Thursday, March 29, 2018

Dentures

 

President Washington's dentures
Mount Vernon Estate Museum
As I am preparing to take mom to the dentist to replace the fourth dentures she had lost, thrown away with a meal or dumped in the trash, I am grateful to the Etruscans, the precursors to the Romans who lived in the northern part of Latium, in today’s Tuscany. Etruscans were expert denture makers and their skill was not replicated until the 19th century.

Etruscans were so skilled at extracting decayed teeth and replacing them with partial or full dentures, that they were renowned all over the ancient world. The bridgework was made from gold and the teeth were carved from ivory, carefully resembling the original tooth.  If a person died, their good teeth were removed and used in dentures for the upper classes.

In the medieval and Renaissance periods, the rich could actually pay poor people to have teeth removed and then implanted in “gums” of ivory. Women of the 1500s had their gums pierced with wires in order to secure dentures or partials in place. In the 1600s uppers were kept in place by springs that were so taut that pressure was necessary to keep the mouth shut.  Not paying constant attention to these springs could result in a mouth flying open uncontrollably.

The first realistic looking dentures were made by Parisian doctors in the 19th century – they were durable porcelain teeth baked in one piece. Dr. Claudius Ash adopted the procedure in America. 

One gory practice had individuals collect the teeth of dead soldiers from the battlefield; sometimes these soldiers were not really dead thus the term “teeth robbers” was born. Many Europeans had dentures made with “Waterloo” teeth and  quite a few Americans had “Civil War” teeth.

Porcelain teeth put an end to teeth robbery. The porcelain teeth were embedded in vulcanized rubber. About the same time period, the practice of using nitrous oxide or “laughing gas” for anesthesia made dentistry less painful.

It is always a good idea to take good care of your natural teeth, however, should that fail, you can thank Etruscans for inventing dentures and modern medicine for perfecting dentures and implants.

Tuesday, March 27, 2018

Trivia I Wanted to Know


"Lenticchie"
For those of us who need help with our eyesight in old age, we have two Italians from Pisa to thank for the invention of spectacles sometime in the 1280s. Although there is no definitive answer, it is believed that the two were Alessandro Spina and Salvino Armato, glass blowers. The lenses were convex, helping only farsighted individuals. It would be more than 100 years before concave lenses would be ground to help nearsighted people.In the mid-forteen century, Italians called these glasses, "lenticchie" or glass lentils because they resembled the legume "lentil." So "lentil" is the origin of the word "lens."
Cardinal Giovanni de Medici bought several pairs of concave-lens eyeglasses to correct his nearsightedness. When he became Pope, he hired Raphael to paint his portrait. It is the first depiction of a person wearing concave corrective lenses.


******

Denis Papin steam digester
Photo: Wikipedia
The pressure cooker was invented by a Frenchman, Denis Papin, a pioneer of steam power. He called his invention the "steam digester." As an assistant to the Irish physicist Robert Boyle, formulator of the the laws governing gases, Papin had developed his steam digester in 1679. It was a metal container with a safety valve and tightly fitting lid, which increased internal steam pressure, raising a cooking liquid's boiling point. He cooked the first meal in his contraption for a London dinner party of the members of the Royal Society.






******

Miracle plastics in the order in which they were developed: cellophane, acetate, vinyl, plexiglas, acrylics, melmac, styrene, formica, polyester, nylon, and polyethylene (a synthetic polymer, one of the most important household plastics as in Tupperware). (1912-1942)

Great Pacific Garbage Gyre (Patches of rotating trash)
Mostly plastics, chemical sludge, and other debris
Photo: Wikipedia
 
Unfortunately, today we are drowning the ocean's creatures in tons of plastics which float at the top or under the water, endangering and strangling marine life. Satellite images of major rivers emptying into oceans show an alarming sea of trash and plastics that grow each day; these plastics and trash should have been recycled or captured and burned to generate energy, not dumped into rivers. Lakes are equally abused, especially in third world countries.

