♪ ♪
>> John: HI THERE!
WELCOME TO THE SHOW.
STILL COMING TO YOU FROM THIS
BLANK VOID.
WHICH I ACTUALLY SHARE WITH THE
PIXAR LAMP.
IT SAYS IF I TRY TO LEAVE, IT'LL
CRUSH ME LIKE THE LETTER "I",
AND I CAN'T TELL HOW SCARED
AND/OR HORNY I SHOULD BE.
IT'S BEEN ANOTHER BUSY WEEK.
IN THE U.S., COVID VACCINATIONS
ARE RACING AGAINST NEW VARIANTS
OF THE VIRUS.
AND IN THE U.K., PRINCE PHILIP
DIED, WHICH IS A TRAGEDY IF YOU
DON'T KNOW A SINGLE THING ABOUT
HIM.
AND EVEN IF YOU KNOW A LITTLE
ABOUT HIM, YOU MIGHT NOT KNOW
THIS.
>> TAKE IT BACK TO THE BEGINNING
FOR US, ALASTAIR, AND TELL US
HOW THE YOUNG PRINCE PHILIP OF
GREECE AND DENMARK MET THE
THEN-PRINCESS ELIZABETH.
>> WELL, THEY WERE RELATED.
>> John: YEAH, THAT'S RIGHT,
PRINCE PHILIP AND
QUEEN ELIZABETH ARE COUSINS WHO
LATER GOT MARRIED -- ALSO KNOWN
AS A "GIULIANI MEET-CUTE."
MEANWHILE, THE MATT GAETZ SAGA
CONTINUES TO UNFOLD THIS WEEK,
AND NOT IN ANY WAYS THAT LOOK
GOOD FOR HIM.
>> THE NEW REPORT OVERNIGHT
ALLEGES GAETZ SENT CLOSE
ASSOCIATE AND ACCUSED
SEX TRAFFICKER JOEL GREENBERG
$900 IN TWO LATE-NIGHT VENMO
TRANSACTIONS IN 2018.
ACCORDING TO THE DAILY BEAST,
GREENBERG USED THE SAME APP TO
SEND THREE YOUNG WOMEN,
INCLUDING ONE WHO HAD RECENTLY
TURNED 18, VARYING SUMS OF MONEY
THAT AMOUNTED TO $900.
GREENBERG MADE THE PAYMENTS TO
THE THREE YOUNG WOMEN WITH THE
DESCRIPTIONS "TUITION,"
"SCHOOL," AND "SCHOOL."
>> John: YOU FUCKING IDIOTS!
I CAN'T BELIEVE I HAVE TO SAY
THIS, BUT IF YOU'RE TRYING TO
SUSPICIOUS POTENTIALLY CRIMINAL
TRANSACTIONS,
VENMO IS NOT THE APP TO USE.
VENMO IS FOR ONE THING AND ONE
THING ONLY: PASSING JUDGMENT ON
FRIENDS' SPENDING HABITS WHILE
OBSESSING OVER WILD FINANCIAL
MYSTERIES.
WAIT, BRIAN PAID HIS GIRLFRIEND
FOR PIZZA?
WHY CAN'T KAITLIN JUST LET HIM
SLIDE ON THIS?
THEY LIVE TOGETHER, AND IT'S
PIZZA.
WAIT, KAITLIN'S PAYING BRIAN
NOW?
FOR CAKE?
BRIAN LIKED IT?
THE FUCK IS GOING ON IN
THIS RELATIONSHIP?
AND LOOK, I HAVE TO TELL YOU,
MATT GAETZ HAS DENIED ALL
ACCUSATIONS.
AND I'M SURE THERE WILL BE MORE
TO SAY ABOUT ALL THIS WHEN HE
GOES TO PRISON.
BUT FOR NOW, LET'S TALK ABOUT
IMMIGRATION.
THERE'S BEEN A LOT OF COVERAGE
LATELY ABOUT WHAT'S HAPPENING ON
THE BORDER, WHICH IS TROUBLING
AND COMPLICATED, BUT I'D
ACTUALLY LIKE TO TALK ABOUT
SOMETHING A LOT LESS COMPLICATED
THAT'S ALSO GETTING A LOT LESS
COVERAGE, AND THAT IS THE U.S.
REFUGEE ADMISSIONS PROGRAM.
IT'S FOR PEOPLE CURRENTLY ABROAD
FLEEING PERSECUTION OR VIOLENCE
WHO'VE APPLIED FOR RESETTLEMENT.
AND THE U.S. USED TO BE A WORLD
LEADER IN HOW MANY REFUGEES WE
ACCEPTED, BUT THIS FUCKING GUY
NOT ONLY SLASHED THE ADMISSIONS
CAP DOWN TO A HISTORIC ANNUAL
LOW OF 15,000, HE ALSO ADDED
DISCRIMINATORY ELIGIBILITY
CATEGORIES THAT HAVE BLOCKED
MANY MUSLIM AND AFRICAN REFUGEES
FROM COMING TO THE U.S.
AND TO HIS CREDIT, BIDEN RAN ON
A PLATFORM THAT INCLUDED
REVERSING TRUMP'S POLICIES.
AND SINCE TAKING OFFICE, HE'S
BEEN ABOUT AS ELOQUENT AS BIDEN
CAN BE ABOUT THE MORAL
IMPERATIVE OF DOING SO.
>> COME WITH ME INTO
SIERRA LEONE.
COME WITH ME INTO PARTS OF
LEBANON.
COME WITH ME AROUND THE WORLD
AND SEE PEOPLE PILED UP IN
CAMPS, KIDS DYING, NO WAY OUT,
REFUGEES FLEEING FROM
PERSECUTION.
WE, THE UNITED STATES, USED TO
DO OUR PART.
WE WERE PART OF THAT.
WE'RE -- AND, YOU KNOW, THAT'S,
YOU KNOW -- SEND ME YOUR
HUDDLED MASSES.
COME ON!
>> John: RIGHT, AND UNDERNEATH
THAT PATRIOTIC WORD SALAD IS A
PRETTY GOOD POINT.
EVEN THOUGH HE'S MAKING IT WHILE
MANAGING TO SOUND LIKE A GUY IN
A STATUE OF LIBERTY COSTUME IN
TIMES SQUARE.
"SEND ME YOUR HUDDLED MASSES.
COME ON.
I'M BREATHING IN GREEN LEAD
PAINT HERE, SO DO YOU WANT
A PICTURE WITH ME AND
BUZZ LIGHTYEAR OR NOT?"
IN EARLY FEBRUARY, BIDEN
ANNOUNCED THAT HE'D RAISE THE
CEILING ON ADMISSIONS TO OVER
62,000, ELIMINATE TRUMP'S
RESTRICTIONS, AND RAISE THE CAP
EVEN HIGHER NEXT YEAR.
WHICH SOUNDS GREAT.
UNFORTUNATELY, THAT WAS TWO
MONTHS AGO, AND HE STILL HASN'T
SIGNED THE PRESIDENTIAL
DETERMINATION THAT WOULD REVISE
TRUMP'S RULES.
AND IT HAS BEEN HARD TO GET A
STRAIGHT ANSWER FROM THIS
ADMINISTRATION ABOUT WHY.
