He died in January 2007 at age 76. On Shepter's death certificate, Dr. Hoshang Pormir, the nursing home's chief medical officer, explained that the cause was heart failure brought on by clogged arteries.

Shepter's family had no reason to doubt it. The local coroner never looked into the death. Shepter's body was interred in a local cemetery.

But a tip from a nursing-home staffer would later prompt state officials to re-examine the case and reach a very different conclusion.

When investigators reviewed Shepter's medical records, they determined that he had actually died of a combination of ailments often related to poor care, including an infected ulcer, pneumonia, dehydration and sepsis.

Investigators also concluded that Shepter's demise was hastened by the inappropriate administration of powerful antipsychotic drugs, which can have potentially lethal side effects for seniors.

Prosecutors in 2009 charged Pormir and two former colleagues with killing Shepter and two other elderly residents. They've pleaded not guilty. The criminal case is ongoing.

Health-care regulators have already taken action, severely restricting the doctor's medical license. The federal government has fined the home nearly $150,000.

This could be about any of us, eventually.

Just 23 ombudsmen in Michigan represent the interests of the nearly 40,000 nursing home residents in the state -- helping families navigate the bureaucracy of nursing care, mediating conflicts and advocating for residents fighting for better care.

They also are responsible for monitoring adult group homes and other long-term facilities -- which means that each ombudsman is responsible for more than 4,000 (mostly filled) beds.

That's more than twice the caseload that the federal government recommends -- 2,000 residents per ombudsman -- and 67% more than the national average of 2,500.

The nation's largest for-profit nursing homes deliver significantly lower quality of care because they typically have fewer staff nurses than non-profit and government-owned nursing homes.

That's the finding of a new UCSF-led analysis of quality of care at nursing homes around the country. It is the first-ever study focusing solely on staffing and quality at the 10 largest for-profit chains.

The MAKS system consists of motor stimulation(M), including games such as bowling, croquet, and balancing exercises; cognitive stimulation (K), in the form of individual and group puzzles; and practicing 'daily living' activities (A), including preparing snacks, gardening and crafts. The therapy session began with a ten minute introduction, which the researchers termed a 'spiritual element' (S), where the participants discussed topics like 'happiness', or sang a song or hymn.

After 12 months of therapy the MAKS group maintained their level on the Alzheimer's Disease Assessment Scale (ADAS) and, even more importantly maintained their ability to carry out activities of daily living, while the control group all showed a decrease in cognitive and functional ability.

Prof. Graessel explained, "While we observed a better result for patients with mild to moderate dementia, the result of MAKS therapy on ADAS (cognitive function) was at least as good as treatment with cholinesterase inhibitors