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The nursing home industry receives three- quarters of its income from government. The industry earns high profits while providing poor patient care. Considerable swindling of government funds occurs. One category is nickel and diming, which consists of clipping every possible dollar from government money as it passes through nursing home accounts. Another method—large scale and often within the law—involves the manipulation of ownership and mortgages. There are several causes for the failure of government to control nursing home swindles. While there is no lack of regulations, the will to enforce them is lacking. Industry lobbyists are especially influential at the state level, where the Medicaid rate is set. The federal govern ment has failed to collect basic information about the industry and denies the public ready access to the reports on nursing home inspections. The industry's immunity from regulation, in large part, results from the lack of countervail ing pressure from the public.

The recent report of the Senate Labor Committee indicates that some new comprehensive & humane rethinking of our overall approach to private pensions is clearly needed. Controversy over the reform of pension plans has focused on vesting, funding, fiduciary standards, & the prohibition of unethical conduct & conflicts of interest in the handling of pension funds. These issues are discussed in terms of the present situation: (1) the dimensions of the pension industry; & (2) the current legal framework within which the industry operates & the techniques of the professionals in the field are analyzed. The issues are discussed with reference to the proposed pension reform bill which is pending before a Senate-House conference committee. A legislative assessment is given stating that bureaucratic lassitude is a factor in the failure of government regulations in addition to corruption & industry/government links. Modified HA.