>> THE PRESIDENT HAS SAID THAT
THAT'S SOMETHING THAT SHOULD BE
DONE IMMEDIATELY.
WHY DIDN'T HE DO IT TODAY?
>> I THINK WE'RE GONNA HAVE MORE
AGAIN SOON IN THE COMING DAYS
AND WEEKS ON MORE STEPS AND
ACTIONS THAT THE PRESIDENT IS
INTERESTED IN TAKING.
SO I'M JUST NOT GONNA GET AHEAD
OF THAT RIGHT NOW.
>> WHY HASN'T THE PRESIDENT
SIGNED THE PAPERWORK TO LIFT
THE, THE -- RAISE THE REFUGEE
CAP?
>> WELL, I WOULD REFER YOU TO
THE STATE DEPARTMENT.
>> LAST MONTH, THE PRESIDENT DID
ANNOUNCE THAT HE INTENDED TO
RAISE THE REFUGEE CAP.
THAT HASN'T SEEMED TO HAPPEN
YET.
WHY HAVEN'T THOSE FLIGHTS
CONTINUED?
>> HE REMAINS COMMITTED, BUT I
DON'T HAVE AN UPDATE ON THE
TIMING OF THE FLIGHTS.
>> DOES IT HAVE ANYTHING TO DO
WITH THE FACT THAT RESOURCES ARE
GOING TOWARDS THE BORDER AT THIS
TIME?
OR --
>> NO, NO, IT'S NOT RELATED TO
THAT.
NO.
>> John: THEN WHAT IS IT RELATED
TO?
ALTHOUGH PROPS TO JEN PSAKI,
ONLY A FEW MONTHS INTO THE JOB
AND SHE'S ALREADY WAVING AWAY
CONCERNS ABOUT STRANDED REFUGEES
WITH THE EASE OF
A SPIRIT AIRLINES GATE
AGENT LETTING YOU KNOW YOUR
FLIGHT'S DELAYED.
"REST ASSURED, WE'RE COMMITTED
TO GETTING YOU TO ORLANDO
EVENTUALLY.
WE JUST CAN'T TELL YOU WHERE
YOUR PLANE IS, WHY IT'S TAKING
SO LONG, OR WHAT YEAR YOU MIGHT
ARRIVE."
AND THE THING IS, THERE ARE
NEARLY 115,000 REFUGEES IN
VARIOUS STAGES OF THE
RESETTLEMENT PROCESS RIGHT NOW,
WITH MORE THAN 35,000 ALREADY
APPROVED FOR RESETTLEMENT HERE.
BUT UNTIL BIDEN SIGNS THAT
DETERMINATION, THEY'RE STILL
BEHOLDEN TO TRUMP'S LOW
ADMISSIONS CEILING AND BULLSHIT
RACIST RULES.
AND MUCH AMONG, MORE THAN 700
REFUGEES HAD THEIR FLIGHTS
CANCELED.
AND REMEMBER, THESE ARE
VULNERABLE PEOPLE WHO MAY HAVE
SURRENDERED THEIR BELONGINGS OR
HOMES IN ANTICIPATION OF LEAVING
THE COUNTRY OR WHO ARE WAITING
IN CAMPS.
ALSO, ANY DELAY CAN MEAN THEIR
REQUIRED HEALTH OR SECURITY
CHECKS EXPIRE, AND THEY HAVE TO
START THE WHOLE PROCESS ALL OVER
AGAIN.
ONE CONGOLESE WOMAN WAS
SCHEDULED TO FLY HERE IN EARLY
MARCH BUT HAD HER TICKET
CANCELED, AND BECAUSE SHE'S
PREGNANT AND NOW IN HER THIRD
TRIMESTER, SHE CAN NO LONGER
TRAVEL AT ALL.
AND BY THE WAY, WHEN HER BABY IS
BORN, THAT CHILD WILL HAVE TO
UNDERGO A SEPARATE SCREENING
PROCESS THAT COULD TAKE MONTHS.
WHICH IS PRETTY WEIRD BECAUSE
I'M RELATIVELY SURE YOU CAN'T
HAVE FOREIGN ALLEGIANCES BEFORE
YOU HAVE OBJECT FUCKING
PERMANENCE.
THERE ARE THOUSANDS OF PEOPLE
NOW STUCK IN THIS POINTLESS
LIMBO.
IT'S AN INFURIATING SITUATION,
PERHAPS BEST SUMMED BY THIS
WOMAN, WHO CAN'T FIGURE OUT WHY
HER FRIEND -- A REFUGEE
CURRENTLY STUCK IN A CAMP IN
MALAWI, WHO'S BEEN APPROVED FOR
RESETTLEMENT -- CAN'T GET ON A
PLANE.
>> THIS PRESIDENT, JOE BIDEN.
WHEN HE CAME, HE SAID THAT HE
WOULD JUST ADD MORE REFUGEES TO
COME TO USA.
AND I HEAR IN THE NEWS THAT
THERE IS A PAPER.
I DON'T KNOW WHICH IS A PAPER OR
SOMETHING THAT HE'S SUPPOSED TO
SIGN.
PLEASE, PLEASE, IF HE HEAR MY
VOICE, PLEASE HELP OUR FRIENDS
WHO ARE STRUGGLING IN THE
REFUGEE CAMP.
>> John: LOOK, AT LEAST SOME
OF THE PEOPLE WHO VOTED FOR
BIDEN -- MAYBE RELUCTANTLY --
DID SO ON THE UNDERSTANDING THAT
REFUGEES WOULD NOT HAVE TO GO ON
CAMERA TO BEG FOR THEIR
ALREADY-APPROVED LOVED ONES TO
BE ALLOWED TO COME HERE, BECAUSE
THAT IS ONE OF THOSE THINGS THAT
GOOD GUYS ARE SUPPOSED TO
CHANGE, RIGHT NEXT TO NOT HIRING
THEIR OWN KIDS OR NOT LETTING
MIKE LINDELL SWAP OUT THE
PILLOWS IN THE LINCOLN BEDROOM.
AND FOR BIDEN, THIS IS ACTUALLY
REALLY SIMPLE.
HE DOESN'T NEED TO NEGOTIATE
WITH REPUBLICANS ON THIS OR
RECKON WITH JOE MANCHIN'S BONER
FOR THE FILIBUSTER.
HE JUST NEEDS TO SIGN A PIECE OF
PAPER.
AND FOR A GUY WHO CLEARLY WANTED
TO BE THE PERSON WHO "RESTORED
THE SOUL" OF AMERICA, IT'S PAST
TIME FOR HIM TO LOOK DEEP INTO
HIS OWN, PICK UP A FUCKING PEN,
AND DO THE RIGHT THING.
AND NOW THIS.
>> Announcer: AND NOW, A
FAREWELL TRIBUTE TO THE GREATEST
QUESTIONS EVER ASKED ON
YAHOO! ANSWERS.
>> WHY DO MY BALLS SMELL LIKE
HAM?
WHAT'S WRONG ABOUT BEING
SEXUALLY ATTRACTED TO POKEMON?
IS IT TRUE THAT SWEAT IN PEE ARE
LIKE COUSINS?
