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

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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.

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On the whole, senior living is in bad shape. Brookdale has suffered net losses since 2005. Before Covid-19 hit, the company was focused on one of those words that means nothing and everything—“streamlining.” They had big plans to “pilot a more integrated healthcare service model,” and to deepen and expand what they call their “healthcare services business, primarily by growing our hospice and home health business lines,” as well as by growing their private duty business—sending care professionals into residences outside of their buildings. While most aspects of hospice care, and much of Brookdale’s “home health” ventures, are reimbursed by government programs, Medicare in particular, “non-covered services,” reads the 10-K, are “paid directly by residents from private pay sources.” In other words, this is health care, and hospice, a la carte. By expanding their services to seniors outside of their communities, to use Brookdale’s own language, they would in time increase move-ins—one of the most important metrics of health for the senior living/housing industry. Everyone, after all, is literally aging in place—the senior living industry just wants that place to be, eventually, in one of their buildings.

Read more in The Baffler.