Since the late 1990s, the federal Centers for Medicare & Medicaid Services (CMS) has maintained a Web site to provide consumer information about nursing homes. The site, Nursing Home Compare, includes data from each facility's latest state inspection report, called Form 2567, and from inspection reports arising from complaints. It also includes some data about the quality of care at each home.

When CMS added the data from complaint surveys in 2002, the Secretary of Health and Human Services at the time, Tommy Thompson, proclaimed that the government's goal was "to give consumers the information they need to make informed decisions about their health care."

Providing such information dovetails with the current administration's market-driven philosophy. In theory, at least, consumers who are equipped with enough information will choose good nursing homes, and the bad homes will eventually disappear without the heavy hand of regulation.

As the report reveals, however, poorly performing homes have not disappeared. And a close review of Nursing Home Compare shows that the site falls far short of delivering what families need to make good choices.

For example, we examined the site's listing for White Blossom Care Center in San Jose, Calif., one of a dozen homes that have appeared on all five of our lists of poorly performing homes since 2000. We soon learned that Nursing Home Compare tended to substitute vague generalities about the home's deficiencies for the vivid details contained in the official Form 2567.

Some side-by-side comparisons:

The Web site says: The nursing home failed to "give or get lab tests to meet the needs of residents."
What it doesn't say: The resident this deficiency refers to was taking the blood thinner Coumadin and should have had her blood tested every month to assess its clotting ability. The home hadn't done it in six weeks, putting the woman at risk for excessive bleeding or developing blood clots.

The Web site says: The nursing home failed to "ensure that each resident receives adequate supervision and assistance devices to prevent accidents."
What it doesn't say: A stroke victim required help eating, but during lunch one of the nursing assistants turned away from the resident, who then picked up her large glass of thickened white liquid and began to gulp it down. That resulted in deep-coughing episodes.

The Web site says: The nursing home failed to "provide care for each resident in a way that keeps or builds the resident's quality of life."
What it doesn't say: The resident in this instance told the inspector that a staffer who answered her call bell refused her request even before she knew what the request was

The site notes the date of correction of deficiencies but says nothing about how the problems were remedied. The 2567 forms themselves give the particulars of the home’s plan of correction. That may be important to you in evaluating a home.

Nursing Home Compare does provide some clues to the kind of care being delivered at White Blossom, but they can be difficult for the average person to interpret. For example, the site notes that 12 percent of the residents were physically restrained, 5 percent higher than the national average, but 2 percent lower than the state average. While sometimes there may be medical justification for the use of restraints, many nursing homes are restraint-free now, and long-term-care experts agree that residents generally should not be tied down to impede their freedom or mobility. If you find a facility frequently using restraints, ask why.

Nursing Home Compare’s data gloss over much of the variation among nursing home residents that can affect care. To interpret the numbers, family members must understand what their loved one needs. For example, if your relative is bedfast and incontinent, you should care about skin and continence care. If he or she is physically active but suffers from dementia, knowing about safety and accident prevention is important.

Because of the Web site’s shortcomings, we suggest families not bother with Nursing Home Compare but instead go right to a home’s Form 2567 to learn how it is treating its residents. Nursing homes are required by law to make this information readily accessible, although we found that some failed to do so. In the three most recent state surveys we studied, 657 nursing homes were cited for just that.

To solve that problem, CMS could make the complete reports available online. Only a handful of states currently do this, including Alabama, Colorado, Iowa, Minnesota, and New Mexico.