Friday, March 23, 2018

Snow, Squeals of Joy, and Snowflakes

Photo: Ileana Johnso
We finally got five inches of winter in one day, on the second day of spring, March 21, 2018. A few powdery flakes in December dashed our hope for a white Christmas.  This was a heavy snow which could easily turn to slush and then refreeze. The Hawk was blowing slightly but the snow did not scatter like powder in all directions.

We tried to go to our local park but it was closed. Two menacing park rangers, high on their minion power to control admission to nature, told us in threatening voices that the park is closed and we should leave. The fact that we were on state roads paid by us as taxpayers of Virginia, seemed to escape the tiny brains of these control freaks. But, in the name of peace and tranquility, we turned around without saying a word.

We decided that we could trudge our way into the park through our own back yard before we got too wet to care about nature and its breathtaking beauty.

Photo: Ileana Johnson
 
The snow was coming down fast covering the landscape in a winter wonderland, to the delight of children in the neighborhood who brought out their sleighs to slide down the many hills around. For the first time ever, I-95 N was completely empty of traffic, only a few south-bound vehicles.

Trucks with ploughs attached were busy clearing main roads and highways while many streets remained covered in a silent white blanket.

Photo: Ileana Johnson
 
Our resident fox surprised me as she dashed across the back yard, running swiftly into the woods in search for food. She has become the object of concern of many neighborhood newbies who are worried about their pets. They don’t know that the fox has a taste for squirrels but in a bind, she might steal other critters.

Grazing under the snow
Photo: Ileana Johnson
 
The snow is coming heavier and the flakes are dancing in the crisp air. It has collected five inches so far; it’s a heavy snow that would sting painfully in a snowball fight.  A few children on our street have brought out their toboggans and are squealing with delight as they wipe out at the bottom of the hill into the white blanket. A few are trying to build snowmen but the snow is too heavy and they give up, making snow angels instead.


Photo: Ileana Johnson
 
We walked to the river bank and, before I had a chance to snap a few shots of the wooden path covered with untouched whiteness, a yellow lab bounded out of the woods sliding on the wet snow. She seemed to be in sledding dog heaven, jumping and running in and out of bushes laden with snowy cotton balls that fell to the ground in a white flurry, covering her with shimmering flakes.

Photo: Ileana Johnson 2018
 
The red cardinals made a stark contrast to the overwhelming brightness – like a jumping feathery stain of blood. A family of deer is foraging at the edge of the park, their heads disappearing in the snow.

We laughed when we caught sight of the marina’s plastic bald eagle nest. We really thought it to be real several years ago when we got five feet of snow and it was much harder to make out shapes accurately in the total whiteout.

Photo: Ileana Johnson
 
The falling snow gives the Potomac River an enchanted glow that only an artist could imagine and paint with his magical pallet and brushes. The barren branches are covered in lacy white designs shooting up to the grey sky. The railroad bridge is cast in the distance in a wintry fog.

A few ducks are slowly gliding on the curiously grey water and birds are chirping in the trees. Yesterday they were ready for spring, preparing their nests and building new ones, the Japanese magnolia was on the verge of opening exquisite pink blooms, and today winter is back, as if it is quarreling with spring and keeps coming back to make one last point before final departure.

Snow is still falling, a myriad of flakes dancing in the air, dancing in my heart, falling on my hair and on my face. Like the kid I used to be, I stuck my tongue out to capture the magic of snow falling from the sky. There is nowhere I would rather be at this moment when I experience the happiness of my childhood winters, carefree and innocent, enjoying life and God’s seasons. It is a dreamy snow, a March snow that appears suddenly like a roaring lion and melts the next day like a lamb, one that will be gone tomorrow, but the memory will linger in my mind’s eyes, my videos, and my photographs.

