Nearly 1.6 million Americans now live in nursing homes. That number will double in the next twenty years, as medical science lengthens our life expectancies and the senior population grows. Inevitably, most of us will have to supervise the care of aging parents or grandparents, and every one of us faces the prospect of growing old and possibly frail. Thirty percent of elderly Americans say they would rather die than move into a nursing home. Their fears are well founded: Inspection documents show that more than a quarter of the nursing homes in the United States have been repeatedly cited for violations that caused serious harm or death to residents. In California, fully one-third caused serious injury or death, and less than 2 percent of nursing homes had no violations!