More bad news for nursing homes. A Health and Human Services report issued this week shows that more than 90 percent of U.S. nursing homes in each of the past three years were cited for violating federal standards. For-profit facilities had a higher percentage of violations – 94 percent compared to 88 percent of not-for- profit facilities.

The most common violations related to improper storage and distribution of food, accident hazards and lack of services necessary for residents’ mental and physical well-being.

Of course the report was accompanied by more talk of increased policing of the industry but guess what, the government simply does not have the resources to get it done. So who does the burden fall on to? Yes you the family caregiver. But it is not just about vigilance on the caregivers part.

This is an industry in which the certified nurse assistant is the most direct care provider, certainly the least paid and sometimes the least valued. There are systemic issues and some of it starts with greed at the corporate level that filters down to poor care because the resources are being siphoned off somewhere else.

This is an industry in which people need to feel there is a career and a career progression, an industry in which caring for the elderly should be viewed as a noble and honorable thing to do and rewarded as such. Yet we continue to marginalize our eldest, pay those who care for them the least so that at any moment they can jump ship and make more money in another industry.

Stricter enforcement is only part of the answer.