Sunday, March 18, 2018

Mom Turned 86 Years Young

Mom turned 86 years young on St. Patrick’s Day. She is a skeletal figure of her former self but she has a strong will to live. Three weeks ago she fell and fractured her hip in at least three places. Dr. Reeves’ skillful surgical intervention put her bone fragments back together again and she convalesced for eleven days in the hospital, in and out of consciousness. She gained nine pounds on decent food and dedicated care. It was stellar nursing compared to ManorCare.

Maybe it was bad luck that she fell; however, if the African CNAs would have come to her help, she would not have fallen in the first place, trying to walk to get some water. Then they let her linger in pain from Wednesday afternoon until early Thursday evening when I arrived from a trip, before they sent her to a hospital to be x-rayed.

She had fallen during the three-year stay at ManorCare more than fifteen times and, thankfully, each time she walked away with a painful bruise or two. But this time her luck ran out. She was gaunt and malnourished because the nursing staff lost her dentures four times and often gave her pills on an empty stomach which caused her to vomit whatever food she did ingest. When she fell directly on her right hip, it crushed it as if she had been in a severe car accident. It was a comminuted fracture.

We could barely dress and lift her onto the wheelchair for fear that we might cause her unnecessary distress. I called a wheelchair van taxi to transport her to her favorite restaurant to celebrate her 86 years of life. I knew she would not eat much, between physical therapy and pain meds, but getting her out of the house and into the world was hope and life outside of four walls.

Mom is now a shell of her former self, frail, child-like, sweet some days, and a hellion on others. After her stroke last year, her incipient dementia had gotten worse and, on most days, she knows we are related, knows my name, but I am either her sister or her mom.

When she was 72, I found her on top of a ladder trying to clean the gutters stuffed with dry leaves. She was very active and moving about all the time. But she had slowed down after a fall on wet leaves in the driveway. She had to wear a corset for six months to repair the hairline fractures in the tailbone and ribs.

Mom took so much pleasure in raising a garden and flowers.  She took trips to Walmart with her Mimi Eileen every spring to buy plants, seeds, pots, and fertilizer. There was a sparkle in her eyes, and a sprint in her walk, as if she was going to a very important event that she did not want to miss. Spring was on its way, mom said, she could smell it in the air and hear it in the melodious birds chirping in the barren trees.

Mom had a green thumb and felt so happy and free among plants and flowers. She brought back to life potted plants our neighbors put out in the street for trash pickup and then she gave them back to the owners green and often in bloom. How did she do that? It was magic.

She was trying to make up for 48 years of living in a communist drab cinder block tiny apartment where the only concessions to a garden were a couple of red geranium plants she grew on the window sill in winter and on the balcony during the summer.

When she first arrived in the U.S., mom had such a large and beautiful garden in our faculty housing yard at MSU that people would drive by in awe watching her toil in dirt with glee, waving at them from her white wide-brim hat. When the eggplants, tomatoes, peppers, green onions, radishes, cucumbers, carrots, okra, and green beans would start coming in, all neighbors had fresh vegetables from her garden.

As mom aged, the large garden dwindled to a few tomato plants and peppers and a few roses and geraniums. I would find her picking Japanese beetle off the rose bushes and putting them in a jar filled with water. Somehow she felt that killing them this way was a more humane way to dispose of God’s creatures that dared to crawl out of dirt to shred her rose bushes.

Every spring, Anthony, our trusted lawn care man, would trim the azalea bushes and the Japanese magnolia we had planted twenty years earlier when we moved into our lovely southern home.  Mom would harass him, trim that, trim this, to my exasperation and his ever patient and smiling demeanor. Anthony had a bossy mom just like her at home and he always did their bidding with an unmistakable southern charm, “yes, ma’am.”

We still talk with love and longing about our fig tree in the back yard that would give so many figs, enough to make jars after jars of preserves each year. The tree was there when we bought the house. If the new owners have not cut it down, the tree is fifty-eight years old now. You never know who will enjoy the fruit of your labor when you plant a fruit tree or a shade tree.

