Take a recent family member's situation. He was in his mid 50's, with one leg amputated and in need of 24-hour care. When we walked into the room to visit him, the staff was rude as hell. One nurse threw away the power of attorney (healthcare) form he had completed and the family had to scramble to get another one faxed to them when he was signed onto hospice. The nursing home social worker then refused to honor the document and completed another one with him, naming a friend as his decision-maker - even though he wasn't able to make decisions at that point. They treated the family like shit, gave him full meals even though he had no teeth and was dying. We walked into the room to find this cold meal:
Another friend had a family member there and they said that their experience was worse - and that they hadn't had one positive encounter with the staff there. This nursing home received a "Two star = below average" rating from Medicare. Yet it receives the same reimbursement from Medicare and Medicaid and other than paying a few fines, are allowed to continue to provide shitty-ass care. It's cheaper to pay the fines than it is to provide quality care from caring professionals.