The pattern of understaffing at Skilled Healthcare Group‘s 22 California nursing homes could have raised red flags for patients and their families, but ownership information is currently difficult to obtain. The company has been ordered to pay $670 million for violating California state staffing minimums. A portion of the fee, the result of a class action lawsuit, is intended to refund patients for the quality of care they received.

Nursing Home Compare, the Center for Medicare and Medicaid (CMS) site that allows the public to evaluate nursing home performance, does not yet identify the names of nursing home owners. And companies are often skilled at obscuring which facilities they run, creating complex corporate structures that are difficult to trace.

As we noted last month, adequate staffing is crucial to patient well being, and California’s ratings are below the national average. (CMS determines ratings based on a formula that takes into account the type of care needed at different types of facilities). Identifying individual offenders will be crucial to bringing up care standards. Until they can be identified easily by the public, this will be an uphill task.