Later On

A blog written for those whose interests more or less match mine.

Archive for May 28th, 2020

Capitalism and death: Private equity and nursing homes — and death (and money)

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Lucy Schiller writes at

RECENTLY, MY GRANDMOTHER LOUISE and I have discovered new uses for the slender stainless steel device known as a turkey lacer. Usually, it stitches up an avian cavity; under our set of circumstances, it gently scrapes out my grandmother’s hearing aids and loosens Velcro rollers from her hair. Our discovery of the implement’s many uses has come out of a particular necessity. About three weeks ago, my extended family extracted Louise from her assisted living facility in Denver, which is owned by a company called Brookdale Senior Living, the largest operator of senior living facilities in the United States. In the frantic move, which was spurred by a sudden burst of Covid-19 deaths in her facility, as well as similar facilities around the country, several things were lost: whatever item is actually meant to clean her hearing aids, the shoehorn she needs, a few slightly-less-essential medications.

I’m giving Louise a pseudonym in case she ever returns to her Brookdale facility. Her boyfriend still lives there, as do many of her friends. She didn’t necessarily want to leave, but she also doesn’t know if she wants to go back: at the time of this writing, her facility has twenty-six Covid-positive patients inside, most of whom Brookdale moved there from their other facilities, with seemingly no warning to residents or most staff. If residents return to the facility, they must undergo a strict two-week quarantine—but everyone inside is already on lockdown, and the two-week clock resets with every new case. Effectively, residents in Louise’s facility have been quarantined for two months in their rooms, while on the fourth floor, Covid-positive residents from Brookdale facilities across Denver struggle.

News on the building’s death statistics comes to residents and their families via mass Zoom calls. We have tried to keep good cheer around Louise, removed so far from her home. After dinner one night, we trotted out a bag of crackerjacks that had come with her from Brookdale—staff had left them at each resident’s door, to cheer them up during their enforced self-isolation. We thought she’d be pleased, but as she began to snack, Louise looked slightly rueful. “I’ll have to check the bill at the end of the month,” she said, “to see if they charged me for these.”

The comment piqued my interest. The move was tiring, and Louise was sleeping a lot of the day. Filled with that restlessly angry quarantine feeling, I began to read two large tomes about private long-term care, released into the world nearly a century apart from one another—Thomas Mann’s The Magic Mountain for joy and humor, and Brookdale’s 10-K filings with the U.S Securities and Exchange Commission for everything else. More than half of Colorado’s Covid deaths have been tied to senior care facilities; I felt, reading, like I was working to fill in the background, the backstory of an unfurling plot. I didn’t yet understand the differences between assisted living, skilled nursing, memory care, independent living, and all of the other deadening terms that the senior living industry very carefully defines—for each has its own profit to make, and each unit can be fitted to another one, like a Lego landscape in which you stand “aging in place,” as the industry calls the very lucrative act of being alive.

In the first few pages of Brookdale’s most recent 10-K, the document that most comprehensively sums up a company’s financial performance to investors, I read that although Brookdale only operates two senior living facilities in the state of Delaware (for comparison, they operate eighty-seven facilities in Florida), the company is what is known as a Delaware Corporation, incorporated there presumably for the state’s amorous relationship to its many big businesses. “The First State,” reported the New York Times in 2012, “land of DuPont, broiler chickens and, as it happens, Vice President Joseph R. Biden Jr., increasingly resembles a freewheeling offshore haven, right on America’s shores.” Reading further, I began feeling increasingly like that endlessly replicated gif so many have used to express the political web in which we’re stickily wrapped—Charlie from It’s Always Sunny in Philadelphia gesturing frantically at his complex diagram of an office mail system. It would be funny if it weren’t so numbing, the largeness of the Brookdale web, and the many directions into which one could look.

You could write a whole book, for instance, on simply the part of the story set in Nashville, where Brookdale is actually headquartered, in a little bronchiole of Brentwood, not far from where Taylor Swift keeps a house. There, too, sits one of the corporate offices of DaVita—whose logo you might recognize from their strip mall dialysis centers across the country—and HCA, the Healthcare Corporation of America. One of the first hospital management companies in the United States, it sprung up uncannily around the same time as Medicare and was structured explicitly after KFC. HCA, of course, remains slightly fragrant with Florida ex-Governor Rick Scott’s tenure as its CEO, during which, one might say, he oversaw the largest Medicare fraud in American history.

Today, for-profit health care companies in Nashville number more than five hundred. They rake in nearly $47 billion in annual revenue. Many of them have been backed by the same tangle of hedge funds, in different permutations over time, those vaguely pastoral names redolent of New England subdivisions: BlackRock, Glenview, Deerfield. Several of these for-profit health care companies donate, too, to the same Tennessee Trumper politicians (Brookdale via its own PAC): Bill Hagerty, Nashville native and free market health care proponent, and Marsha Blackburn, who has voted numerous times to repeal the ACA.

Propelled by the winds of private equity firms like BlackRock, Deerfield, and Glenview Capital Management, Brookdale has, in the past few years, set forth on a strategy of consolidation. They have . . .

Continue reading.

Written by Leisureguy

28 May 2020 at 8:47 pm

The love that lays the swale in rows

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Nicholas Carr writes in his blog:

There’s a line of verse I’m always coming back to, and it’s been on my mind more than usual over these last few disorienting months:

The fact is the sweetest dream that labor knows.