We miss the gorgeous Ginkgo biloba tree in the back yard. Its leaves turned bright yellow in early fall; they blanketed the ground with a thick and beautiful yellow carpet of waxy leaves. Tiger and Bogart loved to chase moles and lizards in this impromptu playground. When Tiger passed, the yellow leaves would cover his grave.

It was mom’s first home since the communists had confiscated my parents’ apartment, their savings, and their pensions. And dad’s relatives took all their personal possessions when dad passed away in 1989. To this day, when she has no clarity, her scrambled brain remembers the confiscation and theft but I am the culprit.

Perhaps she is right, if I had not left the communist country legally, perhaps she would not have followed me here as a defector from communism and would have kept her property. Those commies did not take lightly the acts of defiance of their prison society citizens escaping from their tyranny and oppression.

Mom is 86 years young today. She came a very long way that flew by too quickly, almost nine decades of life full of good and bad experiences. She said, she did not care if she was 100 today as long as she was still alive and breathing, enjoying the sunshine and her plants. She has an assorted collection of small potted plants in her room at ManorCare. When she cannot water or tend to them, she makes sure that Alamatu does it and brings them in and out of the sun.

I have to remember Marcus Aurelius' advice to enjoy the moment because the present is a split second in eternity, minuscule, transitory, and insignificant.

Seeing mom in the outdoors again, my eyes teared up. I thank God, Mom is still with us! I was not sure she was going to make it alive from this difficult surgery. But here we are, we live another day to enjoy each other’s company in the Virginia sunshine, with bright blue skies and a blustery wind.

Friday, March 16, 2018

The Hessian Powder Magazine

On the Carlisle Barracks grounds in Pennsylvania, a non-descript rectangular stone building was witness to so much of our early American history.  The entrance is in the middle, a heavy and simple wooden door with rusted thick latches. It is now a self-guided museum which opens at daylight and closes at sun-down. It was captivating to step inside and to visit alone the former prison cells and powder storage magazine, now a museum which describes the rich history that surrounds the area.

The Carlisle post was purchased by the federal government in 1801 from the heirs of William Penn for $662.20.  The property had been rented previously.

In 1803 Meriwether Lewis was helped by eight recruits from the Carlisle Barracks in his preparation to explore the Missouri River. These recruits were sent by Lieutenant Colonel Thomas Cushing to help transport supplies and a keelboat from Pittsburgh to St. Louis. When the job was done, the recruits traveled down the Mississippi River and reported to Fort Adams, MS.

 
After a big fire destroyed most of the buildings in 1806, the post was rebuilt as a recruit depot. Even the Navy was authorized to use it. In 1828, the post began training cavalry troops. By 1846, the Carlisle Barracks became the principal cavalry and light artillery training depot for the U.S. Army.

Jail Cells
 
Cavalry School brothers were split and had to take sides as the war broke out between North and South.  Few thought that Confederate soldiers would venture out this far north.  But they did. In June of 1863 Gen. Robert E. Lee’s Confederate Army moved north into Maryland and Pennsylvania, moving along the Cumberland Valley towards Harrisburg, Pa.

 
Interestingly, a former soldier who served in 1840 at the Carlisle Barracks, Lt. Richard S. Ewell, 1st Dragoons, returned to Carlisle in 1863 as Confederate Lieutenant General where he headquartered and staged the area for an attack on Harrisburg. But Gen. Lee ordered him to rendezvous south of South Mountain and he left Carlisle on June 30, 1863.

 
Carlisle Barracks was almost burned to the ground by the shelling of Maj. Gen. J.E.B. Stuart and his Confederate cavalry when U.S. Brigadier General William E. Smith division, who was in possession of Carlisle, refused to surrender. One hundred and thirty-four rounds of ammunition also destroyed the city’s gas works (July 1, 1863).

Ironically, before the Civil War, Carlisle Barracks had been commanded by Stuart’s father-in-law, Gen. Phillip St. George Cooke. The post became smoldering ruins, however, by the end of the Civil War Carlisle Barracks had been rebuilt.

Gen. George Washington’s Continental Army was supported by a growing depot which had been built in 1777 during the American War of Independence from the British government. This Hessian Powder Magazine is the building in which I was standing.  This magazine, far away from the reach of British ships, stored gunpowder, cannon shot and small arms.

It is not documented as such but tradition claims that Hessian soldiers, who were interned at Carlisle after their capture by Washington’s Army during the Battle of Trenton in 1776, had built the powder magazine. It is the second oldest building on post after the 1760 Wilson-Henderson Mill on Route 11.

This building served many functions since its construction. The covered gallery, the chimneys and roof ventilators of the 18th century have long been removed. According to the archives, the iron doors were added in the mid-19th century when the building was used as the Hessian Guard House.

When the Carlisle Barracks were used as a cavalry school, the magazine building was used a guard house. From 1879 to 1918, the building was used by the Carlisle Indian Industrial School as a detention center for students. In the early 20th century, the building was used as storage and in 1948 was converted back to a close approximation of its former appearance. It now houses a museum.

It is highly unusual that powder magazines such as this one survived because generally gun powder was stored in earthen cellars or in highly enforced buildings in which the roof could minimize the blast effect but the rock walls would stand. Vaulted brick ceilings, traversed entrances, ventilation shafts and lightning rods were added to the architecture of buildings in order to enhance their safety. Exposed metal was avoided in order to moderate sparks and copper, wood, and leather were used while handling gunpowder.

To 18th century Americans, a “Hessian” was a generic term given to all six German-speaking states that had sent troops to serve the British government in compliance to treaty obligations. Professional mercenaries of sorts, “Hessians” were unforgiving fighters who took no prisoners and were greatly feared by the Continental Army soldiers.  The few soldiers, who were captured after the Battle of Trenton, were sent to Carlisle and used as free labor.

According to the museum archives, on the night of December 25, 1776, Washington’s army crossed the Delaware River by boats since it had not frozen over as he had hoped, and surprised the Hessians who were quartered in Trenton. On January 3, 1777 his army also defeated the British forces in Princeton, causing both the Hessians and the British to retreat into the interior of New Jersey.

A “Hessian” soldier of the Fusilier Regiment von Lossburg at the Battle of Trenton was equipped with a brass helmet plate with a lion cipher of his fusilier regiment and armed with a standard Prussian pattern flintlock musket and brass hilted short sword.

In 1903 when the post housed the Carlisle Indian Industrial School, the football team invented the hidden ball play in a college game against Harvard.

In 1920 when the post housed the Medical Field Service School, Major John P. Fletcher invented the first complete sterile bandage for individual soldiers. It was called the Carlisle Bandage.

In 1918 General Hospital No. 31 was established in Carlisle Barracks as a pioneering rehab center, treating over 4,000 soldiers in WWI.

In another first, in order to evacuate the wounded, a trial for the auto-gyro was executed in 1935 at the Carlisle Medical Field Service School as the first vertical take-off associated with the Army.

The list of schools located on the post is quite long:

-         Artillery School  (1777)

-         School of Cavalry Practice  (1838)

-         Mounted Light Artillery  (1838)

-         Indian Industrial School  (1879)

-         Medical School  (1920)

-         School of Government of Occupied Areas  (1946)

-         Adjutant General School  (1946)

-         Armed Forces Information Schools  (1946)

-         Chaplain School  (1947)

-         Military Police School  (1947)

-         Army Security Agency School  (1949)

-         U.S. Army War College  (1951)

-         U.S. Army Military History Research Collection  (1967)

-         U.S. Army Military History Institute  (1977)

The Indian School envisioned by Richard Pratt trained Native American youth in industry, trades, and farming. Besides academics, students learned blacksmithing, metalworking, carpentry, and printing. Girls learned cooking, sewing, embroidery, and other forms of stitching.

