FATAL NEGLECT

Once she moved into Creekside Care Convalescent Hospital, it didn't take Bessie Seday long to realize that the promises made to her by the nursing home before she arrived had evaporated. "I couldn't get anybody's attention, starting on the fourth day," recalls the bed-bound 84-year-old. "You'd have your call light on for hours, but nobody came." What made her waiting more desolate was the near total deprivation of sunlight during her four months at Creekside. "It was a dungeon," she says. "I really would have liked to see the sunshine, but they never put us outside." Things only got worse when the sun set, and the staff ignored calls for help or pain-killers. "The screaming is what got to me the worst, the screaming when the lights went out," she says. "I couldn't fall asleep until 1 or 2 in the morning with all that screaming going on."

Bessie's daughter Ann used to visit her mother in the home, some 50 miles northeast of San Francisco, and find her lying immobile in a filthy bed. "She was not turned and kept clean and dry, which led to the bedsores," Ann recalls. A bedsore on Bessie's left hip turned into a gaping wound that would not heal, despite repeated whirlpool baths. Creekside nurse Patricia Lloyd knew why: the special washing machine for cleaning dirty bedpans had broken down. "So we washed bedpans in the whirlpool," she says, "and then we'd put patients with big bedsores, like Bessie Seday, in there." Fixing Bessie's wound required repeated surgery, including the removal of her left buttock and part of her pelvis. "They were washing her," says Lesley Clement, her attorney, "in a damn cesspool."

Bessie, who now lives with her daughter, was lucky to get out alive. A TIME investigation has found that senior citizens in nursing homes are at far greater risk of death from neglect than their loved ones imagine. Owing to the work of lawyers, investigators and politicians who have begun examining the causes of thousands of nursing-home deaths across the U.S., the grim details are emerging of an extensive, blood-chilling and for-profit pattern of neglect. In Chicago last week a 73-count indictment was returned against a hospice operator charged with bilking Medicare and others of $28 million for services to the terminally ill that were never delivered. In Detroit a nursing home that was part of a chain whose owner was convicted of Medicaid fraud 17 years ago was cited again last year for bad hygiene, inattention to frail residents and incompetent staff. In Texas attorney general Dan Morales has filed 50 lawsuits against nursing homes this year for neglect and failure to medicate.

In California a team of lawyers specializing in fraud has begun to investigate what's killing people in the state's 1,400 nursing homes. In Washington, Senator Charles Grassley of Iowa, chairman of the Senate's Special Committee on Aging, last week dispatched three investigators from the General Accounting Office to California to pore over data, confer with state officials and visit suspect nursing homes. One of their first stops was Creekside (now operating as Vacaville Rehabilitation and Care Center), which denied the investigators access to medical records--until they returned with a subpoena. Grassley calls the California data "troubling" and says the situation "requires immediate attention."