Long-Term Care: Last Week Tonight with John Oliver – Transcript

John Oliver explains the industry behind nursing homes and assisted living facilities, and why long-term care needs fixing. Other segments: Matt Gaetz sexual misconduct allegations, Immigration policy of the Joe Biden administration
Long-Term Care: Last Week Tonight with John Oliver

Last Week Tonight with John Oliver
Season 8 Episode 8
Aired on April 11, 2021

Main segment: Nursing home care in the United States
Other segments: Matt Gaetz sexual misconduct allegations, Immigration policy of the Joe Biden administration

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John: Hi there! Welcome to the show. Still coming to you from this blank void. Which I actually share with the Pixar lamp. It says if I try to leave, it’ll crush me like the letter “i”, and I can’t tell how scared and/or horny I should be. It’s been another busy week. In the U.S., Covid vaccinations are racing against new variants of the virus. And in the U.K., Prince Philip died, which is a tragedy if you don’t know a single thing about him. And even if you know a little about him, you might not know this.

Take it back to the beginning for us, Alastair, and tell us how the young prince Philip of Greece and Denmark met the then-princess Elizabeth. Well, they were related.

John: Yeah, that’s right, prince Philip and queen Elizabeth are cousins who later got married… Also known as a “Giuliani meet-cute.” Meanwhile, the Matt Gaetz saga continues to unfold this week, and not in any ways that look good for him.

The new report overnight alleges Gaetz sent close associate and accused sex trafficker Joel Greenberg $900 in two late-night Venmo transactions in 2018. According to the Daily Beast, Greenberg used the same app to send three young women, including one who had recently turned 18, varying sums of money that amounted to $900. Greenberg made the payments to the three young women with the descriptions “tuition,” “school,” and “school.”

John: You fucking idiots! I can’t believe I have to say this, but if you’re trying to suspicious potentially criminal transactions, Venmo is not the app to use. Venmo is for one thing and one thing only: passing judgment on friends’ spending habits while obsessing over wild financial mysteries. Wait, Brian paid his girlfriend for pizza? Why can’t Kaitlin just let him slide on this? They live together, and it’s pizza. Wait, Kaitlin’s paying Brian now? For cake? Brian liked it? The fuck is going on in this relationship? And look, I have to tell you, Matt Gaetz has denied all accusations. And I’m sure there will be more to say about all this when he goes to prison. But for now, let’s talk about immigration. There’s been a lot of coverage lately about what’s happening on the border, which is troubling and complicated, but I’d actually like to talk about something a lot less complicated that’s also getting a lot less coverage, and that is the U.S. Refugee Admissions Program. It’s for people currently abroad fleeing persecution or violence who’ve applied for resettlement. And the U.S. used to be a world leader in how many refugees we accepted, but this fucking guy [photo of Donald Trump] not only slashed the admissions cap down to a historic annual low of 15,000, he also added discriminatory eligibility categories that have blocked many Muslim and African refugees from coming to the U.S. And to his credit, Biden ran on a platform that included reversing Trump’s policies. And since taking office, he’s been about as eloquent as Biden can be about the moral imperative of doing so.

[President Biden] Come with me into Sierra Leone. Come with me into parts of Lebanon. Come with me around the world and see people piled up in camps, kids dying, no way out, refugees fleeing from persecution. We, the United States, used to do our part. We were part of that. We’re… And, you know, that’s, you know… Send me your huddled masses. Come on!

John: Right, and underneath that patriotic word salad is a pretty good point. Even though he’s making it while managing to sound like a guy in a statue of liberty costume in times square. “Send me your huddled masses. Come on. I’m breathing in green lead paint here, so do you want a picture with me and Buzz Lightyear or not?” In early February, Biden announced that he’d raise the ceiling on admissions to over 62,000, eliminate Trump’s restrictions, and raise the cap even higher next year. Which sounds great. Unfortunately, that was two months ago, and he still hasn’t signed the presidential determination that would revise Trump’s rules. And it has been hard to get a straight answer from this administration about why.

The president has said that that’s something that should be done immediately. Why didn’t he do it today?

I think we’re gonna have more again soon in the coming days and weeks on more steps and actions that the president is interested in taking. So I’m just not gonna get ahead of that right now.

Why hasn’t the president signed the paperwork to lift the, the… Raise the refugee cap?

Well, I would refer you to the state department.

