John Oliver dedicated the main segment of Sunday’s Last Week Tonight to a perennially overlooked health problem in the US: nursing homes and elderly care. “We tend not to think about it,” said Oliver, “but the truth is that many of us, whether through old age or disability, need or will need help with everyday life.”
From the Cuomo government’s manipulation of nursing home Covid data to horrible contamination rates – nursing homes and assisted health care facilities account for nearly a third of US Covid deaths – “the pandemic has pushed an already strained system to its limits” Oliver continued. “Covid has just revealed what we’ve essentially known for years – that the way the elderly and disabled are treated in far too many of these facilities is indifference at best, abuse and neglect at worst.”
First, Oliver distinguished between the two standards for clinical elderly care in the US, nursing homes and assisted living facilities. Nursing homes are medical facilities supervised by registered nurses and staffed by low-paid nursing assistants. The industry has long been plagued with deep-seated problems of poor care and poor wages – Oliver cited a pre-pandemic study that found 82% of homes were written for infection prevention or control deficiencies, and half had ongoing problems that several years were mentioned. . Nurses, meanwhile, are often overworked and underpaid – the median salary is about $ 30,000 per year.
Meanwhile, over the past decade, major nursing home chains, including Life Care America, Extendicare, Ensign Group, and North American Health Care, have been accused of fraudulent Medicare billing practices and “ denied wrongdoing while paying tens of millions of dollars to run their affairs – you know, as you do when you are totally innocent ”.
Much of this, as well as the actual standard of care provided in nursing home facilities, is masked by a “garbage in, garbage out” classification system where nursing homes submit their own data unsupervised. “That’s sad – something as important as our nursing home rating system shouldn’t follow the same rule as every prescription on the Velveeta website,” Oliver joked. “Because none of these are right.”
Assisted living facilities, on the other hand, offer much less intensive medical support and thus are cheaper than nursing homes and cost an average of $ 50k per year. The vast majority are also profitable, but are paid out of pocket and much less regulated, “making it easy for just about anyone to get started,” said Oliver, “and I mean everyone.”
His example: Stephanie Costa, who appeared on the reality show Millionaire Matchmaker in 2013 with her small fortune in assisted living amenities in Southern California. Costa has brought in so many health and reimbursement violations that California banned her from the assisted living industry – at least on paper. Costa’s homes are now listed under a real estate management company owned by her father, and she is still the general manager. “So the state of California really taught Stephanie Costa a lesson there,” Oliver said.
“In particular, the lesson that you can treat your older caregivers like absolute shit, avoid real consequences, and just keep living your life in the ugliest house in Beverly Hills.”
Aside from cartoonish poor managers, many assisted care institutions are rife with poor management of dementia patients, neglect and elderly suicide. Oliver cited a bizarre and tragic case of an assistant resident with dementia in South Carolina who left unnoticed in the middle of the night and was eaten by an alligator.
That facility was eventually cited for 11 violations, including insufficient nighttime checks and understaffing, but was fined just $ 6,400. “And it feels like when you’ve lost a loved one in such a horrific way, you want more accountability than just ‘don’t worry, someone decided their life was worth the price of a 2013 Chrysler Motown,'” said Oliver.
The host suggested several regulatory changes to prevent such tragedies, such as mandatory funds for certain types of care, standardized levels of care, and public funds for home care for the elderly, although “ every aggressive transition to home care is underway. ” need strict crash barriers and supervision to ensure that no money is wasted, just in a different way, ”he explained.
“ The last thing I want is to put on a show in five years’ time about the evil of new for-profit home care facilities that have somehow destroyed people’s lives in their own homes.
“But we have to do something, and it all starts by showing that we care what happens to the elderly and people with disabilities in this country,” he concluded. “Because at this point, evidence points to the fact that we absolutely don’t, and all the other problems stem from that.”