There never have been enough inspectors, he said, and the department had "a history of not being aggressive enough in pursuing complaints."

But Gannon, now a senior official in the state labor department, disputed the criticism by Rendell's administrators that enforcement had been abysmal under his tenure.

"I take exception to that. I think a lot of people busted their buns to try to do what they could" in the face of a "pathetic" set of regulations, he said.

Quick growth,

looser oversight

The personal-care industry mushroomed after state mental institutions began closing in the 1970s. Small homes sprung up as housing of last resort for many with mental illness.

Then, after scandals beset nursing homes in the 1980s, corporate-run assisted living came to be seen as a more humane alternative.

Assisted-living residents tend to be elderly, disabled, mentally ill, or some combination of the three - a population extremely vulnerable to abuse, neglect and exploitation.

These residents live in a gray area: They are infirm enough to need help with daily living, but legally they are not supposed to be sick enough to qualify for more elaborate and expensive nursing-home care.

Unlike nursing homes, which are subject to federal regulations, assisted living operates under less stringent state-by-state rules. For years, Pennsylvania had some of the country's weakest regulations. A recent update put the state in the middle of the pack, experts say.

In 1999, a federal study of assisted living in four other states - California, Florida, Ohio and Oregon - found that state regulators had cited more than a quarter of the facilities for five or more serious deficiencies, including poor care, understaffing and medication errors.

But the sheer magnitude of the problem in Pennsylvania stands out, experts say - along with Harrisburg's long-standing failure to do much of anything about it.

The welfare department office that licenses and inspects the homes "was always a stepchild," Kroh said.

Industry representatives acknowledge that there are bad operators, but say the horror stories obscure a largely good record in most facilities.

"Bad operators taint everyone," said Michael Leader, president and chief executive officer of Country Meadows Retirement Communities in Hershey, a company that runs nine assisted-living communities and two nursing homes.

"It's horrible. The assumption is that others must also be that way" when, in fact, most operators do a good job, he said.

Rich homes,

poor homes

Pennsylvania's personal-care facilities run the gamut from ramshackle family-run boarding homes to sleek, corporate-owned institutions.