Due to errors in government documents, last week's nursing home report (Cover, June 5) incorrectly said compliance actions had been taken against Oakwood Health Center in Alexandria, where no deficiencies were found, and Lorien Nursing Convalescent Home, Columbia. (Published 6/12/90) The federal Health Care Financing Administration erroneously reported that a corrective "compliance action" was taken in 1988-89 against Sylvan Manor Health Care Center in Silver Spring. No such action was taken. The report was the subject of a cover story on June 5 in the Health section. (Published 7/31/90)

Ask elderly Americans what they fear most and many will say, "Going to a nursing home."

The fear is overdrawn. Just under one in four older persons will ever spend some time in a nursing home. At any time, a quarter of all 65-and-olders need some kind of long-term supportive care -- therapy or help with meals, housekeeping or even the most personal needs, including bathing and dressing. But almost 80 percent of those who depend on these services are living in the community, not in a nursing home.

For many, however, the nursing home reality remains.

How good -- or bad -- are the country's nursing homes?

How do you choose one, for yourself or a loved one or friend?

There are 19,100 nursing homes in the United States. There is no adequate guide to their quality.

In the past two years, however, the Department of Health and Human Services has made a start -- a highly incomplete and controversial start but a start -- on giving the public some guidance.

The agency last week issued its second annual report on specific deficiencies in 32 key kinds of care in the 15,572 nursing homes treating Medicare or Medicaid patients. It also disclosed each home's total number of deficiencies in meeting more than 500 federal requirements.

A quarter of all these homes failed to keep residents clean, give drugs properly or maintain isolation techniques to prevent infection. A third stored or served food improperly. One in seven didn't give prompt attention to residents who needed help eating or drinking. One in 20 failed to provide nursing services at all times.

Only 1.4 percent were found guilty of mental or physical abuse. Some kind of "compliance action" -- usually an order to shape up within 90 days -- was taken against 989 homes in 1989, just under one in 16. Only 69 had their government payments cut off, some of them temporarily pending corrections.

In all, said Gail Wilensky, Health Care Financing Administration administrator, "there are fewer examples of nursing homes not meeting the criteria than in 1987-88. Things are showing improvement, somewhat, not a great deal . . . But we have a lot of work to do."

The finding on each home is only a snapshot. It is the result of one or, if there is a problem, more than one visit by a state-employed inspector sometime in the past 18 months. The average number of visits is in fact 2.5 because of revisits prompted by initial problems. And the inspector is supposed to interview some 50 residents in each home during an initial two-to-four-day inspection.

Yet the picture is hardly complete. The inspector, for example, may be from a state that does a zealous or a careless job of inspection. A bad situation may have been corrected. A home with no or few problems may have developed some. Sometimes, a home with a good reputation shows up badly. Sometimes, a bad home squeaks through.

"It is not the final, definitive word, not a complete guide to selecting a nursing home," Wilensky said. "But we believe it's a valuable aid to decision-making."

In other words, you can't usually rely on this report alone to judge a nursing home. Still, it gives prospective patients and family members things to ask questions about.

It surely acts as a goad to keep nursing home administrators on their toes. And if a home has a bad mark in some area two years in a row or if the number of bad marks is large or if some compliance action and perhaps a penalty has been ordered -- see the chart on these pages on Washington area homes -- the questions should be even sharper.

The Washington area snapshot?

Of 100 nursing homes, six had no deficiencies at all on most recent inspection: In Washington, Health Care Institute. In Maryland, Ginger Cove, Annapolis; Bon Secours, Edgewater. In Virginia, Oakwood, Alexandria; Belvoir Woods, Fort Belvoir; Brookwood, Stafford.

Eight had 20 deficiencies or more: In Washington, D.C. Village, 39; Medlantic Manor/Lamont-Riggs, 25; Washington Center for Aging, 40; Washington Home, 28. In Maryland, Clinton Convalescent Center, 23; Potomac Valley, Rockville, 25; Meridian, Silver Spring, 29. In Virginia, Crystal City, Arlington, 31.

The state of Maryland ordered the Clinton center's license revoked last April, but the facility went to court to try to stay open. The matter is still unresolved.

District homes tended to have the most bad marks, Virginia's the fewest. Fifty-seven percent of Washington homes, 20 percent in Maryland and 19 percent in Virginia failed to give drugs according to doctors' orders. District nursing home administrators say District inspectors are tougher than Maryland's and tougher still than Virginia's. Federal officials admit that comparing state inspections is a problem and have been conducting spot-checks to try to assess comparability.

A surprising finding: the many deficiencies found at the District's Washington Home, a place often cited as a model by nursing home professionals. The Washington Home had 28 deficiencies, including failure to give drugs according to doctors' orders and cleanliness. Jared Falek, executive director, said the report failed to distinguish between major and minor deficiencies -- for example, he said, one deficiency was "dust on a table." Administrators of other homes have made similar complaints.

Officials of the American Health Care Association, which represents nursing homes, the American Association of Homes for the Aging and the National Council on the Aging called the federal report unreliable, inconsistent, out of date and possibly harmful to anyone who uses it to find a nursing home. They said it fails to adjust for the fact that some homes care for far sicker patients than others.

All urged consumers: do your own investigating, tour homes, ask questions, check with local or state authorities.

More critical of nursing homes and the government, the National Council of Senior Citizens called it an "outrage" that so many homes failed their inspections on crucial matters like giving drugs. The militant National Citizens' Coalition for Nursing Home Reform said the federal report reveals the government's "shameful failure to enforce decent standards" and the facts that many homes have serious problems, that inspection agencies are generally understaffed and undertrained and that "enforcement is the exception rather than the rule" in nursing home certifying and licensing."

There are at least two simple additions that might help consumers and improve future reports: printing the names and phone numbers of nursing home owners and administrators, and disclosing each home's ratios of nurses (registered nurses, licensed practical nurses and nurses' aides) to patients.

The federal report comes as there are increasing numbers of very aged, and the nation is failing spectacularly to meet and pay for the health needs of all its citizens, young and old.

Study after study shows there is a critical shortage of nursing home beds and other facilities -- home health care agencies, hospice groups and others -- to give humane care to the ailing aged.

The largest problem of all for nursing homes -- and their patients -- is probably the shortage of qualified nurses and others willing to work for low salaries, kept low in large part by low government and other payments to the homes. In many, annual turnover ranges from 65 percent for nurses to more than 100 percent for nurses' aides, meaning that in a year's time there may be two people in every aide's job.

There are some signs of change. The government's Medicare-Medicaid agency has in place several new rules and is planning others to require better care and to speed enforcement.

A University of Pennsylvania study found that the use of restraints, physical and chemical, on American nursing home patients was common, harmful and undignified, compared with restraint-free care in Britain and Scandinavia. The Manor Care corporation promises to open a restraint-free center in Silver Spring this month, and the use of restraints is under strict control at many other homes.

Yet there is general agreement: the long-term care needs of the nation are far from met, and there is no adequate plan in force to start meeting them.

The rule meanwhile must be: shop for care carefully. There are good nursing homes to be found.

The following are 32 federal "performance indicators" -- key care and safety standards -- for nursing homes:

RIGHTS: The facility insures that its written procedures for residents' rights and responsibilities are followed.

FUNDS: The facility uses a system that assures full accounting of residents' personal funds.

ABUSE: Residents are free from mental and physical abuse.

RESTRAINTS: Drugs to control behavior and physical restraints are used only when authorized by a physician for a specific time or in emergencies.

PRIVACY: Residents are given privacy during treatment and care of personal needs.

ASSOCIATE: Residents may communicate, associate and meet privately with individuals of choice unless infringing on another resident's rights.

