As the average age of the American population increases, we have become more aware from media reports and family experiences of the potential for elder abuse. Whether an elderly person is subjected to abuse or neglect in a nursing home or victimized by financial fraud, the people and institutions that commit such actions are subject to legal action and compensatory or punitive damages.

Surprise inspections of California nursing homes by the state Department of Justice's "Operation Guardians" program have recorded a range of safety and health problems at institutions across the state. Among the most commonly exposed problems were lack of treatment for pressure ulcers (bed sores), intentional overmedication of patients without consent, and dosage mistakes.

Details of the reports were recently released by California Advocates for Nursing Home Reform (CANHR), an advocacy group that is dedicated to improving the quality of services provided to long-term-care consumers. CANHR obtained the reports, which are not public, by filing a Public Records Act request to obtain all records from the past two years and the group has posted and summarized the reports on its website. CANHR has termed the reports evidence of "a shameful state of affairs in the reviewed nursing homes that is fostered, in part, by a lack of statewide enforcement from the Department of Public Health."

Other problems uncovered by Operation Guardians include leaving residents for hours in contact with their own feces or urine, failing to provide sanitary facilities, falsification of medical records, and fraudulent billing for services. CANHR's executive summary stated that the reports it uncovered "demonstrate that some nursing homes are houses of horror with life threatening filthy conditions, lack of staff to perform core functions and poor management."

CANHR's investigation led to a conclusion that government failure to hold institutions accountable is a big part of the problem. Despite the fact that all of the reports are provided to the California Department of Public Health, which is responsible for enforcing state nursing home regulations, CANHR found few instances of action being taken against nursing homes that had reports of substandard care.

In light of these findings, CANHR has made a series of recommendations, including calls for an increase in Operation Guardians investigations as well as publication of all reports to give potential residents and family members access to negative information about particular nursing homes. The group has also called for priority investigation of problems exposed by these reports and called on California's Attorney General to prosecute those who are responsible for the "reprehensible care and conditions" in nursing homes that showed the poorest performance.

Family members or residents of elderly care facilities can take matters into their own hands by filing civil claims against nursing homes that mistreat, neglect or otherwise abuse vulnerable people. By making administrators pay for substandard care and other problems, nursing home lawsuits encourage better care for all Californians.