WHAT IS THAT ONE MOVIE WHERE
LINDSAY LOHAN AND JAMIE LEE
CURTIS SWITCH BODIES?
NOT "FREAKY FRIDAY?"
STD FROM DOUG?
IS IT POSSIBLE?
OKAY, WEIRD QUESTION, I SAW A
FROG CARRYING ANOTHER FROG ON
ITS BACK.
DOES OF ART CONTAIN DNA?
HOW IS BABBY FORMED?
>> John: MOVING ON.
OUR MAIN STORY TONIGHT CONCERNS
NURSING HOMES, THE ABSOLUTE LAST
THING YOU WANT ANDREW CUOMO TO
BE HANDLING, TIED COMFORTABLY
WITH LITERALLY ANYTHING ELSE.
NURSING HOMES, AND LONG-TERM
CARE IN GENERAL, ARE SOMETHING
WE TEND TO AVOID THINKING ABOUT,
BUT THE TRUTH IS, WHETHER DUE TO
OLD AGE OR DISABILITY, MANY OF
US DO OR WILL REQUIRE HELP WITH
DAILY LIVING.
THE NUMBER OF AMERICANS 65 AND
OLDER IS PROJECTED TO NEARLY
DOUBLE OVER THE NEXT 40 YEARS,
AND ONE STUDY ESTIMATED OVER
TWO-THIRDS OF AMERICANS WHO
REACH 65 WILL NEED LONG-TERM
CARE AT SOME POINT IN THEIR
LIVES.
AND THE GOOD NEWS IS, FOR THE
RICH, THERE ARE PLENTY OF
OPTIONS.
THERE ARE MULTIPLE UPSCALE
RETIREMENT COMMUNITIES WHERE
RESIDENTS CAN TRANSITION, IF
NEEDED, INTO FULL-TIME NURSING
CARE, LIKE THIS ONE, TOURED IN
EXQUISITE FASHION BY 2 CHAINZ:
>> ALL RIGHT.
SO THE NAME OF THIS EPISODE IS
CALLED "THE MOST EXPENSIVE
RETIREMENT," RIGHT?
AND SO THIS IS THE MOST
UPSCALE, LUXURIOUS RETIREMENT
HOME THAT I'VE EVER SEEN AND
EVER HEARD ABOUT.
>> THE BUILDING ITSELF COST
$100 MILLION TO BUILD.
>> DAMN.
>> THE -- THE MARBLE, IT'S FROM
ITALY.
IT'S CUSTOM CARPET.
>> I SEE A LOT OF ART.
I SEE THE VERSACE PLATES.
>> John: OKAY.
EXTRAVAGANCE OF THAT PLACE
ASIDE, LET'S ALL JUST AGREE:
THAT $195 PLATE SUCKS SHIT.
AND I'M NOT NORMALLY A PLATE
GUY -- YOUR BOY'S A SAUCER FREAK
FROM WAY BACK.
I'M A BOWL BITCH.
PLATES AREN'T REALLY MY THING.
BUT EVEN I CAN TELL THAT PLATE
IS A 2.
THAT'S A 2 IN OHIO.
IF YOU'RE GONNA SPEND THAT KIND
OF MONEY ON A PLATE, IT BETTER
BE REALLY BIG, REALLY FUN, OR
REALLY, REALLY HOT.
THAT PLATE --
LOOK AT ME.
PUT YOUR PHONE DOWN AND LOOK AT
ME WHEN I'M TALKING TO YOU.
THAT PLATE FUCKS.
BUT THE FACT IS, MOST OF US
AREN'T ENDING UP IN THAT PLACE.
IN FACT, THE VAST MAJORITY OF
PEOPLE RECEIVE LONG-TERM CARE AT
HOME, AND AROUND 80% OF THAT
CARE IS PROVIDED BY UNPAID
CAREGIVERS, OFTEN FAMILY MEMBERS
WHO WANT TO KEEP THEIR LOVED
ONES OUT OF INSTITUTIONAL CARE,
LIKE THIS WIFE AND DAUGHTER.
>> CHERYL AND KRISTIN ARE AMONG
THE 42 MILLION AMERICANS CARING
FOR LOVED ONES AT HOME, AND THE
TASKS THEY PERFORM HAVE BECOME
INCREASINGLY COMPLEX.
>> WHEN WE HAVE TO FLUSH HIS
PICC LINE OR CLEAN HIS PEG TUBE
OR TAKE HIS BLOOD GLUCOSE OR HIS
BLOOD PRESSURE, YOU KNOW, NONE
OF US WENT TO SCHOOL FOR THAT.
I MEAN, WE'RE NOT EDUCATED THAT
WAY.
>> I DON'T FEEL LIKE I HAD
ENOUGH TRAINING AT ALL FOR THIS.
WE'VE KIND OF LEARNED BY TRIAL
AND ERROR.
>> John: THAT SEEMS REALLY HARD.
AND THERE ARE CERTAIN THINGS
YOU EXPECT TO DO BY TRIAL AND
ERROR -- SOLVING A PUZZLE,
LEARNING TO PRONOUNCE THE NAME
OF TAMBOURINE SATURDAY, OR
CHOOSING A HAIRCUT -- FOR THE
RECORD, ERROR, ERROR, ERROR, AND
ERROR -- BUT PROVIDING ESSENTIAL
MEDICAL CARE SHOULD NOT BE ONE
OF THOSE THINGS.
TAKING CARE OF SOMEONE AT HOME
CAN BE AN INCREDIBLY
COMPLICATED, FULL-TIME JOB
THAT IS ALMOST ALWAYS UNPAID.
IN FACT, IN TERMS OF LOST WAGES,
THE LABOR OF FAMILY CAREGIVERS
TOTALS ABOUT $67 BILLION
ANNUALLY.
THAT'S A WORKFORCE THAT, IF IT
WERE PAID, WOULD RIVAL THE
ENTIRE GDP OF BULGARIA.
BUT FOR THOSE WHO CAN'T AFFORD
TO EAT OFF UNFUCKABLE PLATES OR
WHOSE LOVED ONES ARE UNABLE TO
HELP THEM AT HOME, MANY WIND UP
IN LONG-TERM CARE FACILITIES.
THERE ARE TWO MILLION PEOPLE IN
THEM IN THE U.S., AND AS WE'VE
SEEN DURING THE COVID CRISIS,
THEY CAN BE FAR FROM IDEAL.
RESIDENTS AND STAFF IN THEM MAKE
UP LESS THAN 1% OF THE
POPULATION, BUT CURRENTLY
ACCOUNT FOR A THIRD OF COVID
DEATHS.
THE PANDEMIC PUSHED AN ALREADY
HEAVILY STRAINED SYSTEM TO THE
ABSOLUTE BRINK, WITH CONDITIONS
GETTING SO BAD THERE WERE
NEAR-CONSTANT LOCAL NEWS STORIES
LIKE THIS:
>> ONE RESIDENT HERE SAYS HER
CALLS FOR HELP OR IGNORED
BECAUSE THERE WASN'T ENOUGH
STAFF TO RESPOND.
>> I'M SCREAMING, "GET ME OUT OF
HERE, GET ME OUT OF HERE, GET ME
OUT OF THIS THI --"
I WAS SCREAMING AT THEM.
