Our elders deserve the best care available. Unfortunately, not all of our elders who need care will be in  nursing homes with resident centered approaches (even though that was supposed to happen long ago). But no elder should have to live his or her last days in one of these sub-standard homes on the list.

A home that lands on this list, whether it's in a state that has high standards or low, needs to get fixed. It needs close scrutiny. We caregivers and professionals need to nag our local, state and national leaders, mercilessly, to get laws in place that make sure there are no substandard homes operating anywhere.

We caregivers and professionals need to push hard to see that there isn't a huge discrepancy between what is considered good enough in one state, but substandard in another. Kudos to CMS for "outing" these substandard homes. This problem needs to be fixed sooner rather than later. Our elders don't have time to waste.

For more information about Carol go to www.mindingourelders.com or www.mindingoureldersblogs.com.