Since the federal government began a nursing home rating system in 2008, more than 560 nursing homes that received a one-star rating (the lowest rating possible for nursing home care) haven't improved much - they are still listed at only one star.

A USA Today analysis found that, while nursing home care has generally gotten better over the last three years, there is still a lot of work to be done to prevent nursing home abuse and ensure that nursing home residents are receiving quality care.

In California, 45 nursing homes consistently received one-star ratings between 2009 and 2011.

Nursing homes receive one-star ratings if they offer care far below the average nursing homes in their state. Failure to hire licensed caregivers, use of dirty equipment, nursing home abuse, dehydration and other mistreatment of residents can lead to a one-star rating.

According to USA Today, two-thirds of the nursing homes in the U.S. that have consistently been rated at one star are chain-owned, for-profit nursing homes.

The federal ratings give a general idea of the quality of U.S. nursing homes, but they are not perfect. The ratings only reflect the quality of nursing homes at one particular time (the time in which the rating was assessed). The quality of a nursing home can change dramatically within a short period of time.

Nursing home abuse remains a serious problem in California and across the nation. It is important to investigate the quality of nursing homes to ensure that care remains optimal at highly-rated nursing homes and to give poorly-rated nursing homes incentive to improve.

Of course, even the highest-rated nursing home can have hidden abuse. That is why we must continue to advocate against nursing home abuse and hold institutions and individuals accountable when abuse occurs.

Source: USA Today, "As nursing homes care improves, some problems are slow to mend," Paul Monies, Feb. 10, 2012