Modern Family Stars Get Stuck in Crowded Elevator

No good deed goes unpunished.

PICS: Candid Celeb Sightings

While on their way to a fundraiser for the Boys & Girls Club of Greater Kansas City on Friday night, three stars of ABC's hit sitcom Modern Family were trapped in a crowded elevator for almost an hour, ABC News reports.

Julie Bowen, Eric Stonestreet and Jesse Tyler Ferguson took pictures together during the ordeal, which Ferguson posted to his Twitter account.

"This is us right now. 45 minutes stuck in this elevator," Ferguson wrote, captioning the snapshot from the Sheraton Kansas City Hotel's third floor.

The actors were an hour late to the event after the Kansas City Fire Department rescued them, but they maintained a good sense of humor about their plight, reportedly joking about the ordeal on stage.

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With record highs in sight, stocks face roadblocks

NEW YORK (Reuters) - If Wall Street needs to climb a wall of worry, it will have plenty of opportunity next week.

Major U.S. stock indexes will make another attempt at reaching all-time records, but the fitful pace that has dominated trading is likely to continue. Next Friday's unemployment report and the hefty spending cuts that look like they about to take effect will be at the forefront.

The importance of whether equities can reach and sustain those highs is more than Wall Street's usual fixation on numbers with psychological significance. Breaking through to uncharted territory is seen as a test of investors' faith in the rally.

"It's very significant," said Bucky Hellwig, senior vice president at BB&T Wealth Management in Birmingham, Alabama.

"The thinking is, there's just not enough there for an extended bull run," he said. "If we do break through (record highs), then maybe the charts and price action are telling us there's something better ahead."

Flare-ups in the euro zone's sovereign debt crisis and next Friday's report on the U.S. labor market could jostle the market, though U.S. job indicators have generally been trending in a positive direction.

Small- and mid-cap stocks hit lifetime highs in February. Now the Dow Jones industrial average <.dji> and the S&P 500 <.spx> are racing each other to the top. The Dow, made up of 30 stocks, is about 75 points - less than 1 percent - away from its record close of 14,164.53, which it hit on October 9, 2007. The broader S&P is still 3 percent away from its closing high of 1,565.15, also reached on October 9, 2007.

The advantage may be in the Dow's court. So far in 2013, it has gained 7.5 percent, beating the S&P 500 by about 1 percent.

THE RALLY AND THE REALITY CHECK

The Dow's relative strength owes much to its unique make-up and calculation, as well as to investors' recent preference for buying value stocks likely to generate steady reliable gains, rather than growth stocks.

But the more defensive stance illustrates how stock buyers are getting concerned about this year's rally. While investors don't want to miss out on gains, they're picking up companies that are less likely to decline as much as high-flying names - if a market correction comes.

The Russell Value Index <.rav> is up 7.6 percent for the year so far, outpacing the Russell Growth Index's <.rag> 5.7 percent rise. Within the realm of the S&P 500, the consumer staples sector led the market in February, gaining 3.1 percent.

There is some concern that growth-oriented names are being eclipsed by defensive bets, said Ryan Detrick, senior technical strategist at Schaeffer's Investment Research in Cincinnati.

"This isn't a be-all and end-all sell signal by any means, but we would feel much more comfortable if some of the more aggressive areas, like technology and small caps, would start to gain some leadership here," Detrick said.

Signs that investors are becoming concerned about the rally's pace is evident in the options market, where the ratio of put activity to call activity has recently shifted in favor of puts, which represent expectations for a stock to fall.

"We are seeing some put hedging in the financials, building up for the past month," said Henry Schwartz, president of options analytics firm Trade Alert in New York.

The put-to-call ratio representing an aggregate of about 562 financial stocks is 1:1, when normally, calls should be outnumbering puts.

Investors have no shortage of reasons to crave the relative safety of blue chips and defensive stocks. Although markets have mostly looked past uncertainty over Washington's plans to cut the deficit, fiscal policy negotiations still pose a risk to equities.

The $85 billion in spending cuts set to begin on Friday is expected to slow economic growth this year if policymakers do not reach a new deal. Markets so far have held firm despite the wrangling in Washington, but tangible economic effects could pinch stock prices going forward.

The International Monetary Fund warned that full implementation of the cuts would probably take at least 0.5 percentage point off U.S. growth this year.

EASY MONEY AND TEPID HIRING

Investors will also take in a round of economic data at a time when concerns are percolating that the market is being pushed up less by fundamentals and more by loose monetary policy around the world.

