As I begin, I want you to keep in the back of your mind as I proceed the gendered nature of the issue at hand, nursing homes. The typical nursing home resident in Pennsylvania is female, over the age of 85, widowed with some form of dementia.

The typical caregiver in a nursing home is also a woman and not infrequently a low paid one.

As I proceed the discussion will be dominated by questions of expenditures & revenues.

But always lurking below that surface is an inherent devaluing of the lives of woman whether at the end of their lives or in the grueling & emotionally exhausting care work that falls to them in their working lives.

As public budgets have been drained of revenues by tax cuts for the richest 1% the dirty work of spending fewer of our resources on the women and men in the final stages of their lives has fallen to for-profit entities.

These for-profit firms often supercharged private equity firms seek to maximize the rate of return within a low regulatory boundary that often skirts on elder abuse.

Slowly being chewed up in this process are public and non-profit nursing homes established long ago to provide quality long term care where none previously existed.

And thus begins our story here in Cumberland County.

In October of 2020 the entire Cumberland County Commission, 1 Democrat & 2 Republicans announced a process to sell the County’s nursing home.

Phrases such as “failed business model”, “fiduciary responsibility”, “higher county taxes” have all been deployed in noting the private sector will do a better job than the county in caring for the women and men in its facility.

A group of citizens was organized to attempt to slow if not stop the County Commissions plan which by any metric is oddly timed given we are in the middle of a pandemic.

Or at least I should say it struck me as odd up until I started to look into the buyers who have bid on the facility. More on that later but as I did my research it became a bit more clear what is going on.

As you can imagine running a nursing home in the middle of the worst pandemic in a century is challenging. Much of the terrible death toll from the pandemic has been in nursing homes.

Here it is important to stop and acknowledge, we are talking about people with friends and families. People whose lives have been cut short by a deadly virus. The human emotional toll there is unfathomable. Death is always with us but mass death widens and sharpens the pain.

That pain is particularly sharp when it is clear as it is now that so much could have been done differently by federal policy makers to lessen the spread of the disease.

The human death toll has carried with it less important but relevant implications for nursing home balance sheets, it appears that expenditures are up and revenues are down in much of the industry.

Who you might imagine would want to buy a nursing home in this environment? Here economic history is an important aid. As many economic historians have noted for all the suffering in the Great Depression in the 1930s it was also a profitable period for some.

Indeed any economic crisis is a business opportunity for those with easy access to capital.

Your competitors are under pressure and many will have been caught in rough financial shape going into the crisis, creating opportunities as some of your competition fails and or for you to buy up your competition on the cheap.

Thus Cumberland County reported at least 9 bidders expressed interest in buying the counties 282 bed facility. And just before Christmas the county reported to have interviewed 6 of that 9.

So over my holiday break instead of binge watching The Expanse during Stata Intern nap times I spent some screen time looking at data collected by the U.S. Department of Health and Human Service’s Centers for Medicare and Medicaid Services (CMS) on nursing homes.

Focusing first on the County’s home called Claremont Nursing and Rehabilitation Center.