I WAS IN TERRIBLE PAIN, AND THEY
DIDN'T COME FOR ME.
>> PENNY SHAW WAS IN PAIN AS SHE
LAY HELPLESS IN HER BED AT
BRAINTREE MANOR NURSING HOME IN
THE MIDST OF THE COVID-19
PANDEMIC.
SHE BECAME SO DESPERATE SHE EVEN
CALLED BRAINTREE POLICE FOR
HELP.
>> I CAN'T LAY IN BED FOR HOURS
AND HOURS, YOU KNOW, IN PAIN
LIKE THAT.
>> John: I HAVE TO TELL YOU,
WE CONTACTED THAT FACILITY, IT
INSISTED THAT THE SAFETY OF ITS
RESIDENTS IS OF UTMOST
IMPORTANCE, BUT THAT IS PRETTY
FUCKING HARD TO BELIEVE WHEN
THEY ARE CALLING THE POLICE FOR
HEALTH.
THEIR ONLY TWO INSTANCES WHERE
THAT IS TO BE EXPECTED, AND THAT
IS
IF YOU'RE GIVING BIRTH OR
DIGESTING A CRUNCH WRAP SUPREME.
BUT IT'S A LOT MORE UPSETTING
AND THE TRUTH IS, COVID JUST
EXPOSED WHAT WE'VE BASICALLY
KNOWN FOR YEARS -- THAT THE WAY
THE ELDERLY AND DISABLED ARE
TREATED IN FAR TOO MANY OF THESE
FACILITIES IS WITH, AT BEST,
INDIFFERENCE, AND AT WORST,
ABUSE AND NEGLECT.
SO TONIGHT, LET'S TALK ABOUT
LONG-TERM CARE -- HOW THE
INDUSTRY IS STRUCTURED, HOW THAT
STRUCTURE CREATES BAD
INCENTIVES, AND WHAT WE CAN DO
GOG FORWARD.
AND WE'RE GOING TO FOCUS ON THE
TWO MAIN TYPES OF LONG-TERM
CARE FACILITIES: NURSING HOMES,
AND ASSISTED LIVING FACILITIES.
NURSING HOMES ARE MEDICAL
FACILITIES OVERSEEN BY TRAINED
NURSES AND LARGELY STAFFED BY
LOW-PAID NURSING ASSISTANTS.
AND THERE HAVE LONG BEEN ISSUES
WITH NURSING HOME CARE -- A GAO
REPORT COVERING A FIVE-YEAR
PERIOD BEFORE THE PANDEMIC FOUND
THAT 82% OF HOMES HAD BEEN CITED
FOR INFECTION PREVENTION AND
CONTROL DEFICIENCIES, AND ABOUT
HALF HAD PERSISTENT PROBLEMS
THAT HAD BEEN CITED ACROSS
MULTIPLE YEARS.
AND A BIG REASON FOR THAT MAY BE
BECAUSE UNDERSTAFFING IS A BIG
PROBLEM, WITH EMPLOYEES OFTEN
TASKED WITH TAKING CARE OF WAY
TOO MANY RESIDENTS, AS THESE
NURSING ASSISTANTS POINTED OUT
JUST LAST YEAR.
>> THEY'RE NOT BEING SHOWERED.
>> PEOPLE FALLING OUT OF BED.
>> THE MEN AREN'T BEING SHAVED.
>> PEOPLE FALLEN TO WHERE THEY
FELL OUT OF THEIR WHEELCHAIRS.
>> WHAT IF THEY NEED CHANGED?
>> THEY MIGHT GET IT ONE TIME.
>> A DAY?
>> A DAY.
WE HAVE 22 RESIDENTS APIECE.
MOST DAYS, THAT'S FOR ONE PERSON
TO WASH, DRESS, GET UP, TWO
MEALS, AND THEY'RE BEING
NEGLECTED BECAUSE YOU CAN'T GET
TO EVERYBODY.
I TOLD THE ADMINISTRATOR, I'M
EMBARRASSED OF MY WORK PROCESS
BECAUSE I CAN'T DO WHAT I WAS
TRAINED TO DO ON HOW TO TAKE
CARE OF THESE RESIDENTS.
>> John: THAT IS OBVIOUSLY
UNACCEPTABLE.
DO YOU HAVE ANY IDEA HOW BAD
THINGS NEED TO GET FOR YOU TO
TELL YOUR BOSS YOU'RE
EMBARRASSED BY YOUR WORK?
I'M NOT EVEN EMBARRASSED BY MY
WORK, AND JUST THREE MINUTES
AGO, I JOKED ABOUT FUCKING A
PLATE.
ALSO, THAT WASN'T REALLY A JOKE.
CALL ME, WOLF PLATE.
AND NURSING ASSISTANTS AREN'T
JUST OVERWORKED -- THEY'RE
REALLY UNDERPAID.
THE MEDIAN NATIONAL SALARY FOR
THAT JOB IS BARELY $30,000 A
YEAR.
AND ONE REASON IS THAT NEARLY
70% OF NURSING HOMES ARE NOW
FOR-PROFIT INSTITUTIONS.
AND THERE IS A LOT OF PROFIT FOR
THEM TO MAKE, BECAUSE THEY DON'T
PAY STAFF MUCH, BUT THEY CHARGE
YOU A LOT.
THE AVERAGE PER-PERSON COST FOR
A PRIVATE ROOM IS $100,000 PER
YEAR.
AND IF YOU'RE THINKING, "YEAH,
THAT IS EXPENSIVE, BUT DOESN'T
THE MEDICARE PROGRAM I HAVE PAID
INTO ALL MY LIFE COVER THAT?"
WELL, NO, IT DOESN'T.
MEDICARE ONLY FULLY COVERS THE
FIRST 20 DAYS OF NURSING HOME
CARE AFTER AN ELIGIBLE HOSPITAL
VISIT, THEN PARTIALLY PAYS FOR
UP TO 100 DAYS.
BUT AFTER THAT, YOU ARE ON THE
HOOK FOR ALL COSTS.
THE ONLY OTHER WAY TO ACCESS
TAXPAYER HELP TO LIVE IN A
NURSING HOME IS TO ALMOST
COMPLETELY IMPOVERISH YOURSELF,
TO BASICALLY SPEND YOUR WAY DOWN
TO THE POINT YOU QUALIFY FOR
MEDICAID, THE GOVERNMENT PROGRAM
FOR THE POOR, WHICH, CRUCIALLY,
REIMBURSES NURSING HOMES AT LESS
THAN HALF THE AVERAGE DAILY RATE
PAID BY MEDICARE.
AND WHILE YOU WOULD LIKE TO
THINK THAT NURSING HOMES WOULD
TREAT ALL PATIENTS THE SAME,
WHETHER THEY'RE ON MEDICARE OR
MEDICAID, THE TRUTH IS, YOU
MIGHT GET TWO VERY DIFFERENT
EXPERIENCES.
BECAUSE IF YOU'RE ON MEDICARE,
YOU COULD WIND UP GETTING TOO
MUCH ATTENTION.
JUST LISTEN TO AN ASSISTANT
MANAGER AT ONE NURSING HOME
CHAIN DESCRIBE HOW MEDICARE
PATIENTS THERE WERE TREATED.
