Private-equity firms serve some purpose, I'm sure. However, it is of paramount importance that private-equity firms are kept away from any business that deals in real life with actual human beings, because private-equity firms have demonstrated a positive genius in converting even the sick and the old into dividends and windfalls and other species of mathematical inhumanity.

The latest example comes to us from The Washington Post.

A disabled man who had long, dirty fingernails told them he was tended to “once in a blue moon.” The bedside “call buttons” were so poorly staffed that some residents regularly soiled themselves while waiting for help to the bathroom. A woman dying of uterine cancer was left on a bedpan for so long that she bruised.

The lack of care had devastating consequences. One man had been dosed with so many opioids that he had to be rushed to a hospital, according to the inspection reports. During an undersupervised bus trip to church — one staff member was escorting six patients who could not walk without help — a resident flipped backward on a wheelchair ramp and suffered a brain hemorrhage. When a nurse’s aide who should have had a helper was trying to lift a paraplegic woman, the woman fell and fractured her hip, her head landing on the floor beneath her roommate’s bed.

The Washington Post Getty Images

The reason? The facility in question was run by a massive private-equity firm called The Carlyle Group. And if you're wondering how in the uncharted fck it makes sense for some high-end beancounters to run a elder-care facility, well, you're just painfully uninformed about how late-stage capitalism works.

Under the ownership of the Carlyle Group, one of the richest private-equity firms in the world, the ManorCare nursing-home chain struggled financially until it filed for bankruptcy in March. During the five years preceding the bankruptcy, the second-largest nursing-home chain in the United States exposed its roughly 25,000 patients to increasing health risks, according to inspection records analyzed by The Washington Post.

The number of health-code violations found at the chain each year rose 26 percent between 2013 and 2017, according to a Post review of 230 of the chain’s retirement homes. Over that period, the yearly number of health-code violations at company nursing homes rose from 1,584 to almost 2,000. The number of citations increased for, among other things, neither preventing nor treating bed sores; medication errors; not providing proper care for people who need special services such as injections, colostomies and prostheses; and not assisting patients with eating and personal hygiene.

But if any of those sick old folks needed a stock tip, I'm sure that Carlyle would have been right on that.

The rise in health-code violations at the chain began after Carlyle and investors completed a 2011 financial deal that extracted $1.3 billion from the company for investors but also saddled the chain with what proved to be untenable financial obligations, according to interviews and financial documents. Under the terms of the deal, HCR ManorCare sold nearly all of the real estate in its nursing-home empire and then agreed to pay rent to the new owners.

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Taking the money out of ManorCare constrained company finances. Shortly after the maneuver, the company announced hundreds of layoffs. In a little over a year, some nursing homes were not making enough to pay rent. Over the next several years, cost-cutting programs followed, according to financial statements obtained by The Post.

Bastards. Just avaricious, ignorant evil fckwad bastards, is all they are.

“You wonder how these people could have run a place that treated people so poorly,” said Bojo, who, like others interviewed, attributed the problems to lack of staff. “We would ask the director of the place, ‘Would you treat your mother this way?’ That stopped him for a minute, but we didn’t get an answer.”

“One time we came in to visit him and he was sitting there in a wheelchair naked, with just a blanket on him — no pants, no underpants,” said Michelle Maldonado, whose father, a former factory worker, was at the Pottsville home for several months in 2017. “He got bedsores, infections, and he had a couple of falls. It was like they would never check on him.”

“Carlyle was a very interesting group to deal with,” said Andrew Porch, a consultant on quality statistics to whom HCR ManorCare referred questions about health-code violations. “They’re all bankers and investment people. We had some very tough conversations where they did not know a thing about this business at all.”

But if you want a nice Havana to smoke at an outdoor cafe in midtown, or if you want to know where to get the best martini in Georgetown, they're your people, no question.

George H.W. Bush John Moore Getty Images

The Carlyle Group will sound very familiar to anyone whose memory extends back over the past three decades. George H.W. Bush was hip-deep in the place, and, on September 11, 2001, Poppy was at a Carlyle meeting in D.C. Also in attendance was one Shafiq bin Laden, whose brother was otherwise occupied that day. So any doubt that these people are greedy automatons with no concern for how enriching themselves damages other people should have been laid to rest a long time ago.

At the suggestion of an HCR ManorCare expert, The Post looked at the five states where the chain has the most nursing homes. In four of those five states, violations at ManorCare homes rose steadily and outpaced increases at other nursing homes. For example, in Pennsylvania, the number of violations rose 12 percent faster than violations at others in the state; in Ohio, the number of violations rose more than two times faster. In Florida, the number of violations rose for two years and then fell for two years, leaving no clear trend.

Carlyle officials attributed the company’s financial trouble primarily to the U.S. government, and specifically the Medicare program, which in October 2011 reduced how much it paid for nursing-home services. In Carlyle’s view, the trouble was not primarily caused by the real estate deal, but the ensuing shortfall in Medicare revenue.

Oh, shut your gob. You got in and out for the buck the same way you get in and out for the buck in all your other dealings. You had no more business running nursing homes than I have flying a 747. Even if you had a conscience, I wouldn't envy you for it.

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Charles P. Pierce Charles P Pierce is the author of four books, most recently Idiot America, and has been a working journalist since 1976.

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