"It is appalling that Pennsylvania’s two U.S. senators — Democrat Bob Casey and Republican Pat Toomey — had to fight to secure a “secret list” of substandard nursing homes. But their battle pales in comparison to the travesties that list revealed..." https://www.post-gazette.com/opinion/editorials/2019/06/09/Protecting-the-elderly-America-s-nursing-homes-need-more-oversight/stories/201906090036

"...hundreds of facilities that are subjecting America’s senior citizens to inexcusable conditions. The report, pried from the hands of the Centers for Medicare and Medicaid Services, documents approximately 400 nursing homes — including four in the Pittsburgh area — that have.."

a “persistent record of poor care.” This phrasing means nursing homes were found to have some of the following conditions....infection, malnutrition, sewage backups, insect infestations, a failure to deliver medication and staff members under investigation for sexual assault.