>> WHAT PERCENTAGE OF THE
THERAPY THAT YOU WERE BEING TOLD
TO ADMINISTER DO YOU THINK WAS
NOT NECESSARY?
>> I WOULD SAY PROBABLY, AS TIME
WENT ON, ABOUT 40%.
>> 40% OF THE WORK THAT YOU WERE
DOING --
>> WAS NOT REASONABLE AND NOT
NECESSARY UNDER MEDICARE
GUIDELINES.
AT ANOTHER FACILITY, THE ENTIRE
REHAB STAFF SIGNED A LETTER TO
THEIR BOSS.
IT READS, "WE HAVE BEEN
ENCOURAGED TO MAXIMIZE
REIMBURSEMENT EVEN WHEN
CLINICALLY INAPPROPRIATE."
>> John: THAT IS ABSURD.
THE DOJ ACTUALLY FILED A LAWSUIT
CLAIMING THAT THE CHAIN THAT
WOMAN WORKED FOR, LIFE CARE
CENTERS OF AMERICA -- WHICH RUNS
OVER 200 NURSING HOMES -- WAS
SUBJECTING ITS PATIENTS TO
THERAPY EVEN AS THEY WERE ON
THEIR DEATHBEDS.
IT ALLEGED ONE 92-YEAR-OLD WHO
WAS DYING OF METASTATIC CANCER
WAS RECORDED AS HAVING HAD
48 MINUTES OF PHYSICAL THERAPY,
47 MINUTES OF OCCUPATIONAL
THERAPY, AND 30 MINUTES OF
SPEECH THERAPY, JUST TWO DAYS
BEFORE HIS DEATH, ON A DAY HE
WAS SPITTING UP BLOOD.
WHICH IS ABSURD.
RESIDENTS SHOULD BE GETTING
PROPER NURSING CARE.
NOT SHIT-TONS OF EXPENSIVE
THERAPEUTIC TREATMENTS THAT ARE
CLINICALLY INAPPROPRIATE.
WHICH, BY THE WAY, I'M PRETTY
SURE WAS THE ORIGINAL SLOGAN OF
GOOP.
NOW, LIFE CARE DENIED
WRONGDOING, BUT AGREED TO PAY
$145 MILLION TO RESOLVE THAT
LAWSUIT.
AND THEY'RE HARDLY ALONE HERE.
OVER THE PAST DECADE, MULTIPLE
OTHER LARGE NURSING HOME CHAINS
HAVE BEEN CHARGED WITH
FRAUDULENT MEDICARE BILLING
PRACTICES AND DENIED WRONGDOING
WHILE PAYING MILLIONS OF DOLLARS
TO SETTLE THEIR CASES.
YOU KNOW, LIKE YOU DO WHEN
YOU ARE TOTALLY INNOCENT.
SO TO RECAP HERE: IF MEDICARE IS
PAYING, THE RISK IS, YOU COULD
BILLED FOR UNNECESSARY
TREATMENTS.
BUT IF MEDICAID IS PAYING --
WHICH, REMEMBER, REIMBURSES
NURSING HOMES AT LESS THAN HALF
THE AVERAGE DAILY RATE -- THINGS
COULD GET MUCH WORSE.
BECAUSE IF FACILITIES WANT TO
OPEN UP A BED TO A MORE
LUCRATIVE PATIENT, THEY CAN TAKE
DRASTIC ACTION.
>> RONALD, WHO WAS 51 AND
HOMELESS, GOT REHAB AT THE
NURSING HOME WHERE HE LIVED FOR
MORE THAN A YEAR.
THEN ONE NIGHT, AROUND
10:00 P.M., HE SAYS AN
ADMINISTRATOR CAME INTO HIS
ROOM.
>> BIG SMILE ON THEIR FACE,
SAYING, "WE'RE KICKING YOU OUT."
YEAH.
AND THEY JUST BUNDLED ME INTO A
VAN AND JUST DROPPED ME OFF HERE
ON THE SIDEWALK.
>> THE AVALON VILLA CARE CENTER,
THROUGH ITS LAWYERS, TOLD NBC
NEWS IT STRONGLY DISPUTES THAT
IT HAS INAPPROPRIATELY
DISCHARGED ANY PATIENTS.
THE HOMELESS SHELTER WHERE
RONALD IS LIVING NOW SAYS IT'S
SEEN CASES LIKE THIS BEFORE.
EXPERTS EVEN HAVE A TERM FOR IT:
RESIDENT DUMPING.
>> John: OH, COME ON, THAT'S
JUST FUCKING EVIL.
"RESIDENT DUMPING" IS A
COMPLETELY UNACCEPTABLE
PRACTICE.
I DON'T EVEN LIKE IT WHEN
RESIDENTS ARE DUMPED ON
"GREY'S ANATOMY."
AT THE ALTAR, BURKE?
YOU DUMPED THAT RESIDENT AT THE
FUCKING ALTAR?
HOW COULD YOU DO THAT TO
CRISTINA?
YOU FUCKING MONSTER!
AND YOU'D HOPE REGULATORS WOULD
PUNISH NURSING HOMES FOR DOING
THINGS LIKE THAT.
BUT THE OVERSIGHT HERE HAS SOME
MASSIVE GAPS.
FOR INSTANCE, THE FEDERAL
GOVERNMENT KEEPS A LIST OF
SO-CALLED "SPECIAL FOCUS
FACILITIES" -- HOMES THAT HAVE A
PATTERN OF SERIOUS PROBLEMS OVER
A LONG PERIOD OF TIME, AND
THEREFORE RECEIVE EXTRA
INSPECTIONS.
THERE ARE 88 NURSING HOMES ON
THAT LIST -- BUT INTERESTINGLY,
NOT BECAUSE THERE ARE ONLY
88 HOMES THAT DESERVE TO BE, BUT
BECAUSE, DUE TO LIMITED
RESOURCES, THE GOVERNMENT HAS
CAPPED THE LIST AT THAT EXACT
NUMBER, DESPITE THE FACT THEY
FULLY ACKNOWLEDGE AN ADDITIONAL
400 FACILITIES QUALIFY FOR THE
PROGRAM.
AND LOOK, I'M NOT SAYING EVERY
LIST SHOULD GO ON FOREVER.
IF A LIST OF CUTEST OTTERS WAS
CAPPED AT 88, THAT'D BE A
PERFECTLY FINE LIST.
BUT IF THERE WERE 400 OTHER CUTE
OTTERS THAT WERE ALSO ABUSING
THE ELDERLY, I'D REALLY LIKE TO
KNOW WHO ALL OF THEM ARE.
AND IF YOU'RE THINKING, "WELL,
THAT'S GOOD TO KNOW.
IF I NEED TO MOVE A LOVED ONE
INTO A NURSING HOME, I'M
DEFINITELY GOING TO LOOK ONLINE
AND MAKE SURE IT'S A GOOD ONE,"
WELL, BE CAREFUL.
BECAUSE WHILE THE GOVERNMENT
DOES HAVE A WEBSITE WHERE
NURSING HOMES ARE RATED FROM ONE
TO FIVE STARS, IT HAS AN
ABSOLUTELY MASSIVE LOOPHOLE.
>> OF THE THREE FACTORS THAT
DETERMINE AN OVERALL RATING,
ONLY THE HEALTH INSPECTIONS ARE
CONDUCTED INDEPENDENTLY.
THE OTHER STATISTICS, STAFFING
AND QUALITY MEASURES, ARE
SELF-REPORTED BY THE NURSING
HOME.
THESE SELF-REPORTED STATISTICS
CAN BOOST A THREE-STAR RATING
INTO A FIVE-STAR RATING OVERALL.
>> THE PROBLEM IS, YOU KNOW,
IT'S GARBAGE IN, GARBAGE OUT.
SO WHATEVER THEY'RE TELLING THE
FEDS, THE FEDS ARE NOT -- THAT
FEDERAL GOVERNMENT ISN'T GOING
IN AND DOUBLE-CHECKING THAT
THEIR NUMBERS ARE ACCURATE.
>> John: YEAH.
"GARBAGE IN, GARBAGE OUT."
AND THAT IS PATHETIC.
SOMETHING IMPORTANT AS OUR
NURSING HOME RATING SYSTEM
SHOULDN'T FOLLOW THE SAME RULE
AS EVERY RECIPE ON VELVEETA'S
WEBSITE.
BECAUSE THERE'S JUST NO WAY ANY
OF THOSE ARE GOOD.
IF YOU'RE MAKING A RECIPE
THAT CALLS FOR A PUDDLE OF
LORAX JIZZ, THEN DON'T BE
SURPRISED WHEN THE FINISHED
PRODUCT IS EQUALLY REPULSIVE.
IT'S GARBAGE IN, GARBAGE OUT.
SO GIVEN EVERYTHING YOU'VE SEEN,
IT'S HARDLY SURPRISING THAT --
FOR REASONS OF COST OR
CONDITIONS -- MANY MIGHT WANT TO
AVOID A NURSING HOME ALTOGETHER.
WHICH BRINGS US TO ASSISTED
LIVING FACILITIES, OR ALFs.
AROUND A THIRD OF PEOPLE IN
LONG-TERM CARE ARE IN ONE OF
THESE, AND THEY DO COST FAR LESS
THAN A NURSING HOME -- TYPICALLY
AROUND $50,000 A YEAR.
ALFs STARTED OUT AS AN
ALTERNATIVE FOR THOSE WHO NEEDED
HELP WITH KEY ACTIVITIES -- LIKE
DRESSING, TOILETING, TAKING
MEDICINES AND EATING -- BUT ONLY
NEEDED LIMITED MEDICAL SUPPORT.
JUST AS WITH NURSING HOMES, THE
VAST MAJORITY OF ALFs ARE
FOR-PROFIT.
BUT THERE ARE ALSO SOME KEY
DIFFERENCES.
ALFs ARE LARGELY PAID FOR
OUT-OF-POCKET.
AND THEY ARE FAR LESS REGULATED,
MAKING EASY FOR BASICALLY ANYONE
TO START ONE.
AND I DO MEAN ANYONE.
TAKE STEPHANIE COSTA.
BY 30, SHE OWNED SIX SMALL ALFs
IN SOUTHERN CALIFORNIA AND HAD
MADE A LOT OF MONEY FROM THEM,
ENOUGH TO QUALIFY HER TO
APPEAR IN AN EPISODE OF
"THE MILLIONAIRE MATCHMAKER."
>> MY NAME IS STEPHANIE AND I'M
30 YEARS OLD AND I OWN A CHAIN
OF ELDERLY CARE FACILITIES.
MY NET WORTH IS $3-4 MILLION,
PROBABLY.
I'VE ALWAYS HAD THIS THING OF
TAKING CARE OF OLDER PEOPLE.
LIKE SICK, PEOPLE THAT ARE
DYING.
I'VE ALWAYS REALLY FELT FOR
THEM.
SO I COULDN'T WAIT TO GRADUATE
COLLEGE AND START MY OWN
BUSINESS DOING ASSISTED LIVING
FACILITIES LIKE NURSING HOMES.
>> John: OKAY.
THERE ARE A LOT OF UNFAIR
REASONS THAT I INHERENTLY DON'T
TRUST STEPHANIE COSTA, FROM HER
DRIVING A DOUCHEY FERRARI TO THE
FACT SHE LOOKS LIKE AN
UNCREDITED EXTRA FROM AN
"ENTOURAGE" PARTY SCENE TO THAT
VOICE, WHICH SOUNDS LIKE A MOUSE
WHO WOULDN'T DRESS CINDERELLA
BECAUSE IT HAD BETTER THINGS TO
DO.
BUT IT TURNS OUT THAT
GUT FEELING IS ENTIRELY VALID,
BECAUSE COSTA TREATED HER
EMPLOYEES AND RESIDENTS SO
TERRIBLY THAT, AFTER MULTIPLE
HEALTH AND SAFETY VIOLATIONS,
CALIFORNIA BANNED COSTA FROM THE
INDUSTRY FOR LIFE AND ORDERED
HER AND HER COMPANY TO PAY ABOUT
$1.6 MILLION FOR UNPAID
WAGES AND PENALTIES.
BUT IF YOU THINK THAT GAVE HER
ACCOUNTABILITY, YOU'RE GOING TO
WANT TO THINK AGAIN.
>> SHE KEPT THIS HOME AFTER
FILING FOR BANKRUPTCY AND
SETTLED WITH WORKERS FOR A
FRACTION OF WHAT SHE OWED.
HER SIX CARE HOMES ARE NOW OWNED
BY A PROPERTY INVESTMENT COMPANY
REGISTERED BY HER FATHER.
>> John: OH, YEAH.
NOT JUST THAT, AS RECENTLY AS
LAST YEAR, SHE WAS STILL LISTED
AS THAT COMPANY'S CEO.
SO THE STATE OF CALIFORNIA
REALLY TAUGHT STEPHANIE COSTA A
LESSON THERE.
SPECIFICALLY, THE LESSON THAT
YOU CAN TREAT YOUR ELDER CARE
WORKERS LIKE ABSOLUTE SHIT,
AVOID ANY REAL CONSEQUENCES, AND
JUST KEEP LIVING YOUR LIFE IN
THE SINGLE UGLIEST HOME IN
BEVERLY HILLS -- ALTHOUGH IT'S
LEGITIMATELY HARD TO TELL
WHETHER THAT'S ACTUALLY A HOME
OR JUST AN ABANDONED
WHITE CASTLE.
BUT IT'S NOT JUST INDIVIDUALS
INVOLVED HERE.
THERE ARE ALSO BIG CORPORATIONS
RUNNING ALFs, WHO'VE BEEN
WORKING HARD TO FILL BEDS.
AND DESPITE THE FACT ALFs ARE
SUPPOSED TO BE FOR PEOPLE WHO
REQUIRE LESS MEDICAL ATTENTION,
RECENTLY, SOME HAVE BEEN
AGGRESSIVELY COURTING DEMENTIA
PATIENTS FOR MEMORY CARE
PROGRAMS, AS SEEN IN THIS
ADVERTISEMENT FOR BROOKDALE, THE
LARGEST ALF PROVIDER IN THE
COUNTRY.