Last month, the president did announce that he intended to raise the refugee cap. That hasn’t seemed to happen yet. Why haven’t those flights continued?

He remains committed, but I don’t have an update on the timing of the flights.

Does it have anything to do with the fact that resources are going towards the border at this time? Or…

No, no, it’s not related to that. No.

John: Then what is it related to? Although props to Jen Psaki, only a few months into the job and she’s already waving away concerns about stranded refugees with the ease of a spirit airlines gate agent letting you know your flight’s delayed. “Rest assured, we’re committed to getting you to Orlando eventually. We just can’t tell you where your plane is, why it’s taking so long, or what year you might arrive.” And the thing is, there are nearly 115,000 refugees in various stages of the resettlement process right now, with more than 35,000 already approved for resettlement here. But until Biden signs that determination, they’re still beholden to Trump’s low admissions ceiling and bullshit racist rules. In March alone, more than 700 refugees had their flights canceled. And remember, these are vulnerable people who may have surrendered their belongings or homes in anticipation of leaving the country or who are waiting in camps. Also, any delay can mean their required health or security checks expire, and they have to start the whole process all over again. One Congolese woman was scheduled to fly here in early March but had her ticket canceled, and because she’s pregnant and now in her third trimester, she can no longer travel at all. And by the way, when her baby is born, that child will have to undergo a separate screening process that could take months. Which is pretty weird because I’m relatively sure you can’t have foreign allegiances before you have object fucking permanence. There are thousands of people now stuck in this pointless limbo. It’s an infuriating situation, perhaps best summed by this woman, who can’t figure out why her friend… a refugee currently stuck in a camp in Malawi, who’s been approved for resettlement here… can’t get on a plane.

This president, Joe Biden. When he came, he said that he would just add more refugees to come to USA. And I hear in the news that there is a paper. I don’t know which is a paper or something that he’s supposed to sign. Please, please, if he hear my voice, please help our friends who are struggling in the refugee camp.

John: Look, at least some of the people who voted for Biden… maybe reluctantly… did so on the understanding that refugees would not have to go on camera to beg for their already-approved loved ones to be allowed to come here, because that is one of those things that good guys are supposed to change, right next to not hiring their own kids or not letting Mike Lindell swap out the pillows in the Lincoln bedroom. And for Biden, this is actually really simple. He doesn’t need to negotiate with republicans on this or reckon with Joe Manchin’s boner for the filibuster. He just needs to sign a piece of paper. And for a guy who clearly wanted to be the person who “restored the soul” of America, it’s past time for him to look deep into his own, pick up a fucking pen, and do the right thing. And now this.

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Announcer: And now, a farewell tribute to the greatest questions ever asked on Yahoo! Answers.

Why do my balls smell like ham?

What’s wrong about being sexually attracted to Pokémon?

Is it true that sweat and pee are like “cousins”?

What is that one movie where Jidnsey Lohan switched bodies with Jamie Lee Curtis? Not “Freaky Friday,” the other one?

STD from Dog? Is it possible? Help…?

Okay, weird question, I saw a frog carrying another frog on its back, .. huh?

Does a fart contain DNA?

How is babby formed?? ?

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John: Moving on. Our main story tonight concerns nursing homes, the absolute last thing you want Andrew Cuomo to be handling, tied comfortably with literally anything else. Nursing homes, and long-term care in general, are something we tend to avoid thinking about, but the truth is, whether due to old age or disability, many of us do or will require help with daily living. The number of Americans 65 and older is projected to nearly double over the next 40 years, and one study estimated over two-thirds of Americans who reach 65 will need long-term care at some point in their lives. And the good news is, for the rich, there are plenty of options. There are multiple upscale retirement communities where residents can transition, if needed, into full-time nursing care, like this one, toured in exquisite fashion by 2 Chainz:

All right. So the name of this episode is called “The Most Expensive Retirement,” right? And so this is the most upscale, luxurious retirement home that I’ve ever seen and ever heard about.

The building itself cost $100 million to build.

Damn.

The… The marble, it’s from Italy. It’s custom carpet.

I see a lot of art. I see the Versace plates.