Some of the best athletes and teams in the nation were instructed by Glenn S. “Pop” Warner:  William Henry “Lone Star” Dietz, Charles “Chief” Bender; Louis Tewanima of the Hopi tribe earned trophies in the 1908 and 1912 Olympics and Jim Thorpe was named All American football halfback in 1911 and 1912 and won the decathlon and pentathlon at the 1912 Olympics. The Associated Press named Thorpe the greatest athlete of the first 50 years of the 20th century.

The athletic field and the cemetery are a testimony to 39 years of existence of the Indian School. Students like Happy Lucy who passed away while studying are buried here.

Captain Johann Ewald, commander of a company of Hessian riflemen, who fought against the American Army of the Revolution had this to say:

“Concerning the American army, one should not think that it can be compared to a motley crowd of farmers. The so-called Continental regiments are under good discipline and drill in the English style as well as the English themselves…  This army consists of handsome… well-built men whose appearance suffers very much indeed from a lack of clothing, hats, and shoes. For I have seen many soldiers of this army without shoes, with tattered breeches and uniforms patched with all sorts of colored cloths, without neckband and only the lid of a hat, who marched and stood their guard as proudly as the best uniformed soldier in the world, despite the raw weather and hard rain… Indeed, very many stood quite proudly under arms without shoes and stockings. Although I shuddered at the distress of these men, it filled me with awe for them. Who would have thought a hundred years ago that out of this multitude of rabble would arise a people who could defy kings and enter into a close alliance with crowned heads?”

The American Patriots stood against the mighty English empire, one of the greatest military powers of all time, spanning the world.  With little prior military experience and learning their craft on the drill field and in battle, the Americans won.

Today the U.S. Army War College produces “graduates who are skilled critical thinkers tasked with solving complex problems in the global application of land power.”

“The Strategic Studies Institute of the U.S. Army War College conducts and publishes national security and strategic research and analysis which serve to influence policy debate and bridge the gap between Military and Academia.” One recent wargame looked at three critical outcomes of the Syrian conflict. (Museum Archives)

At the time of its founding in 1751, the tiny village of Carlisle, Pa, located on the banks of the Letort Creek in the Cumberland Valley was the county seat of Cumberland County, the westernmost county in Pa. The small township of Carlisle has been at the cross roads of American history. Carlisle Barracks played a significant role in the training of the American soldier.

Monday, March 12, 2018

Stylish Clothes for the Modern Day Muslimah

Holly Rhue wrote in the northernvirginiamag.com about 22-year old Sana Mahmood, the George Mason University (GMU) business student who “is making stylish modesty more accessible to Muslim-American women” through her online Veiled Beaut brand – clothes for the “modern day Muslimah.”

Appealing to “feminism,” the Merriam-Webster’s 2017 word of the year, Rhue quotes Mahmood that the American fashion industry “wrongfully affirms that a woman’s influence must only lay within her appeal and physical features.”  Mahmood’s Veiled Beaut is a “complete line of stylish hijabs and a full-blown humanitarian effort.”

But feminism as defined by Merriam Webster’s dictionary, “the advocacy of women's rights on the grounds of political, social, and economic equality to men,” is the antithesis of what burkas and hijabs represent.

If appeal and physical features were not important in a woman’s influence, then why bother to make stylish burkas and hijabs, and why bother to use heavy makeup?

For the fashion-conscious western women, it is hard to imagine the hijab and the burka, a tent-like item of clothing that conceals any human shape, as stylish.

Western women cannot understand how a burka is sold as an expression of modesty when in some Muslim countries women are forced to wear it, beaten or jailed if they are seen or caught in public without a burka and a hijab. Even foreign female dignitaries who visit Muslim countries are expected to wear a hijab in public.

We see clothing in the Western world as a way to cover our bodies for warmth in winter and for coolness in summer.  We have uniforms but these are hardly designed to conceal the human form. Some clothes are stylish, some are just practical; some are too revealing and others cover more. Some are odd, some are inappropriate, some more modest, and some are creative. People wear what they like and are comfortable in, not what theocrats order them to.

