The idea that one might be able to profit from the painful fact of senescence is inherently grotesque. But these companies’ business models, like any other, depend upon the minimization of costs and the maximization of revenue. In practice what this means is that the owners of many of these facilities do their very best to meet the minimum standards of conduct necessary for their businesses to remain open, going through the motions and paying out fines when necessary, while raking in as much cash from patients’ savings or trusts or younger relations or, failing that, Uncle Sam, as they possibly can.

They are parasites that feed, literally, on decay and death.

While it goes without saying that more should be done to ensure that nursing facilities, including those not run for profit, operate in accordance with federal guidelines concerning the health and safety of their residents, there is something to be said for the idea that millions of Americans now living in them would be better off being taken care of by their families. Much of this cruelty could be avoided if more of us found it in our hearts to look after our parents and grandparents in our own homes.