John: Okay. Extravagance of that place aside, let’s all just agree: that $195 plate sucks shit. And I’m not normally a plate guy… Your boy’s a saucer freak from way back. I’m a bowl bitch. Plates aren’t really my thing. But even I can tell that plate is a 2. That’s a 2 in Ohio. If you’re gonna spend that kind of money on a plate, it better be really big, really fun, or really, really hot. That plate… Look at me. Put your phone down and look at me when I’m talking to you. That plate fucks. But the fact is, most of us aren’t ending up in that place. In fact, the vast majority of people receive long-term care at home, and around 80% of that care is provided by unpaid caregivers, often family members who want to keep their loved ones out of institutional care, like this wife and daughter.

Cheryl and Kristin are among the 42 million Americans caring for loved ones at home, and the tasks they perform have become increasingly complex.

When we have to flush his PICC line or clean his peg tube or take his blood glucose or his blood pressure, you know, none of us went to school for that. I mean, we’re not educated that way.

I don’t feel like I had enough training at all for this. We’ve kind of learned by trial and error.

John: That seems really hard. And there are certain things you expect to do by trial and error… Solving a puzzle, learning to pronounce the name of tambourine Saturday, or choosing a haircut… For the record, error, error, error, and error… But providing essential medical care should not be one of those things. Taking care of someone at home can be an incredibly complicated, full-time job that is almost always unpaid. In fact, in terms of lost wages, the labor of family caregivers totals about $67 billion annually. That’s a workforce that, if it were paid, would rival the entire GDP of Bulgaria. But for those who can’t afford to eat off unfuckable plates or whose loved ones are unable to help them at home, many wind up in long-term care facilities. There are two million people in them in the U.S., and as we’ve seen during the Covid crisis, they can be far from ideal. Residents and staff in them make up less than 1% of the population, but currently account for around a third of Covid deaths. The pandemic pushed an already heavily strained system to the absolute brink, with conditions getting so bad there were near-constant local news stories like this one:

One resident here says her calls for help or ignored because there wasn’t enough staff to respond.

I’m screaming, “get me out of here, get me out of here, get me out of this thi… ” I was screaming at them. I was in terrible pain, and they didn’t come for me.

Penny Shaw was in pain as she lay helpless in her bed at Braintree manor nursing home in the midst of the covid-19 pandemic. She became so desperate she even called Braintree police for help.

I can’t lay in bed for hours and hours, you know, in pain like that.

John: Now, I have to tell you, we contacted that facility, which chose not to address its staffing levels back then in its response to us, instead insisting that “The safety of our residents is of the utmost importance,” but that is pretty fucking hard to believe when they are calling the police for help. Their only two instances where that is to be expected, and that is if you’re giving birth or digesting a crunch wrap supreme. That is it! And the truth is, Covid just exposed what we’ve basically known for years… that the way the elderly and disabled are treated in far too many of these facilities is with, at best, indifference, and at worst, abuse and neglect. So tonight, let’s talk about long-term care, how the industry is structured, how that structure creates bad incentives, and what we can do going forward. And we’re going to focus on the two main types of long-term care facilities: nursing homes, and assisted living facilities. Nursing homes are medical facilities overseen by trained nurses and largely staffed by low-paid nursing assistants. And there have long been issues with nursing home care… A GAO report covering a five-year period before the pandemic found that 82% of homes had been cited for infection prevention and control deficiencies, and about half had persistent problems that had been cited across multiple years. And a big reason for that may be because understaffing is a big problem, with employees often tasked with taking care of way too many residents, as these nursing assistants pointed out just last year.

They’re not being showered.

People falling out of bed.

The men aren’t being shaved.

People fallen to where they fell out of their wheelchairs.

What if they need changed?

They might get it one time.

A day?

A day. We have 22 residents apiece. Most days, that’s for one person to wash, dress, get up, two meals, and they’re being neglected because you can’t get to everybody.

I told the administrator, I’m embarrassed of my work process because I can’t do what I was trained to do on how to take care of these residents.

