LCCN: 2025908101
LCCN: 2025908101
By Steven Donahue, nursinghomerhymes.com
I've become a sort of Mr. Nursing Home, a retired professor fighting to rescue my wife Linda, trapped in a nursing home's grip. 
Linda's endured a 2010 stroke, a 2022 setback, 33 months at Prestige Care Center in a town of 6,000 souls in Plattsmouth, Nebraska. I'm Steven Donahue, and this is Nursing Home Rhymes. A love story set against a money-making machine. Picture the Bullseye, like Dante's Hell. 
Residents at the core, crushed by greed. Revenue runs it, cash in, cost down, beds full.
Mine is a rescue mission. I'll fight like a tiger to bring Linda home.
Stay with me.
Picture a bullseye. In the center, residents like my Linda, 66, suffer an unrelenting hell. She's learned to walk four times: as a toddler, skiing mishap, stroke, now confined to Prestige's 111 beds. Her guardian, a so-called sister Carol, does not allow her to go to Catholic mass next door. 
You can put lipstick on a pig, but a nursing home is just four walls.
While her mind's sharp, the system traps her forever. I handed guardianship to her sister, a misstep, yet Linda fights back.
My odds of freeing her: five to 15%. Residents are powerless, like Dante's limbo. Innocent but tormented.
I am daily driven to prayer and poetry as an antidote to the upside-down world of a nursing home.
In W.H. Auden's poem, Old People's Homes, some stanzas come to heart about the relatively recent trend, 1950s, of putting our loved ones in a place other than in the bosom of the family. He writes:
As of now, we all know
what to expect, but their generation
is the first to fade like this.
Not at home, but assigned
to a numbered frequent ward.
Stowed out of conscience
as unpopular luggage.
Nursing homes are a lonely crowd. 16 million in nursing homes today. 23 million predicted by 2030, and at least 50 million Americans know someone inside right now. So this is the story of millions of Americans, and sadly, it is a terminal story.
What is my wife's life worth? $3,033,520. It has already been entered into the accounting profit spreadsheet.
NPV = ∑(t=1 to 240) 20000 / (1 + 0.004167)^t
Annuity formula:
NPV = 20000 * [1 - (1 + 0.004167)^(-240)] / 0.004167
Result:
NPV ≈ $3,033,520
When Linda had her husband able to visit: Making great strides
Here's my trick: the structured visit. Having a plan after visiting my wife for over two years and driving some 15,000 miles in near-daily trips has become as natural as riding a bicycle. The visits are bookended by prayer and kisses.
Always bring something, always take something home to clean or repair, then return. Send cards at least weekly as residents look forward to the mail. Encourage residents to go to PT and activities. Follow up with phone calls. Ask the names of those attending. Keep your loved ones' number two pencil sharp in exchanges, always offer hope.
Be in the now, not the then.
For some of you who are visiting a nursing home, it may be awkward, not knowing quite what to do. Psychologically, it is not a task that some look forward to as they enter bleak territory. Visitors and most residents know that the future is mostly terminal.
Over the past couple of years, the Office of Public Guardian here in Nebraska has only been able to get a handful of residents home from a nursing home. To a home where the needs are better met by a care team. But getting home for some is like Don Quixote, tilting at windmills.
Without help, letters and pleas to a judge will be ignored, according to the Disability Rights of Nebraska. For many residents, nursing homes can be overkill, and their needs can be met at home with a care team in place.
Back to how to visit: some folks just bring food, stand by the bed. It is not ideal, but it is gold to the residents. Others, like my friend Kate shine. She's there daily for her daughter. Just by bringing her things, escorting her to bingo or meals, it provides a sort of life for her daughter to look forward to.
Kate wrote for me when I asked: "Steve and I sign in minutes apart. Summers are porch days, feeding the squirrels. Steve's got snacks for Linda too." Sadly, her daughter, also named Lynda, is fading. But we talk, we connect. It lifts us all.
Kate's truth, she said, "visit near daily to know their care". She knows you gotta keep an eye on them. She wrote, "If I'm ever in a home, I hope my husband is as good as Steve." That hit me hard.
Good grows even here.
Here's the secret: try to find something beautiful each day, even if it's the color of a bruise on your arm. Say a prayer before you enter a nursing home, and a prayer afterwards.
The next circle holds enablers. Families, desperate, place loved ones, hoping for care. A trap door. 
Nurses pour love into residents, but attorneys hoard guardianships for profit. Judges ignore pleas. Agencies like Nebraska's Disability Rights warn of Who's Guarding the Guardians? Yet stay quiet in Dante's Hell.
This is desire, love, or greed trapping residents. The head of nursing said Medicaid won't let patients go home. Truth or lie? I'm finding out.
Later, we will dissect this enabling circle.
Cash in, cost down, beds full. 
For profit syndicates drive quality down to 1 star, the lowest government rating.
They make money 6-ways from Sunday and escape all culpability behind shell corporations.
They borrow against the actuarial tables and each patient's number is their Net Present Value (NPV):
NPV = ∑(t=1 to 240) 20000 / (1 + 0.004167)^t Annuity formula: NPV = 20000 * [1 - (1 + 0.004167)^(-240)] / 0.004167 Result: NPV ≈ $3,033,520 Above the enabling circle, wolves prowl. There are syndicates, like Meyer Lahasky's, running one-star homes like Prestige. They value Linda as a human asset, using net present value: $3,000 monthly Medicaid over her 20-year life, discounted. Because today's cash beats tomorrow's risk. That's $3,033,520 added to their spreadsheet.They pack beds, cut staff, borrow against her life. Dodge fraud suits with bankruptcy. Like in Pennsylvania and New York. Because of syndicates like these, residents have lost both life and limb in Dante's Hell. This is fraud, greed, crushing Linda's care. This is one of the most important stories about who is behind running your life into the arms of a Nursing Home Industry.
I smell waste, fraud, corruption, campaign donations, and apathy.
Medicaid is big. It accounts for 60% or more of the residents and half of the $130 billion pot for this nursing home industry.
Getting out alive is rare from long-term care. Only five to 10% get out alive. It is a growth industry.
In the Outermost circle, CMS pours endless Medicaid money, feeding this hell like a trophic chain. Groups like the American Healthcare Association spend $4 million yearly to block staffing rules, while for-profit homes siphon $12 billion to shell companies they own, hiding profits.
Oversight fails.
See no evil, letting syndicates thrive in Dante's lowest circle.
This is treachery, betraying residents like Linda with funds meant for care.
She's not a number. She's my love.
This fight is for everyone trapped. You have to fight like a tiger.
Syndicates value Linda at $406,844 and 34 cents. To me, she's infinitely precious. This is a rescue mission. Yes, for my Linda, but also, potentially, for your loved ones too.
By Steven Donahue, donahue.steven@gmail.com
Watch Podcast I. It is a gut-punch with Nursing Home Rhymes, a podcast series tearing into the nursing home industry and its dark underbelly, aka "the Syndicate." Raw, real, and unfiltered. 
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Got a Story? Drop the bombshell. Reach Steven at donahue.steven@gmail.com.