By Debra Jasper and Spencer Hunt
Photos by Michael E. Keating
The Cincinnati Enquirer

State officials acknowledge they rarely crack down on troubled facilities.

"We cite, they correct, and it just goes round and round and round," says Dr. Baird, director of the Health Department. "I'd like to see all the facilities offer top quality care, and that's just not the case."

Ken Ritchey, director of the Mental Retardation Department, says that even if officials went to court to shut them down, there are few other places for people to go. Nursing homes for the mentally retarded stay nearly full.

"Some providers consistently have mediocre reviews, and you turn back around and (the same problems) are there again," Mr. Ritchey says. "We don't have a lot of tools in our arsenal."

He backs a proposal by Sen. Robert Spada, a Parma Heights Republican, that would allow the state to suspend admissions at all nursing homes owned by a company that's had repeated problems at any one home.

"We think that's the best way to get their attention," Sen. Spada says.

The measure faces tough opposition by the powerful nursing home lobby. And even if the proposal becomes law, officials say other reforms are needed.

The state can fine regular nursing homes when residents are harmed, under a federal law pushed through by powerful lobbies for the nation's older citizens. But nursing homes for the mentally retarded aren't subject to such fines.

The Health Department isn't even very good at making unannounced inspections. The state must visit each home once a year and typically visits just before the time limit ends.

"It doesn't take a rocket scientist to figure out when we're going to show up," Mr. Baird says.

Staffing problems >