Safety alert: the quality of nursing-home care.(View point: the consumers union perspective)

In July, an 81-year-old Arkansas woman was beaten at a nursing home by two of the facility's employees, who police say used brass knuckles to inflict fatal injuries. While her death may have been more gruesome than most among the nation's 1.5 million nursing-home residents, physical abuse and neglect at nursing facilities are not unheard of.

Study after study by independent researchers and government agencies have documented problems with the quality of care in hundreds of the 17,000 nursing homes in the U.S. "Abuse and neglect are persistent problems," says Charles D. Phillips, a gerontologist and professor at the School of Rural Public Health at Texas A&M University

To make consumers more aware of nursing-home problems, Consumers Union's Center for Consumer Health Choices recently released a report, "How Good Are Your State's Nursing Homes?" It identified 368 facilities across the country that either have appeared on all three of Consumers Union's Nursing Home Watch Lists over the past three years or have exhibited a "yo-yo" pattern of compliance with health and safety regulations: They correct deficiencies one year but have recurring problems the next.

CU's Watch List identifies about 10 percent of nursing homes in each state whose inspection reports raise questions, in our judgment, about the quality of care given to residents.

The Center also found an increase in the percentage of facilities cited for placing residents in immediate jeopardy: 6.8 percent of facilities were cited in 2002, compared with 5.6 percent in 2001.

Why do the studies tell such a grim story? Much of the problem stems from a reimbursement system that many experts say does not adequately compensate facilities for providing good care. Poor care also results from a failure of the ...