POSSESSIONS: Residents may keep and use personal possessions and clothing as space permits.

CHANGE: Except in medical emergency, a resident is not transferred or discharged, nor is treatment changed radically, without consultation with the resident or, if the resident is incompetent, without prior notification of next of kin or sponsor.

PHYSICIAN: The health care of each resident is under a physician's continuous supervision.

EMERGENCY: A physician's emergency services are available and provided when required.

NURSING: Nursing services are provided at all times.

HYGIENE: Residents get daily personal hygiene to assure cleanliness, skin care, grooming and oral hygiene, taking individual preferences into account. Residents are encouraged to care for themselves.

SKIN: Residents get care to prevent skin breakdown.

BED SORES: Residents with bed sores get care necessary to promote healing, including proper dressing.

CONTROL: Residents with bowel and bladder control problems get care necessary to encourage self control, including frequent toileting and opportunities for rehabilitative training.

CATHETER: Residents with a urinary catheter get proper routine care, including periodic evaluation.

TREATMENTS: Residents get proper care for injections, fluids given through tubes, colostomy/ileostomy, breathing and tracheotomy care, suctioning and tube feeding.

REHAB: Residents get rehabilitative nursing care to promote maximum functioning to prevent loss of ability to walk or move freely, deformities and paralysis.

EATING: Residents needing assistance in eating or drinking get prompt assistance. Self-help devices are available when necessary.

DRUGS: Drugs are given according to the attending physician's written orders.

MENUS: Menus meet each patient's nutritional needs in accordance with physician's orders, and, to the extent medically possible, recommended dietary allowances.

THERAPY: Therapy is provided according to the physician's orders by qualified therapists or assistants.

SOCIAL/EMOTIONAL: Services are provided to meet social and emotional needs.

ACTIVITIES: A program of meaningful activities is provided, based on each resident's needs and interests, designed to promote normal pursuits, including religions.

HEALTH CARE: Appropriate staff implements a written health care plan for each resident, according to physician's instructions.

TOILET: Toilet and bath facilities are clean, sanitary and odor free.

CLEANLINESS: Common resident areas are clean sanitary and odor free.

MECHANICAL: Essential mechanical and electrical equipment is maintained in safe operating condition.

EQUIPMENT: Resident care equipment is clean and maintained in safe operating condition.

ISOLATION: Isolation techniques to prevent spread of infection are followed.

LINEN: A quantity of linen essential for proper care and comfort is always available.

FOOD: Food is stored, refrigerated, prepared, distributed and served under sanitary conditions.

Following are deficiences noted for area nursing homes, including:

(1) The phrase "compliance action" if a federal or state compliance order was issued as a result of a serious finding or findings in the past two surveys. Such an order often includes some penalty, such as a fine or a ban on admissions.

(2) Key deficiencies, if any, noted by inspectors (* means the same deficiency was found two years in a row).

(3) The total number of deficiencies (key ones and others) in the most recent survey.



Grant Park Care Ctr., 5000 Nannie Helen Burroughs Ave. NE.: DRUGS* / ACTIVITIES / CLEANLINESS* / FOOD* / 18.

Health Care Institute, 1380 Southern Ave.: No deficiencies.

J.B. Johnson Nursing Home, 901 1st St. NW.: Compliance action / DRUGS* / MENUS / CLEANLINESS* / FOOD / 15.

Jeanne Jugan Residence-Little Sisters of the Poor, 4200 Harewood Rd. NE.: 5.

Lisner Louise Dukson Home, 5425 Western Ave.: FUNDS / MENUS / CLEANLINESS* / FOOD / 17.

Medlantic Manor/Lamond-Riggs, 6000 New Hampshire Ave. NW.: PHYSICIAN / NURSING* / BED SORES / TREATMENTS / 25.

Rock Creek Manor, 2131 O St. NW.: Compliance action / REHAB* / EATING / DRUGS* / CLEANLINESS* / 17.

