Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid. You can read about John's early experiences in his JAGS commentary titled, "Waiting for the Other Shoe to Drop." The tone is bleak. John's experience since Covid, as you'll hear, is very positive. Many of the concerns he raised about isolation have been addressed.

Second, we hear from Bill Applegate, Geriatrician, retired faculty at Wake Forest, and former Editor in Chief of JAGS (Bill recruited Eric and me to join JAGS as editors about 10 years ago). Bill had a distinctly negative experience in two assisted living facilities (ALFs), which you can read about in his JAGS essay, titled, "My Journey Through Assisted Living Facilities." Bill is seriously concerned about the lack of national oversight, poor staffing, and financial motivations behind for-profit and private-equity owned ALFs.

Finally, we hear from Melissa Aldridge, a former banker turned health services researcher, about the rise of private equity purchases of Assisted Living Facilities nationally. This is a follow up to our prior podcast on private equity gobbling up hospices with Melissa, Lauren Hunt, and Krista Harrison. Melissa is concerned that private equity has a very short time frame to turn acquisitions profitable, and cutting staff is often their first move. Further, private equity is financing these acquisitions with debt that is increasingly hard to trace and regulate. We talk about how private equity moving from purchasing fast food chains, toy stores, and hotels into CCRC, ALF, nursing home, and hospice ownership is a major concern. This is not the same as Blackstone buying the Hilton and turning a profit. These institutions provide healthcare, daily care needs, and community for a huge swath of older adults. These concerns should trigger a higher level of scrutiny, oversight, and regulation than other industries.

What can you do about this, dear listeners? Listen to the end to find out!

Thanks to Jerry Gurwitz for suggesting this podcast. We appreciate your suggestions. Keep 'em coming.

-Alex Smith