Jesus christ how did this happen?

@title Because its expensive to run a care home. And often insurance companies will pay more for higher needs individuals, but less for lower needs. So you need to find a way to pay to run the place by having enough higher needs individuals but not so many that you need extra staff to keep up, as extra staff is expensive

https://www.npr.org/2014/11/21/365433685/if-we-left-they-wouldnt-have-nobody