Stoddard Baptist Nursing Home, 1818 Newton St. NW.: NURSING / HYGIENE / DRUGS* / 11.

Thomas House, 1330 Mass. Ave. NW.: FUNDS* / DRUGS* / MECHANICAL / 8.

Washington Ctr. for Aging, 2601 18 St. NE.: EATING / DRUGS* / MENUS / CLEANLINESS / ISOLATION* / 40.

Washington Home, 3720 Upton St. NW.: REHAB / DRUGS / MENUS* / CLEANLINESS* / MECHANICAL / EQUIPMENT / ISOLATION* / FOOD / 28 (31 deficiencies listed; home says three in error).

Washington Nursing Facility, 2425 25th St. NE.: Compliance action / THERAPY / 2.

Wisconsin Ave. Nursing Home, 3333 Wisconsin Ave. NW.: Compliance action / MENUS / CLEANLINESS* / 9.

Hillhaven Nursing Home, Adelphi: CATHETER / 3.

Presidential Woods Health Care Ctr., Adelphi: HYGIENE / TOILET / ISOLATION / 13.

Annapolis Nursing & Convalescent Ctr., Annapolis / 2.

Ginger Cove, Annapolis: no deficiencies.

Fernwood House Retirement Nursing Ctr., Bethesda: MENUS / 4.

Grosvenor Health Care Ctr., Bethesda: Compliance action / SKIN / EATING / DRUGS / MENUS / MECHANICAL / ISOLATION / 18.

Suburban Hospital Skilled Nursing, Bethesda: 4.

Gladys Spellman Nursing Care Ctr., Cheverly: CATHETER* / TREATMENTS / 12.

Bethesda Retirement Nursing Ctr., Chevy Chase: TREATMENTS / 5.

Bradford Oaks Nursing & Retirement Ctr., Clinton: TREATMENTS / 7.

Clinton Convalescent Ctr., Clinton: Compliance action / NURSING / HYGIENE* / CATHETER* / TREATMENTS / DRUGS / EQUIPMENT / ISOLATION* / 23.

Pineview Manor Extended Care Ctr., Clinton: FUNDS / CATHETER* / EQUIPMENT / ISOLATION / 11.

Lorien Nursing Convalescent Home, Columbia: Compliance action / EATING / ACTIVITIES / 3.

Crofton Convalescent Ctr., Crofton: 1.

Fairfield Nursing Ctr., Crownsville: Compliance action / EATING / ACTIVITIES / MECHANICAL / FOOD / 17.

Pleasant Living Convalescent Ctr., Edgewater: MENUS / 7.

Bon Secours Extended Care Facility, Ellicott City: No deficiencies.

Regency Health Services, Forestville: ISOLATION / 5.

Fort Washington Rehabilitation Ctr., Fort Washington: TREATMENTS / THERAPY / EQUIPMENT* / FOOD / 11.

Herman M. Wilson Health Ctr., Gaithersburg: ACTIVITIES / 7.

Arundel Geriatric & Nursing Ctr, Glen Burnie: NURSING / EATING / DRUGS / TOILET / MECHANICAL / 19.

Maryland Manor Convalescent Ctr., Glen Burnie: 3.

North Arundel Nursing Convalescent Ctr., Glen Burnie: 3.

Greenbelt Nursing Ctr., Greenbelt: CATHETER / MENUS* / 14.

Carroll Manor, Hyattsville: CATHETER* / MENUS / 8.

Hyattsville Manor, Hyattsville: FUNDS* / BED SORES / MECHANICAL / 13.

Madison Manor Nursing Home, Hyattsville: BED SORES / CATHETER / 10.

Sacred Heart Home, Hyattsville: No deficiencies.

Circle Manor Nursing Home, Kensington: NURSING / CATHETER / EATING / 12.

Kensington Gardens Nursing Ctr., Kensington: CATHETER* / TREATMENTS / MENUS / EQUIPMENT / FOOD / 18.

