this out. The cause of death studies will be very interesting. I think the flu may be the only cause of death that probably saw a decrease. We have gotten incredibly good at treating heart conditions, but much of that is preventative. What happens when people miss those preventative care appointments? What about long-term mental health effects from lockdowns and living in a pandemic?
Essentially we have
1) a general increase in the healthiness of the population because of the loss of unhealthy people, and yes some healthy people died but they were just such a small portion of deaths compared to those who were older or had pre-existing conditions (just mathematically that's what happens with averages)
2) general decrease in healthiness of population due to delayed healthcare or other indirect impacts from Covid and also impacts from long-Covid
Anyone who thinks they know how this is going to play out is kidding themselves at this point.
posted by LizBoBiz at 12:33 AM on September 19, 2022 [1 favorite]
« Older ‘A new way of life’ | Middle school boys made "pedo database" to expose... Newer »
This thread has been archived and is closed to new comments
Not even a sort of canary in a coal mine, but the metaphor expressed here should not be ignored as it seems to be universal across humanity.
posted by hippybear at 7:17 PM on September 9, 2022 [27 favorites]