Often nuns’ habits are compared to wearing burkas and hijabs but the comparison is absurd. Nuns wear habits because they want to serve God and this is their way of doing it. Nobody forces them to put on a habit or lashes them in public if they don’t.

Creating “stylish hijabs” and “kimonos” (I thought kimonos were Japanese), Rhue explains that “through these products, Mahmood hopes to shift the paradigm on how the world sees female empowerment and social justice.” So liberals now equate female empowerment and social justice with colorful burkas and hijabs with tassels and other decorative embroidery.

Seriously? Wearing a burka and a hijab is female empowerment and social justice? On what planet is being whipped, jailed, and beaten for not wearing a hijab or a burka in public female empowerment? Is it social justice that Muslim women are considered half a human in a court of law? And how is that expressed in a tent-like item of clothing which they are forced to wear?

Seeing the dearth of products for the American Muslim market seeded Mahmood’s idea to target Muslim-American women and their needs.

Do we have a Christian-American market and Christian-American women needs? We do because this country, despite of what liberals tell us, was founded and populated by Christian Americans. But, unlike liberals, we don’t like to hyphenate people; we refer to all our citizens as Americans regardless of religion, race, and sex.

Rhue describes how Mahmood “went to great lengths to find a manufacturer with high safety standards and ethical treatment of employees.” Who knew that American manufacturers did not have safety standards or ethical treatment of their employees?

Mahmood “selflessly” donates 10 percent of Veiled Beaut’s annual profits to Helping Hand, “an organization that feeds, clothes, shelters, and educates orphans in Jordan.” Sounds like a generous humanitarian cause. “Islamic finance is based on the profit-sharing principle and requires investment in ethical causes or projects.”

 

Friday, March 9, 2018

HCR ManorCare Bankruptcy and Patients

One of the largest nursing home chains in the U.S., HCR ManorCare Inc. has filed for bankruptcy protection on March 4, 2018 in the Bankruptcy Court in Wilmington, Delaware.  Quality Care Properties Inc., HCR’s landlord, will take control of the company.

The private-equity firm Carlyle Group owns HCR ManorCare Inc. The departing CEO, Paul Ormond received $115 million in deferred compensation and severance even though HCR is approximately $230 million in debt.

HCR missed numerous rent payments even though Quality Care Properties Inc. agreed to multiple temporary reductions in such payments. Last August QCP took legal action and sued “to replace the company’s management and to appoint a receiver with the power to collect rent.”

The plan of reorganization filed with the bankruptcy court stipulates that the operating business will stay out of bankruptcy and Carlyle’s equity stake will be wiped out.

As per chapter 11 bankruptcy rules, HCR ManorCare will pay all creditors, vendors, and suppliers in full and on time with the exception of QCP. HCR blamed its problems on low reimbursement rates from government health programs.

According to the Wall Street Journal, “The Company, which employs 50,000 people, last year posted a pretax loss of $267.9 million on revenue of $3.7 billion, 82% of which derived from the long-term care business. HCR ManorCare listed $4.3 billion in total assets and $7.1 billion in total liabilities, debt and financing obligations, in court filings.” https://www.wsj.com/articles/hcr-manorcare-files-for-bankruptcy-1520261353?emailToken=3e08c926ad937feb42c06a6e927e293e9epWtsVf4xiOTCAmih%2FzF90OQmpFg%2FwrZe27eRUH2LN9hFhst1liU6fj2rUQEqSWwLOngxtntQr57quk37ilag%3D%3D

When the ownership transfer will be completed, the current Chief Executive Steven Cavanaugh will be replaced by Guy Sansone and Laura Linynsky, the senior vice president at QCP will become interim CFO at HCR ManorCare.

The Toledo-based HCR ManorCare will need approval of the chapter 11 bankruptcy plan within 40 days while QCP will seek government regulatory approval, which may take three to six months, in order to operate a health care business.

