The nation's 1.5 million nursing home residents are a highly vulnerable population of elderly and disabled individuals for whom remaining at home is no longer feasible. With the aging of the baby boom generation, the number of individuals needing nursing home care and the associated costs are expected to increase dramatically. The federal government plays a key role in ensuring that nursing home residents receive appropriate care by setting quality-of-care, quality-of-life, and life safety requirements that nursing homes must meet to participate in the Medicare and Medicaid programs and by contracting with states to encourage compliance with these requirements, Congress has authorized certain enforcement actions. This book addresses and evaluates the quality of nursing home care across the nation and explores the enforcement and oversight functions intended to ensure high-quality care.