John: That is obviously unacceptable. Do you have any idea how bad things need to get for you to tell your boss you’re embarrassed by your work? I’m not even embarrassed by my work, and just three minutes ago, I joked about fucking a plate. Also, that wasn’t really a joke. Call me, wolf plate. And nursing assistants aren’t just overworked… they’re really underpaid. The median national salary for that job is barely $30,000 a year. And one reason is that nearly 70% of nursing homes are now for-profit institutions. And there is a lot of profit for them to make, because they don’t pay staff much, but they charge you a lot. The average per-person cost for a private room is $100,000 per year. And if you’re thinking, “yeah, that is expensive, but doesn’t the Medicare program I have paid into all my life cover that?” Well, no, it doesn’t. Medicare only fully covers the first 20 days of nursing home care after an eligible hospital visit, then partially pays for up to 100 days. But after that, you are on the hook for all costs. The only other way to access taxpayer help to live in a nursing home is to almost completely impoverish yourself, to basically spend your way down to the point you qualify for Medicaid, the government program for the poor, which, crucially, reimburses nursing homes at less than half the average daily rate paid by Medicare. And while you would like to think that nursing homes would treat all patients the same, whether they’re on Medicare or Medicaid, the truth is, you might get two very different experiences. Because if you’re on Medicare, you could wind up getting too much attention. Just listen to an assistant manager at one nursing home chain describe how Medicare patients there were treated.

What percentage of the therapy that you were being told to administer do you think was not necessary?

I would say probably, as time went on, about 40%.

40% Of the work that you were doing…

Was not reasonable and not necessary under Medicare guidelines.

At another facility, the entire rehab staff signed a letter to their boss. It reads, “we have been encouraged to maximize reimbursement even when clinically inappropriate.”

John: That is absurd. The DOJ actually filed a lawsuit claiming that the chain that woman worked for, life care centers of America… which runs over 200 nursing homes… was subjecting its patients to therapy even as they were on their deathbeds. It alleged one 92-year-old who was dying of metastatic cancer was recorded as having had 48 minutes of physical therapy, 47 minutes of occupational therapy, and 30 minutes of speech therapy, just two days before his death, on a day he was spitting up blood. Which is ridiculous. Residents should be getting proper nursing care. Not shit-tons of expensive therapeutic treatments that are clinically inappropriate. Which, by the way, I’m pretty sure was the original slogan of goop. Now, Life Care denied wrongdoing, but agreed to pay $145 million to resolve that lawsuit. And they’re hardly alone here. Over the past decade, multiple other large nursing home chains have been charged with fraudulent Medicare billing practices and denied wrongdoing while paying tens of millions of dollars to settle their cases. You know, like you do when you are totally innocent. So to recap here: if Medicare is paying, the risk is, you could billed for unnecessary treatments. But if Medicaid is paying… which, remember, reimburses nursing homes at less than half the average daily rate… things could get much worse. Because if facilities want to open up a bed to a more lucrative patient, they can take drastic action.

Ronald, who was 51 and homeless, got rehab at the nursing home where he lived for more than a year. Then one night, around 10:00 p.m., He says an administrator came into his room.

Big smile on their face, saying, “we’re kicking you out.”

The smiled?

Yeah. And they just bundled me into a van and just dropped me off here on the sidewalk.

The Avalon Villa Care Center, through its lawyers, told NBC News it strongly disputes that it has inappropriately discharged any patients. The homeless shelter where Ronald is living now says it’s seen cases like this before. Experts even have a term for it: resident dumping.

John: Oh, come on, that’s just fucking evil. “Resident dumping” is a completely unacceptable practice. I don’t even like it when residents are dumped on Grey’s Anatomy. At the altar, Burke? You dumped that resident at the fucking altar? How could you do that to Cristina? You fucking monster! And you’d hope regulators would punish nursing homes for doing things like that. But the oversight here has some massive gaps. For instance, the federal government keeps a list of so-called “special focus facilities”… homes that have a pattern of serious problems over a long period of time, and therefore receive extra inspections. There are 88 nursing homes on that list… but interestingly, not because there are only 88 homes that deserve to be, but because, due to limited resources, the government has capped the list at that exact number, despite the fact they fully acknowledge an additional 400 facilities qualify for the program. And look, I’m not saying every list should go on forever. If a list of cutest otters was capped at 88, that’d be a perfectly fine list. But if there were 400 other cute otters that were also abusing the elderly, I’d really like to know who all of them are. And if you’re thinking, “well, that’s good to know. If I need to move a loved one into a nursing home, I’m definitely going to look online and make sure it’s a good one,” well, be careful. Because while the government does have a website where nursing homes are rated from one to five stars, it has an absolutely massive loophole.

Of the three factors that determine an overall rating, only the health inspections are conducted independently. The other statistics, staffing and quality measures, are self-reported by the nursing home. These self-reported statistics can boost a three-star rating into a five-star rating overall.

The problem is, you know, it’s garbage in, garbage out. So whatever they’re telling the feds, the feds are not… That federal government isn’t going in and double-checking that their numbers are accurate.

John: Yeah. “Garbage in, garbage out.” And that is pathetic. Something important as our nursing home rating system shouldn’t follow the same rule as every recipe on Velveeta’s website. Because there’s just no way any of those are good. If you’re making a recipe that calls for a puddle of Lorax jizz, then don’t be surprised when the finished product is equally repulsive. It’s garbage in, garbage out. So given everything you’ve seen so far, it’s hardly surprising that… For reasons of cost or conditions… many might want to avoid a nursing home altogether. Which brings us to assisted living facilities, or ALFs. Around a third of people in long-term care are in one of these, and they do cost far less than a nursing home… typically around $50,000 a year. ALFs started out as an alternative for those who needed help with key activities like dressing, toileting, taking medicines and eating… but only needed limited medical support. Just as with nursing homes, the vast majority of ALFs are for-profit. But there are also some key differences. ALFs are largely paid for out-of-pocket. And they are far less regulated, making easy for basically anyone to start one. And I do mean anyone. Take Stephanie Costa. By 30, she owned six small ALFs in southern California and had made a lot of money from them, enough to qualify her to appear in an episode of “The Millionaire Matchmaker.”

My name is Stephanie and I’m 30 years old and I own a chain of elderly care facilities. My net worth is $3-4 million, probably. I’ve always had this thing of taking care of older people. Like sick, people that are dying. I’ve always really felt for them. So I couldn’t wait to graduate college and start my own business doing assisted living facilities like nursing homes.

John: Okay. There are a lot of unfair reasons that I inherently don’t trust Stephanie Costa, from her driving a douchey Ferrari to the fact she looks like an uncredited extra from an “entourage” party scene to that voice, which sounds like a mouse who wouldn’t dress Cinderella because it had better things to do. But it turns out that gut feeling is actually entirely valid, because costa treated her employees and residents so terribly that, after multiple health and safety violations, California banned Costa from the industry for life and ordered her and her company to pay about $1.6 million for unpaid wages and penalties. But if you think that gave her accountability, you’re going to want to think again.

She kept this home after filing for bankruptcy and settled with workers for a fraction of what she owed. Her six care homes are now owned by a property investment company registered by her father.

John: Oh, yeah. Not just that, as recently as last year, she was still listed as that company’s CEO. So the state of California really taught Stephanie Costa a lesson there. Specifically, the lesson that you can treat your elder care workers like absolute shit, avoid any real consequences, and just keep living your life in the single ugliest home in Beverly Hills… Although it’s legitimately hard to tell whether that’s actually a home or just an abandoned white castle. But it’s not just individuals involved here. There are also big corporations running ALFs, who’ve been working hard to fill up beds. And despite the fact ALFs are supposed to be for people who require less medical attention, recently, some have been aggressively courting dementia patients for memory care programs, as seen in this advertisement for Brookdale, the largest ALF provider in the country.

This is a compassionate place that helps families through very difficult stages of dementia in a safe and comfortable setting, and I have peace of mind knowing there is a staff, fully trained, 24 hours a day, seven days a week. I can’t believe how much my mom’s quality of life has improved since coming here. I’m seeing her smiling and laughing again.

We help them maintain their abilities and encourage the use of their current skills in a warm, engaging environment.

This is a special place, and every day is a new beginning with lots of smiles and memories.

John: Okay. I get that a senior living commercial might want to have at least one staffer with their arms around a resident’s shoulders. That’s kind of nice. Trustworthy. Makes you feel safe. But immediately cutting to another one feels like a bit much. And then a third starts to make me feel a little nervous. And when that fourth hits, as a British person, I’ve got to say, that is just too much physical contact. That said, even I’ll admit, an ALF that offered all that commercial claims to but with significantly less touching would really be great. Unfortunately, a woman who worked at a Brookdale facility in South Carolina painted a very different picture of how staffers are trained to work with dementia patients.

When you first start, they have you sit through a series of in-services or orientation and it lasts about a week, but it’s just videos, but once they put you out on the floor, they don’t… they don’t give you any training. They just stick you out there.