Magnolia Gardens, Lanham: FOOD / 6.


Greater Laurel Nursing Home, Laurel: DRUGS* / 1.

Brooke Grove Nursing Home, Olney: 4.

Sharon Nursing Home, Olney: 4.

Manor Care, Potomac: CATHETER / TREATMENTS / 5.

Collingswood Nursing Ctr., Rockville: TREATMENTS* / REHAB / EATING / MENUS* / MECHANICAL / 14.

Hebrew Home of Greater Washington, Rockville: CATHETER / 5.

Natl. Lutheran Home for Aged, Rockville: 4.

Potomac Valley Nursing Home, Rockville: CATHETER* / EATING / DRUGS / ACTIVITIES / 25.

Rockville Nursing Home, Rockville: 1.

Shady Grove Adventist Nursing Home, Rockville: NURSING / CATHETER / EATING / 17.

Meridian Nursing Home, Severna Park: MENUS / 10.

Carriage Hill Nursing & Convalescent Ctr., Silver Spring: TREATMENTS / DRUGS* / 8.

Colonial Villa Nursing Home, Silver Spring: 1.

Fairland Nursing Home, Silver Spring: ABUSE / SKIN* / CATHETER* / EATING / MENUS / 9.

Fox Chase Rehab. & Nursing Ctr., Silver Spring: ABUSE / CATHETER / 5.

Medlantic Manor at Layhill, Silver Spring: FUNDS / ABUSE / CATHETER / TREATMENTS / DRUGS* / MECHANICAL / ISOLATION* / LINEN / 18.

Meridian Nursing & Rehab. Ctr., Silver Spring: PHYSICIAN / SKIN / BED SORES / CATHETER / TREATMENTS / REHAB / DRUGS* / ACTIVITIES / TOILET / FOOD / 29.

Sylvan Manor Health Care Ctr., Silver Spring: Compliance action / BED SORES / CATHETER / LINEN / 11.

Heritage Health Care Ctr., Takoma Park: Compliance action / TREATMENTS* / DRUGS* / 11.

Manor Care of Largo, Upper Marlboro: 5.

Manor Care, Wheaton: TREATMENTS* / ACTIVITIES / 8.

Randolph Hills Nursing Home, Wheaton: 3,

University Nursing Home, Wheaton: BED SORES / DRUGS / FOOD / 11.

Goodwin House, Alexandria: FOOD / 4.

Mount Vernon Nursing Ctr., Alexandria: HYGIENE / REHAB / FOOD / 5.

Oak Meadow Nursing Home, Alexandria: DRUGS* / 7.

Oakwood Health Care Ctr., Alexandria: Compliance action / No deficiencies in most recent survey.

Woodbine Nursing & Convalescent Ctr., Alexandria: BED SORES / DRUGS / FOOD* / 10.

Leewood Nursing Home, Annandale: 1.

Sleepy Hollow Manor, Annandale: 2.

Camelot Hall-Cherrydale, Arlington: ABUSE / DRUGS / 8.

Crystal City Nursing Ctr., Arlington: Compliance action / RIGHTS / ABUSE / PRIVACY / NURSING / HYGIENE* / BED SORES / DRUGS / ISOLATION / LINEN / FOOD / 31.

Manor Care, Arlington: CLEANLINESS / 2.

Ashland Convalescent Ctr., Ashland: 1.

Rose Hill Nursing Home, Berryville: RESTRAINTS / TREATMENTS / 3.


Shenandoah Manor, Clifton Forge: DRUGS / 2.

Iliff Nursing Home, Dunn Loring: 4.

Commonwealth Care Ctr., Fairfax: MECHANICAL / FOOD / 10.

Fairfax Nursing Home, Fairfax: MECHANICAL / 3.

Barcroft Institute, Falls Church: 1.

Goodwin House West-Health Care Unit, Falls Church: HYGIENE / 5.

Belvoir Woods Health Care Ctr., Fort Belvoir: No deficiencies.

Southampton Mem. Hospital-East Pavilion, Franklin: RESTRAINTS / 1.

Southampton Mem. Hospital, Franklin: RESTRAINTS / HYGIENE / TREATMENTS / REHAB / MECHANICAL / 11.

Carriage Hill Nursing Home, Fredericksburg: PRIVACY / 1.

Fredericksburg Nursing Home, Fredericksburg: RESTRAINTS / REHAB / 5.

Woodmont Nursing Home, Fredericksburg: 3.

Cameron Glen Care Ctr., Reston: RESTRAINTS / DRUGS / 7.

Brookwood Nursing Home, Stafford: No deficiencies.

District Nursing Home, Warrenton: 1.

Oak Springs of Warrenton, Warrenton: TOILET / 7.

Woodbridge Nursing Ctr., Woodbridge: 4.

Learn. Ask. Investigate. See for yourself. Visit often.

These are the rules for finding the best possible nursing home, then helping insure the best possible care for anyone there.

If you think a nursing home or other long-term care may be needed, start investigating and planning now. Don't wait for an emergency.

Visit as many facilities as you can. Ask to meet the administrator, nursing director, social services director.

Once a relative or friend is in a nursing home, the National Citizens' Coalition for Nursing Home Reform has this to say: "The most important key to quality care is {your} continued active involvement, love and support. Speak up to support positive situations and to raise concerns in bad situations.

"Seek out other residents and family members. Get to know the staff."

Nursing home staffs quickly discover which residents get regular visits and caring. Such is human nature, they too may find these residents worth an added measure of attention.

Before you make the decision and even after you have chosen a nursing home, here are some key questions to ask: Who owns the home -- a corporation or a nonprofit or religious organization?

Is it approved for Medicare and Medicaid programs? Is it accredited by the Joint Commission on Accreditation of Healthcare Organizations? Has it ever applied for accreditation? Does the staff conduct regular self-appraisals?

May I have a copy of the residents' rights policy? Is there a residents' council that meets regularly?

How are residents' personal cash and valuable possessions protected? Do residents get receipts and regular reports?

Very important: May I have a tour of the home? Also try to walk around on your own. Chat with some residents and friends and relatives of residents.

Do you like what you see? Does the atmosphere seem welcoming? Are things attractive, comfortable, well-lit and clean -- as clean as your home? Are halls roomy and free of obstacles? Are there unpleasant odors?

Do residents look clean and well cared for? Does the staff seem to treat them with real interest, affection and respect? Are call signals answered promptly? Are many residents physically restrained?

Does each room have a window and access to the hall? A reading light, nurse call bell, comfortable chair, enough closet and storage space? Possibility for individual decorations or preferences?

Are toilet and bathing facilities clean and adequate? Accessible to a handicapped resident?

Are patients out of their beds, dressed and, when possible, occupied? Are lounges and common areas used and comfortable? In good weather, can residents sit or walk outdoors?

In case of fire, are exits clearly marked and unobstructed, with exit doors unlocked from the inside? Are doors to stairways kept shut?

Is the dining area inviting? Do the residents seem to be enjoying themselves? Is the food good? Do those needing help get it? Meals become exceedingly important to nursing home residents. Ask to have a meal with them.

On medical and other care and services:

Is regular medical attention assured? Are there regular reports or contacts with the resident's own doctor?

Who is the home's medical director? How much time does he or she spend at the home? Is a physician always available in an emergency?

Does the home make and regularly review a treatment plan? The patient's medications and any reactions? Is the resident, or family, involved in treatment decisions?

Are there enough nurses on hand at all hours?

What about care for (whatever a resident's medical problems)?

Are there physical therapy and rehabilitation to preserve as many abilities as possible? Speech therapy?

How are other services (dentist, podiatrist, eye doctor) provided?