It’s the second to last line of one of Robert Frost’s earliest and best poems, a sonnet called “Mowing.” He wrote it just after the turn of the twentieth century, when he was a young man, in his twenties, with a young family. He was working as a farmer, raising chickens and tending a few apple trees on a small plot of land his grandfather had bought for him in Derry, New Hampshire. It was a difficult time in his life. He had little money and few prospects. He had dropped out of two colleges, Dartmouth and Harvard, without earning a degree. He had been unsuccessful in a succession of petty jobs. He was sickly. He had nightmares. His firstborn child, a son, had died of cholera at the age of three. His marriage was troubled. “Life was peremptory,” Frost would later recall, “and threw me into confusion.”

But it was during those lonely years in Derry that he came into his own as a writer and an artist. Something about farming—the long, repetitive days, the solitary work, the closeness to nature’s beauty and carelessness—inspired him. The burden of labor eased the burden of life. “If I feel timeless and immortal it is from having lost track of time for five or six years there,” he would write of his stay in Derry. “We gave up winding clocks. Our ideas got untimely from not taking newspapers for a long period. It couldn’t have been more perfect if we had planned it or foreseen what we were getting into.” In the breaks between chores on the farm, Frost somehow managed to write most of the poems for his first book, A Boy’s Will; about half the poems for his second book, North of Boston; and a good number of other poems that would find their way into subsequent volumes.

“Mowing,” from A Boy’s Will, was the greatest of his Derry lyrics. It was the poem in which he found his distinctive voice: plainspoken and conversational, but also sly and dissembling. (To really understand Frost—to really understand anything, including yourself—requires as much mistrust as trust.) As with many of his best works, “Mowing” has an enigmatic, almost hallucinatory quality that belies the simple and homely picture it paints—in this case of a man cutting a field of grass for hay. The more you read the poem, the deeper and stranger it becomes:

There was never a sound beside the wood but one,
And that was my long scythe whispering to the ground.
What was it it whispered? I knew not well myself;
Perhaps it was something about the heat of the sun,
Something, perhaps, about the lack of sound—
And that was why it whispered and did not speak.
It was no dream of the gift of idle hours,
Or easy gold at the hand of fay or elf:
Anything more than the truth would have seemed too weak
To the earnest love that laid the swale in rows,
Not without feeble-pointed spikes of flowers
(Pale orchises), and scared a bright green snake.
The fact is the sweetest dream that labor knows.
My long scythe whispered and left the hay to make.

We rarely look to poetry for instruction anymore, but here we see how a poet’s scrutiny of the world can be more subtle and discerning than a scientist’s. Frost understood the meaning of the mental state we now call “flow” long before psychologists and neurobiologists delivered the empirical evidence. His mower is not an airbrushed peasant, a rustic caricature. He’s a farmer, a man doing a hard job on a still, hot summer day. He’s not dreaming of “idle hours” or “easy gold.” His mind is on his work—the bodily rhythm of the cutting, the weight of the tool in his hands, the stalks piling up around him. He’s not seeking some greater truth beyond the work. The work is the truth.

The fact is the sweetest dream that labor knows.

There are mysteries in that line. Its power lies in its . . .

Continue reading.

Old tools can be better than new tools: cf. shaving, pens, paper, and more.

Written by Leisureguy

28 May 2020 at 5:41 pm

Posted in Daily life, Technology

Sarah Cooper is my new favorite insightful person

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Consider, for example, this post. Anyone from a corporate workplace will recognize all of this.

Of look through the short videos in her Twitter feed. (I discovered the easy way to turn on the sound, which is needed, is to restart the video by click the start of the video progress bar.)

YouTube has several. Here’s one:

Written by Leisureguy

28 May 2020 at 11:12 am

Modifying the Martin de Candre shave — and it worked

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Yesterday I found that the combination of Martin de Candre lather and the Yaqi DOC razor produced perfect smoothness but did not leave my skin so soft and supple as (say) Declaration Grooming’s Milksteak formula or Phoenix Artisan’s CK-6. I speculated that the fault might be remedied by using a balm (or aftershave milk) rather than a splash, and this morning I took another run at the same shave, even Frenchier than yesterday’s shave: Plisson, Martin de Candre, and Hermès are the French representatives, with my other Yaqi DOC being the outlier.

Again, I got a great lather from MdC, the Plisson brush having much the same fine fibers as the Yaqi brush used yesterday. And this Yaqi has the same wonderful DOC head as yesterday’s, so the end result was again perfect smoothness (despite shaving only a one-day stubble).

The difference from yesterday is the Hermès Eau d’Orange Verte moisturizing balm. It’s quite wonderful stuff, and it did the trick. My skin is, in addition to being smooth, as soft and supple as with Milksteak and CK-6 (though after using those an aftershave splash is fine: no balm required).

I imagine any good aftershave balm or milk would work — e.g., Phoenix Artisan’s Star Jelly balm, the readily available Nivea Sensitive aftershave balm, and probably D.R. Harris After Shaving Milk (or my vintage Mickey Lee Italian Stallion aftershave milk).

More experimentation is called for — always. In the meantime I am greatly enjoying the feel of my face.

Written by Leisureguy

28 May 2020 at 10:28 am

Posted in Shaving

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