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Lower standards: a Chicago reporter analysis shows that the quality of black seniors' nursing home care is drastically behind that of white seniors.

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Luzella Roberts knew something was wrong when a nurse in the dialysis room at her nursing home approached her with a syringe and moved it toward her left arm. It was Sept. 25, 2006, and Roberts' sixth day at International Nursing and Rehab Center in Chicago's New City neighborhood.

There were explicit instructions on her medical chart not to administer dialysis through that arm, said the family's lawyer Steven M. Levin. Instead, they were to use a catheter that was surgically implanted in Roberts' right arm. It was there for the dialysis treatments that Roberts, an African American, received three times a week to remove waste from her body, Levin said.

But now, the nurse was preparing to insert the needle in Roberts' left arm. It was the same arm that for 60 years had cooked dinner for her husband, dressed her four children, and had three weeks earlier cupped her newest great-granddaughter.

Roberts didn't have an M.D. or RN behind her name and thought, perhaps, that the medical staff knew something she didn't. So she kept quiet.

An hour went by with the needle still intact. Then two hours. Then three before Roberts' daughter, Cynthia Wade, stopped by to visit and saw her mother's arm and face gray and swollen. Wade began screaming at the nurse to remove the needle. As she did, Roberts' arm began to bleed uncontrollably and she was rushed to the emergency room.

An investigation by The Chicago Reporter found that Illinois is arguably the worst state in the nation for black senior citizens seeking quality nursing home care. There is just one home in Illinois rated "excellent" by the federal government when more than 50 percent of the home's residents are black. In Illinois, these facilities get the worst federal ratings and on average have more violations than facilities where a majority of residents are white. And in Chicago, on average, these homes have more medical malpractice and personal injury lawsuits. People in white homes got better care than those in black homes, even if both were poor.

The Reporter also found that the staff at Illinois' black nursing homes spent less time daily with residents than staff at facilities where a majority of the residents are white. Of that time, black residents got a smaller percentage of time with more-skilled registered nurses than facilities where the residents were white.

"It is a real big disgrace and another black eye for the state of Illinois and the city of Chicago," said state Rep. Monique Davis. "It's almost like being in Mississippi in 1920."

A facility can lose its certification and Medicaid funding for failing to meet federal standards. But the Reporter investigation found that it rarely happens and has occurred with just five of the nearly 16,000 Medicaid-certified U.S. facilities in the past year.

Given the increasing population of seniors nationwide, things could get worse. Experts say the ranks of seniors who need nursing home and other care will increase from about 8 million in 2000 to 19 million in 2050.

The Reporter analyzed the records of 15,724 nursing homes listed in the federal Nursing Home Compare ranking database to determine if disparities existed in the quality of care. The overall rating is based on a combination of health inspection results, staffing levels and how well each home performs on 10 important aspects of...

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