HCR ManorCare runs 500 skilled-nursing and rehabilitation centers, assisted living facilities, hospice, and home health agencies. The skilled-nursing industry blames its many problems on low government reimbursement, declining occupancy, and high labor expense.

 “As part of the agreement, HCR ManorCare paid QCP $23.5 million in past-due rent. The companies' plan sponsor agreement stipulates that HCR ManorCare will continue to pay rent during the Chapter 11 period.” http://www.modernhealthcare.com/article/20180305/NEWS/180309949

According to health experts, HCR ManorCare treated 143,000 patients in 2017 and has experienced declining Medicare reimbursements due to the growing Medicare Advantage plans offered through private insurers.

The bankruptcy agreement promises to provide stability for employees, residents, and patients. However, the turnover of employees at one such HCR ManorCare facility in northern Virginia is constant as I have witnessed first-hand over the last four years.

Medicare has been stripped of more than $716 billion over a ten year period in order to fund Obamacare. This has affected seniors and their medical care, including their ability to keep their doctors or to find specialists. Some have decided to no longer accept new Medicare and Medicaid patients and keep only the well-established patients who were grandfathered into the private system they began to accept. https://www.forbes.com/sites/theapothecary/2012/08/16/fact-checking-the-obama-campaigns-defense-of-its-716-billion-cut-to-medicare/#326c1c37385f

Nursing homes are financially strapped due to continuing underfunding. Mark Parkinson, CEO of the American Health Care Association, wrote, "In many areas of the country, nursing homes are paid for only a fraction of the care they provide. Our nation is at turning point where we must decide if we are going to continue to take care of America's seniors and individuals with disabilities." http://www.modernhealthcare.com/article/20180305/NEWS/180309949

This statement hits home for me. HCR ManorCare patients are cared for in one facility in northern Virginia where the atmosphere is somewhat strained, the staff is always short-handed, residents are not always cared for well, medications are denied because they are too expensive, doctors, nurses, and CNAs come and go without as much as a call to the families, patients fall all the time and break bones and hips as was the case for my mom for the last four years and most recently, UTIs are commonplace due to many reasons, one being lack of proper sanitation and slow diapering, not changing gloves between patients, not changing soiled sheets due to low CNAs to patient ratios, and lackadaisical cleaning of rooms.

HCR ManorCare is not the worst facility in the industry and not the best. There is a constant turnover of aides from African countries and new students come to learn on the job; there are employees and CNAs who really care about their patients and go above and beyond the call of duty; they tend to remain on the job long-term; and there are others who do not care at all for their patients.

It is a difficult and demanding job to care for human beings who are so sick that they can no longer fend for themselves and some are even helpless to feed themselves. Care givers must detach themselves from the pain and suffering and meet their patients’ needs. To make matters worse, some patients have dementia and are not cooperative with their CNAs.

Bureaucrats look at the business side of the operation. Due to financial reasons, social workers are often struggling to find transport for their handicapped patients to doctors and hospitals when families are physically unable to do so.

Occasionally nursing homes replace lost or stolen items, yet there is no plan in place for employees to watch for the dentures of the patients they care for. Consequently, dentures are constantly thrown away with the meal tray even though the nursing home must spend money to replace them.

Patients who no longer have families to insist that lost dentures be replaced, are left toothless and meals are chopped up for them every day. Mom’s nursing home lost four of her dentures, sometimes uppers, sometimes lowers. And it’s not just dentures and glasses that are lost, personal belongings are stolen constantly, and even food brought from the outside disappears.

I have watched new recruits who do not understand well or don’t care how disease spreads and the importance of sanitary conditions and gloved, gowned, and masked precautions for themselves and their patients.

Whether they are good or bad, nursing homes and other rehab facilities are a necessary “evil” that our society does not really understand well until they bother to visit their loved ones more than once a year or wind up themselves in one. Not everybody can afford to buy full-coverage private nursing home insurance in order to spend the last years of their lives in the posh five star private facilities, with care and dignity. But then, who is to say that they will be treated better?