>> THIS IS A COMPASSIONATE PLACE
THAT HELPS FAMILIES THROUGH VERY
DIFFICULT STAGES OF DEMENTIA IN
A SAFE AND COMFORTABLE SETTING,
AND I HAVE PEACE OF MIND KNOWING
THERE IS A STAFF, FULLY TRAINED,
24 HOURS A DAY, SEVEN DAYS A
WEEK.
I CAN'T BELIEVE HOW MUCH MY
MOM'S QUALITY OF LIFE HAS
IMPROVED SINCE COMING HERE.
I'M SEEING HER SMILING AND
LAUGHING AGAIN.
>> WE HELP THEM MAINTAIN THEIR
ABILITIES AND ENCOURAGE THE USE
OF THEIR CURRENT SKILLS IN A
WARM, ENGAGING ENVIRONMENT.
>> THIS IS A SPECIAL PLACE, AND
EVERY DAY IS A NEW BEGINNING
WITH LOTS OF SMILES AND
MEMORIES.
>> John: OKAY.
I GET THAT A SENIOR LIVING
COMMERCIAL MIGHT WANT TO HAVE AT
LEAST ONE STAFFER WITH THEIR
ARMS AROUND A RESIDENT'S
SHOULDERS.
THAT'S KIND OF NICE.
TRUSTWORTHY.
MAKES YOU FEEL SAFE.
BUT IMMEDIATELY CUTTING TO
ANOTHER ONE FEELS LIKE A BIT
MUCH.
AND THEN A THIRD STARTS TO MAKE
ME FEEL A LITTLE NERVOUS.
AND WHEN THAT FOURTH HITS, AS A
BRITISH PERSON, I'VE GOT TO SAY,
THAT IS JUST TOO MUCH PHYSICAL
CONTACT.
THAT SAID, EVEN I'LL ADMIT, AN
ALF THAT OFFERED ALL THAT
COMMERCIAL CLAIMS TO BUT WITH
SIGNIFICANTLY LESS TOUCHING
WOULD BE GREAT.
UNFORTUNATELY, A WOMAN WHO
WORKED AT A BROOKDALE FACILITY
IN SOUTH CAROLINA PAINTED A VERY
DIFFERENT PICTURE OF HOW
STAFFERS ARE TRAINED TO WORK
WITH DEMENTIA PATIENTS.
>> WHEN YOU FIRST START, THEY
HAVE YOU SIT THROUGH A SERIES
OF IN-SERVICES OR ORIENTATION
AND IT LASTS ABOUT A WEEK, BUT
IT'S JUST VIDEO, BUT ONCE
THEY PUT YOU OUT ON THE FLOOR,
THEY DON'T -- THEY DON'T GIVE
YOU ANY TRAINING.
THEY JUST STICK YOU OUT THERE.
>> John: WELL, THAT'S NOT REALLY
IDEAL, IS IT?
IT'S HARD TO RETAIN IMPORTANT
INFORMATION JUST BY WATCHING A
VIDEO.
CASE IN POINT: THIS VIDEO.
THINK ABOUT IT.
WHAT HAVE YOU REALLY LEARNED
FROM THIS?
SURE, A FEW RANDOM FACTS ABOUT
THE LONG-TERM CARE INDUSTRY THAT
YOU'LL PROBABLY IMMEDIATELY
FORGET.
BUT MAINLY, YOU'VE LEARNED THAT
IT'S POSSIBLE TO WANT TO FUCK A
PLATE.
AND THAT'S A LESSON YOU WILL
NEVER FORGET.
AND BROOKDALE INSISTS THAT IT
OFFERS ONGOING TRAINING FOR ITS
WORKERS AND THAT ITS TRAINING
PROGRAM FOR DEMENTIA CARE
WORKERS MEETS OR EXCEEDS STATE
GUIDELINES.
BUT THAT IS NOT REALLY SAYING
MUCH, AS SOME STATES ONLY
REQUIRE TWO TO 30 HOURS, AND
SOUTH CAROLINA -- WHERE THAT
FACILITY IS LOCATED -- HAS NO
STATE MINIMUM AT ALL.
AND BY THE WAY, IF YOU'RE
WONDERING ABOUT WHY THERE WERE A
BUNCH OF SHOTS OF A POND IN THAT
STORY, THE ANSWER IS HORRIFYING.
BECAUSE A 90-YEAR-OLD RESIDENT
THERE, WHO WAS SUPPOSED TO BE
UNDER CONSTANT SUPERVISION
BEFORE BEING TRANSFERRED TO A
MEMORY CARE UNIT, DIED AFTER
LEAVING THE FACILITY UNNOTICED
IN THE MIDDLE OF THE NIGHT.
>> THERE ARE SIGNS OUT HERE
WARNING PEOPLE ABOUT ALLIGATORS.
TAKE A LOOK AT THIS ONE, IT
SAYS, "ALLIGATORS MAY LIVE HERE,
BE GATOR SAFE."
IN THIS CASE, THE SIGNS PROBABLY
WOULD NOT HAVE MADE A
DIFFERENCE, ACCORDING TO
AUTHORITIES.
WE'RE TOLD THE VICTIM LIKELY
SLIPPED OR FELL DOWN A STEEP
EMBANKMENT AND LANDED IN THE
WATER, ATTRACTING THE GATOR'S
ATTENTION.
>> John: HOLY FUCKING SHIT.
I HONESTLY DON'T EVEN KNOW WHERE
TO BEGIN THERE.
BUT I GUESS I'D START WITH: WHY
WOULD ANYONE PUT AN ASSISTED
LIVING FACILITY NEXT TO A
FUCKING ALLIGATOR POND?
THAT SEEMS LIKE THE SORT OF
DETAIL THAT REALLY HAS TO BE
INCLUDED AT THE END OF ONE OF
BROOKDALE'S HEARTWARMING ADS.
>> THIS IS A SPECIAL PLACE AND
EVERY DAY IS A NEW BEGINNING
WITH LOTS OF SMILES AND
MEMORIES.
ALSO, ONE OF OUR RESIDENTS
WAS EATEN BY AN ALLIGATOR, SO...
Y'KNOW...
THERE'S THAT.
>> John: YEAH.
THERE IS THAT.
AND THAT'S IMPORTANT INFORMATION
FOR PEOPLE TO KNOW, BROOKDALE.
AND LOOK, OBVIOUSLY, THAT'S AN
APPALLING STORY.
BUT TO BE FAIR, IT IS HARD TO
TALK ABOUT LONG-TERM CARE
WITHOUT SHOWING YOU AT LEAST ONE
OF THOSE.
JUST BE GRATEFUL I DIDN'T SHOW
YOU THE STORY WHERE A RESIDENT
JUMPED FROM A FOURTH-STORY
WINDOW OF AN ALF, OR THE ONE
ABOUT A NURSING HOME RESIDENT
WHO SET HERSELF ON FIRE, OR THE
ONE ABOUT A 91-YEAR-OLD
SUFFERING FROM ALZHEIMER'S WHO
FROZE TO DEATH ON CHRISTMAS DAY.
WHICH, BY THE WAY SOUNDS LIKE A
HOLIDAY ALBUM WRITTEN BY
FUCKING BJORK.
