Editor's note: This story originally ran in June.

State inspection reports describe Utah's elderly languishing in nursing homes ignored by staff. Or senile people getting hit by cars. Or choking to death on a hot dog despite doctors' orders they receive only soft foods.

These terrible tales are the exception rather than the rule, as most of Utah's nursing homes receive few serious "deficiencies." Some receive no bad marks at all.

In a number of states like Arizona and Minnesota, people can review these inspections online, giving them an easy way to compare nursing homes as they decide where to bring their ailing mom or dad.

But not here.

To see Utah's reports, you have to take a trip to each nursing home and flip through a hard copy. Even then, it is only one year's worth of data.

That doesn't make sense to two senators who want to load a federal Web site with more information to give consumers a chance to differentiate the good homes from the poor performers.

"Too many Americans receive poor care, often in a subset of nursing homes," said Sen. Chuck Grassley, R-Iowa. "Unfortunately, this subset of chronic offenders stays in business, in many ways keeping their poor track record hidden from the public at large."

Grassley is sponsoring a bill with Sen. Herb Kohl, D-Wis., that would provide online access to the inspections nationwide, replacing a system where the surveys are summarized in general categories. The legislation would also add ownership information and more accurate data on staffing hours to the Nursing Home Compare site, which is accessible through www.medicare.gov. Grassley's proposal would also boost fines and allow the government to go after nursing home chains that have poor compliance histories.

The bill is in its infancy, having just been introduced in February. It has yet to get a hearing.

The Nursing Home Compare site should not only have the links to the reports, but also should put the information into context, allowing people to compare homes over multiple years, said Lewis Morris, chief counsel to the inspector general at the Department of Health and Human Services.

He said this new level of information would help families identify what he calls "yo-yo" facilities that bounce in and out of compliance.

Grassley said the online information is needed because many families must make a rush decision on a nursing home after a relative has an unexpected medical problem.

That's what happened to Linda Lee, who had to quickly pick a home for her mom Renee, a year and a half ago.

"It was a scramble," she said. "You are in a predicament and you have to make a decision."

After a little online searching, Lee brought her mom to the state's largest nursing home, Christus St. Joseph Villa in Salt Lake City. She said she would have liked to review the inspections online.

Marc Babitz likes the idea too. He is the director of Utah's Division of Health Systems Improvements, which conducts the surveys. But he said Utah doesn't follow the example of Arizona and other states because it can't afford to.

"It is a matter of money," Babitz said. "Many of the states that do this are much better funded."

State surveyors inspect each nursing home at least once every 15 months and maybe more if they get complaints. The inspection normally lasts a few days and involves a detailed look at the medical records of patients, the conditions of the kitchen and interviews with residents.

A nursing home is given a deficiency for violating a federal or state rule and an actual harm deficiency if a resident is hurt. The most severe deficiencies result in fines, and in very rare cases, the state can pull a home's certification. Looking at inspection reports over time can show which homes have problems with nutrition, restraints or even abuse.

"I think it is just extremely important that people should be able to read these reports," said Janet Wells, public policy director for the National Citizens' Coalition for Nursing Home Reform.

But those representing the nursing home industry warn that inspection reports are only a snapshot in time and should not be the only tool used to determine quality. Some criticize the inspections all together.

"It is a punitive system based on a gotcha¹ mentality," said Dirk Anjewierden IV, the executive director of the Utah Health Care Association, which is the industry group for nursing homes. "It really doesn't measure the quality of care a facility provides on an ongoing basis."

He said even a good nursing home can have a bad inspection report, and he worries that the public will have a hard time understanding the bureaucratic and medical language. He says people should only worry if they see a pattern of deficiencies.

Greg Bateman leads Utah's survey team and he said his staff doesn't have a "gotcha mentality."

"It is simply going out as an objective source checking on compliance," Bateman said. "There is value in it."

He urges people to read the inspection surveys and ask nursing home administrators how they have responded to the violations.

The Tribune has placed the more serious reports on its Web site. If a person is looking for more information, Babitz said the surveyors would be willing to help people access the reports if they call the office. The number is 801-538-6158.

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mcanham@sltrib.com

Nursing Home Transparency and Improvement Act of 2008

Sponsors: Sens. Chuck Grassley, R-Iowa, and Herb Kohl, D-Wis.

The bill would: