About Us


Nursing Home Report Card is a Families for Better Care project that analyzes, compares and ranks state’s nursing home quality.

Families for Better Care is a non-profit citizen advocacy group dedicated to creating public awareness of the conditions in our nation’s nursing homes, assisted living facilities, and home and community based settings and developing effective solutions for improving quality of life and care.

The Heart of the Issue

Brian Lee, Executive Director, Families for Better Care

Brian Lee, Executive Director

Publication of the second annual Nursing Home Report Card dovetails the heralded success of last year’s report that evaluated and scored the quality of resident care on a state-by-state basis using federal data.

We were greatly encouraged by the overwhelming positive responses from families, advocates, ombudsmen, lawmakers, and industry representatives who explored opportunities to strengthen safety and quality in their home states.  Based on their helpful feedback, this year’s report card now incorporates even more nurse to resident ratio data, sharpening our staffing measures.

Our Report Card’s intent is to advocate for better care for our loved ones.

We’re happy to report that many states heard our message and are now developing safer nursing home solutions.  On behalf of the 1.5 million Americans who live in nursing homes and their families, we are grateful.

We want to salute state leaders in Kentucky, Nevada, Oklahoma, and Texas.  Despite being ranked among the worst nursing home states in 2013, lawmakers and state officials pulled up their bootstraps and launched some groundbreaking initiatives to upgrade regulatory safeguards and to explore padding bleak staffing levels.

Here’s just a snapshot of some of their thoughtful work:

  • Kentucky—Governor Steve Beshear, in a letter to the Kentuckians for Nursing Home Reform, tasked the state’s Elder Abuse Council to convene a series of statewide hearings on nursing home staffing.
  • Nevada—Assemblywoman Teresa Benitez-Thompson rallied the Committee on Senior Citizens, Veterans and Adults with Special Needs to hold a number of public hearings on nursing home abuse and neglect, demanding answers where state officials could shore up regulatory oversight and accountability.
  • Oklahoma—Representative Richard Morrisette, in cooperation with consumer advocacy group A Perfect Cause, convened a statewide press conference and hosted a special legislative hearing with families in hopes of enacting a state mandated staffing standard.   In response, House and Senate leaders recently approved a legislative study to examine areas for long overdue for nursing home reform.
  • Texas—Senator Charles Schwertner called for a crackdown on Texas’s worst nursing homes, proposing new regulations that would shutter homes that are cited three or more immediate jeopardy violations within a 24-month period.

Families for Better Care applauds and supports these and other collaborative statewide efforts to improve nursing home quality.

But once again, state nursing home grades and rankings fell short, underscoring the desperate situation for far too many residents.  Painful neglect and abuse remains pervasive in too many nursing homes.  But our nation has the means and the know-how to make nursing homes safer and more life enriching for residents.  The best solution is to hire more staff.

That’s why Families for Better Care earnestly recommends that lawmakers in each state that scored a “below average” grade in our 2014 Nursing Home Report Card promptly enact, at minimum, the 4.1 hours of nursing time per resident daily as proposed by the National Consumer Voice for Quality Long-Term Care.

Mandating the hiring of more caregivers to work at the bedside of our parents and grandparents will radically improve state nursing home grades.



Brian Lee, Executive Director
Families for Better Care


Families for Better Care recognizes the outstanding contributions of the following whose insight and guidance helped bring the Nursing Home Report Card to fruition. We are very grateful for the support.

Richard Mollot, Ph.D.
Executive Director, Long-Term Care Community Coalition

Richard Mollot is the executive director of the Long-Term Care Community Coalition, a nonprofit organization dedicated to improving care for seniors, the disabled and other long-term care consumers through advocacy, education and policy research.

Richard has served on a number of state and national consumer, government and advisory groups relating to such issues as: geriatric mental health, long-term care restructuring, palliative care, nursing home “pay for performance” and quality improvement organizations. He is a graduate of Howard University School of Law and a member of the Maryland Bar.

Margaret Niederer, Ph.D.
Nursing Home Resident Advocate and Retired Illinois Regional Ombudsman

Margaret Niederer was a regional long-term care ombudsman for the Illinois Long Term Care Ombudsman Program for 12 years after her retirement from the Illinois State Board of Education.

Over a million dollars of grants were awarded to the regional program to assure the independence of the state program and to promote the recruitment of volunteer ombudsmen. This resulted in two Illinois laws passed in 2003, to assure the independence of the program, and to create the Illinois Long Term Care Council.  She continues to advocate for older peoples’ rights and lives in Springfield, Illinois with her husband.

Long-Term Care Ombudsmen

Editor’s note: As a former ombudsman, I can say unequivocally that I have a special appreciation and a deep affection for the work of our nation’s ombudsman corp.  The inclusion of their work in this report card, I believe, validates and honors their hard work on behalf of residents.