John: Well, that’s not really ideal, is it? It’s hard to retain important information just by watching a video. Case in point: this video. Think about it. What have you really learned from this? Sure, a few random facts about the long-term care industry that you’ll probably immediately forget. But mainly, you’ve learned that it’s possible to want to fuck a plate. And that’s a lesson you will never forget. And Brookdale insists that it offers ongoing training for its workers and that its training program for dementia care workers meets or exceeds state guidelines. But that is not really saying much, as some states only require only two to 30 hours, and South Carolina, where that facility is located, has no state minimum at all. And by the way, if you’re wondering about why there were a bunch of shots of a pond in that story, the answer is horrifying. Because a 90-year-old resident there, who was supposed to be under constant supervision before being transferred to a memory care unit, died after leaving the facility unnoticed in the middle of the night.

There are signs out here warning people about alligators. Take a look at this one, it says, “alligators may live here, be gator safe.” In this case, the signs probably would not have made a difference, according to authorities. We’re told the victim likely slipped or fell down a steep embankment and landed in the water, attracting the gator’s attention.

John: Holy fucking shit. I honestly don’t even know where to begin there. But I guess I’d start with: why would anyone put an assisted living facility next to a fucking alligator pond? That seems like the sort of detail that really has to be included at the end of one of Brookdale’s heartwarming ads.

This is a special place and every day is a new beginning with lots of smiles and memories. Also, one of our residents was eaten by an alligator, so… y’know… There’s that.

John: Yeah. There is that. And that’s important information for people to know, Brookdale. And look, obviously, that’s an appalling story. But to be fair, it is hard to talk about long-term care without showing you at least one of those. Just be grateful I didn’t show you the story where a resident jumped from a fourth-story window of an ALF, or the one about a nursing home resident who set herself on fire, or the one about a 91-year-old suffering from Alzheimer’s who froze to death on Christmas day. Which, by the way sounds like a holiday album written by fucking Bjork. So what can we do here? Well, obviously, increased oversight and enforcement are badly needed. That facility with the alligators was eventually fined by the state for 11 violations, including not properly performing night checks and letting staffing drop below required levels, but the penalty issued was just $6,400. And it feels like if you lost a loved one in such a horrific way, you’d want more accountability than “don’t worry, someone decided their life was worth the price of a 2013 Chrysler Motown.” And the fact is, there are lots of ideas on how to force facilities to improve… Mandating a certain amount of money has to go to patient care, for instance, or that residents have access to a minimum amount of care per day. But the bigger fix here might be to try and make it easier for as many people as possible not to end up in these institutions in the first place and instead receive whatever support they need at home. Nearly 90% of people over 65 apparently want to stay in their home for as long as possible, which does make sense. The problem is, right now, many of them can’t, because under Medicaid, nursing home care is an entitlement… but home-based care is not. To access long-term services and supports through Medicaid in your home, you need a waiver from your state. And to be fair, some, like Washington, do that pretty well. More than 70% of the Medicaid money they spend on long-term care for older people and adults with disabilities is spent on home and community based services. Things like skilled nursing visits, home care aides who can help with daily tasks, and even the ability to pay family caregivers. You know, people like those two women you saw earlier. The problem is, other states have waiting lists that can be many years long, by which point, seniors trying to access that care can be dead, because, sadly, that is how time works. Nationwide, more than 800,000 people are on these kinds of waiting lists. What we need is reform at a national level. And there are actually some promising developments here. A discussion draft of a bill was recently introduced that would make home and community-based care an entitlement under Medicaid. And Biden’s proposed infrastructure plan actually calls for $400 billion to be spent on those exact services. And that would be a really big deal. And look, aggressive transition to home-based care is going to need rigorous guardrails and oversight to make sure that money is not misspent, just in a different way. The last thing I want is, five years from now, to be having to do a show on the evils of new for-profit home care agencies who’ve been destroying people’s lives in their own homes. And if you’re thinking, “wait, five years from now you’ll still be doing shows in the void?” Oh, no. We’ll be back in the void. I don’t want to get into specifics, but… spoiler alert… it’s not a pandemic next time! It’s spiders. But we do need to do something. And it all starts with showing that we give a shit about what happens to the elderly and people with disabilities in this country, ’cause right now, evidence points to the fact that we absolutely don’t, and all the other problems are stemming from that. And the longer we continue to ignore this, the worse it’s going to get. Because the fact is, right now, this is an industry where the people in its care are being figuratively, and sometimes literally, Eaten alive. And now this.

Announcer: and now, a few more of the greatest questions ever asked on Yahoo! Answers.

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Alvin and the chipmunks?

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John: That’s our show, thanks so much for watching, we’ll see you next week. Good night.

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