How about activities? Are interesting sounding daily schedules posted and given residents? Is there an activities director? Are there outside trips? A volunteer program to help patients? Arrangements for residents to worship?

Is there a social services director or social worker to work with patients and families on any problems? Are other mental health or counseling services available?

The National Citizens' Coalition says: "Be sure to visit a second time on the weekend or in the evening, times when many nursing homes reduce their staff and services."

David Banks, chairman of Beverly Enterprises, a national nursing home company, says: "Don't make any decisions until you're satisfied with what you've found."

But how do you start looking for a nursing home? Ask doctors, nurses, welfare workers, social workers, especially social workers or discharge planners in hospitals. Also clergy who visit patients, and anyone who has placed or visited someone in a nursing home.

Every state and almost every local government has an office of aging or an ombudsman for the aged who should be well informed.

To learn about a particular nursing home, to ask about homes in general, to complain about an unresolved problem, to ask about nursing home inspection findings, you can try a number of government agencies and private organizations. In the new federal nursing home report, the District, Maryland and Virginia governments all list offices that deal with aging and long-term care.

But there are government offices and government offices, and the information supplied by the District government in particular makes the fact-finding sound hard. Be prepared to be persistent and to try several numbers, if need be. Then you may find a friend.

In the District: Consumer and Regulatory Affairs Service Facility Regulation for survey, certification, licensing and complaint investigation results, 727-7190. The D.C. government says a written request regarding a specific home or homes is required and search and duplication fees may be assessed. The federal government says citizens are entitled to see these results. If you can't afford a fee, ask if you can come in and read the reports.

Central Referral Bureau, repository for information about licensed placement facilities for adults, 767-8356.

Long-Term Care Ombudsman and Legal Counsel for the Elderly, Anne Hart, 662-4933, (hotline) 369-7449, investigates reports of poor quality and abuses of nursing home residents' rights.

Adult Protective Services, (hotline) 727-2345, investigates reports of abuse and neglect of impaired adults.

Office on Aging Information and Referral Services, 727-5626.

In Maryland: Office of Licensing and Certification Programs, Baltimore, (301) 764-2770. On compliance actions: Laura Nottingham, (301) 764-2750.

Long-Term Care Ombudsman, Office on Aging, Baltimore, (301) 225-1083.

Complaints: Office of Licensing and Certification Program, (301) 764-4970 or 1-800-492-6005.

In Virginia: Nursing Home Compliance Actions, Licensing Inspection and Survey Reports, Richmond, (804) 786-2081.

State Long-Term Care Ombudsman / State Office on Aging, Richmond, advocate, mediator and investigator of complaints, advocacy and mediation services, Virginia Dize, (804) 225-2271, (hotline) 1-800-552-3402. Federal Inspector General. "If you have reason to believe a health care service provider is performing unnecessary or inappropriate services or billing Medicare for services you did not receive," call 1-800-368-5779; except in Maryland, 1-800-638-3986.

Copies of the federal report. These are being supplied to state offices on aging, senior citizens' organizations and congressional offices. A copy for any locality may be purchased from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. Prices: District, $6; Maryland or Virginia, $34.

Some other resources:

For a newly revised Guide to Nursing Homes and Alternate Support Services in Montgomery County, send $1.05 in stamps (and a $2 check if you're a non-resident) to Nursing Home Guide, Office of Consumer Affairs, 100 Maryland Ave., Rockville, Md. 20850. Libraries should have copies soon.

For information on long-term care in general, as well as nursing homes, write:

American Association of Retired Persons, 1909 K St. NW, Washington, D.C. 20049.

American Health Care Association, 1201 L St. NW, Washington, D.C. 20005, whose pamphlet, "Thinking About a Nursing Home," is among the best.

American Association of Homes for the Aging, 1129 20th St. NW, Washington, D.C. 20036.

National Citizens' Coalition for Nursing Home Reform, 1424 16th St. NW, Washington, D.C. 20036. -- Victor Cohn