SO WHAT CAN WE DO?
WELL, OBVIOUSLY, INCREASED
OVERSIGHT AND ENFORCEMENT ARE
BADLY NEEDED.
THAT FACILITY WITH THE
ALLIGATORS WAS EVENTUALLY FINED
BY THE STATE FOR 11 VIOLATIONS,
INCLUDING NOT PROPERLY
PERFORMING NIGHT CHECKS AND
LETTING STAFFING DROP BELOW
REQUIRED LEVELS, BUT THE PENALTY
ISSUED WAS JUST $6,400.
AND IT FEELS LIKE IF YOU LOST A
LOVED ONE IN SUCH A HORRIFIC
WAY, YOU'D WANT MORE
ACCOUNTABILITY THAN "DON'T
WORRY, SOMEONE DECIDED THEIR
LIFE WAS WORTH THE PRICE OF A
2013 CHRYSLER MOTOWN."
AND THE FACT IS, THERE ARE LOTS
OF IDEAS ON HOW TO FORCE
FACILITIES TO IMPROVE --
MANDATING A CERTAIN AMOUNT OF
MONEY HAS TO GO TO PATIENT CARE,
FOR INSTANCE, OR THAT RESIDENTS
HAVE ACCESS TO A MINIMUM AMOUNT
OF CARE PER DAY.
BUT THE BIGGER FIX HERE MIGHT BE
TO TRY AND MAKE IT EASIER FOR AS
MANY PEOPLE AS POSSIBLE NOT TO
END UP IN THESE INSTITUTIONS IN
THE FIRST PLACE AND INSTEAD
RECEIVE WHATEVER SUPPORT THEY
NEED AT HOME.
NEARLY 90% OF PEOPLE OVER 65
APPARENTLY WANT TO STAY IN THEIR
HOME FOR AS LONG AS POSSIBLE,
WHICH DOES MAKE SENSE.
THE PROBLEM IS, RIGHT NOW, MANY
OF THEM CAN'T, BECAUSE UNDER
MEDICAID, NURSING HOME CARE IS
AN ENTITLEMENT -- BUT HOME-BASED
CARE IS NOT.
TO ACCESS LONG-TERM SERVICES AND
SUPPORTS THROUGH MEDICAID IN
YOUR HOME, YOU NEED A WAIVER
FROM YOUR STATE.
AND TO BE FAIR, SOME, LIKE
WASHINGTON, DO THAT PRETTY WELL.
MORE THAN 70% OF THE MEDICAID
MONEY THEY SPEND ON LONG-TERM
CARE FOR OLDER PEOPLE AND ADULTS
WITH DISABILITIES IS SPENT ON
HOME AND COMMUNITY BASED
SERVICES -- THINGS LIKE SKILLED
NURSING VISITS, HOME CARE AIDES
WHO CAN HELP WITH DAILY TASKS,
AND EVEN THE ABILITY TO PAY
FAMILY CAREGIVERS.
YOU KNOW, PEOPLE LIKE THOSE TWO
WOMEN YOU SAW EARLIER.
THE PROBLEM IS, OTHER STATES
HAVE WAITING LISTS THAT CAN BE
MANY YEARS LONG, BY WHICH POINT,
SENIORS TRYING TO ACCESS THAT
CARE CAN BE DEAD, BECAUSE,
SADLY, THAT IS HOW TIME WORKS.
NATIONWIDE, MORE THAN 800,000
PEOPLE ARE ON THESE KINDS OF
WAITING LISTS.
WHAT WE NEED IS REFORM AT A
NATIONAL LEVEL -- AND THERE ARE
ACTUALLY SOME PROMISING
DEVELOPMENTS HERE.
A DISCUSSION DRAFT OF A BILL WAS
RECENTLY INTRODUCED THAT WOULD
MAKE HOME AND COMMUNITY-BASED
CARE AN ENTITLEMENT UNDER
MEDICAID.
AND BIDEN'S PROPOSED
INFRASTRUCTURE PLAN ACTUALLY
CALLS FOR $400 BILLION TO BE
SPENT ON THOSE EXACT SERVICES.
AND THAT WOULD BE A BIG DEAL.
AND LOOK, AGGRESSIVE TRANSITION
TO HOME-BASED CARE IS GOING TO
NEED RIGOROUS GUARDRAILS AND
OVERSIGHT TO MAKE SURE THAT
MONEY IS NOT MISSPENT, JUST IN A
DIFFERENT WAY.
THE LAST THING I WANT IS, FIVE
YEARS FROM NOW, TO BE HAVING TO
DO A SHOW ON THE EVILS OF
NEW FOR-PROFIT HOME CARE
AGENCIES WHO'VE BEEN DESTROYING
PEOPLE'S LIVES IN THEIR OWN
HOMES.
AND IF YOU'RE THINKING, "WAIT,
FIVE YEARS FROM NOW YOU'LL STILL
BE DOING SHOWS IN THE VOID?"
OH, NO.
WE'LL BE BACK IN THE VOID.
I DON'T WANT TO GET INTO
SPECIFICS, BUT --
SPOILER ALERT --
IT'S NOT A PANDEMIC NEXT TIME!
IT'S SPIDERS.
BUT WE DO NEED TO DO SOMETHING.
AND IT ALL STARTS WITH SHOWING
THAT WE GIVE A SHIT ABOUT WHAT
HAPPENS TO THE ELDERLY AND
PEOPLE WITH DISABILITIES IN THIS
COUNTRY, 'CAUSE RIGHT NOW,
EVIDENCE POINTS TO THE FACT THAT
WE ABSOLUTELY DON'T, AND ALL THE
OTHER PROBLEMS ARE STEMMING FROM
THAT.
AND THE LONGER WE CONTINUE TO
IGNORE THIS, THE WORSE IT'S
GOING TO GET.
BECAUSE THE FACT IS, RIGHT NOW,
THIS IS AN INDUSTRY WHERE THE
PEOPLE IN ITS CARE ARE BEING
FIGURATIVELY -- AND SOMETIMES
LITERALLY -- EATEN ALIVE.
AND NOW THIS.
>> Announcer: AND NOW, A FEW
MORE OF THE GREATEST QUESTIONS
EVER ASKED ON YAHOO! ANSWERS.
>> HOW DO I GET SPAGHETTI STANDS
OFF MY UNDERWEAR.
IS IT OKAY TO GET A TRAMPOLINE
WET ONCE AND A WHILE?
DOES THE MOVIE "AIR BUD" PAINT
ACCURATE PICTURE OF A DOG'S
SKILL?
MY DAD IS A GOLF, WHAT DO I DO?
WHY ARE THE HOLES AND KETCHUP
ARE ALWAYS IN THE RIGHT PLACES
FOR THEIR EYES?
WHY WASN'T I BORN AN OCTOPUS?
CAN A BIRD STAY ON A CLOUD?
HOW DO I FIX MY FARTING PENIS?
ALVIN AND THE CHIPMUNKS?
HOW DO I TURN OFF MY CAPS LOCK?
>> John: THAT'S OUR SHOW,
THANKS SO MUCH FOR WATCHING,
WE'LL SEE YOU NEXT WEEK.
GOOD NIGHT.