The main economic event will be Friday's non-farm payrolls report for February. The U.S. economy is expected to have added 160,000 jobs last month, only a tad higher than in January, in a sign the labor market is healing at a slow pace. The U.S. unemployment rate is forecast to hold steady at 7.9 percent.

While lackluster data has been a catalyst in the past for stock market gains as investors bet it would ensure continued stimulus from the Federal Reserve, that sentiment may be wearing thin.

Markets stumbled last week following worries that the Fed might wind down its quantitative easing program sooner than expected.

"It shows the underpinning of the market is being driven at this point by monetary policy," Hellwig said.

With investors questioning what is behind the rally, it will make a run to record highs even more significant, Hellwig added.

"There's smart people that are in the bull camp and the bear camp and the muddle-through camp," Hellwig said. "The fact that you can statistically, using historical evidence, make a case for going higher, lower, or staying the same makes this number very important this time around."

(Wall St Week Ahead runs every Friday. Comments or questions on this column can be emailed to: leah.schnurr(at)thomsonreuters.com)

(Reporting by Leah Schnurr; Additional reporting by Doris Frankel in Chicago; Editing by Jan Paschal)

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Ellen DeGeneres Pens Open Letter to Supreme Court to Pass Prop 8 for Gay Marriage

With a touch of her trademark humor, Ellen DeGeneres tackles a very serious topic close to the talk show host's heart: gay marriage.

In an open letter posted to her website, Ellen reaches out to members of the Supreme Court, who will soon decide the fate of same-sex couples who wish to wed.

Pics: 'Amazing Race' Stars Cheer Up Bullied Gay Fan

"Portia and I have been married for 4 years and they have been the happiest of my life," she blogs of her longtime partner Portia De Rossi. "And in those 4 years, I don't think we hurt anyone else's marriage. I asked all of my neighbors and they say they're fine."

Ellen, who tied the knot in 2008 during a brief period when gay marriage was legal in California, now urges the powers that be to open their heart and extend the privilege to every gay couple.

"I hope the Supreme Court will do the right thing, and let everyone enjoy the same rights," Ellen writes. "It's going to help keep families together. It's going to make kids feel better about who they are. And it is time."

Related: Neil Patrick Harris: I Knew I was Gay at 6

In closing the comedian writes, "In the words of Benjamin Franklin, 'We're here, we're queer, get over it.'"

Read Ellen's entire plea to the supreme court here.

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

__

Online:

WHO report: http://bit.ly/YDCXcb

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The CW Says Goodbye to 90210

The CW's remake of the '90s hit show 90210 will reportedly end its five-year run in May.

PICS: The High School Hotties of 90210

According to Us Weekly, the show (starring AnnaLynne McCord, Shenae Grimes, Matt Lanter, Jessica Stroup and Jessica Lowndes) has been canceled due to meager ratings.

The show has reportedly averaged 1.23 million viewers this season, being overshadowed by new hits The Vampire Diaries and Arrow.

"The CW has had five great seasons with America's favorite zip code, 90210," CW network president Mark Pedowitz announced in a statement. "I'd like to thank the talented cast, producers, and crew for all their hard work and dedication to the series. We are very proud of the West Beverly High alumni."

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

__

Online:

WHO report: http://bit.ly/YDCXcb

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Stock index futures signal mixed start to March

LONDON (Reuters) - Stock index futures pointed to a mixed open on Wall Street on Friday, with futures for the S&P 500 up 0.3 percent, while Dow Jones and Nasdaq 100 futures were broadly flat at 0956 GMT.

Overnight equity market performance has been mixed, with Tokyo shares edging higher <.n225>, while European bourses were hit by economic growth concerns <.fteu3>.

China's factory growth cooled to multi-month lows in February as domestic demand dipped, weighing on firms already hit by slack foreign sales and underlining the patchiness of the country's economic recovery.

Euro zone manufacturing activity appeared no closer to recovery last month, when a dire performance in France offset a return to growth in Germany, PMI data showed. British manufacturing, meanwhile, shrank unexpectedly.

Absent a highly unlikely last-ditch deal, the $85 billion in cuts across federal government agencies start on Friday after the White House and Republicans failed to reach a deal. The measures are expected to shave at least 0.5 percent off U.S. economic growth.

Groupon Inc fired Andrew Mason as chief executive officer on Thursday, sending its shares up as much as 8 percent in after-hours trade, ousting a co-founder who failed to stop a gradual erosion of its main daily deals business.

Boeing Co will cut hundreds of jobs at a South Carolina plant that makes 787 Dreamliners over the course of this year, but the move has nothing to do with the recent grounding of the troubled jetliner, the Wall Street Journal reported on Thursday.

U.S. government-run mortgage finance provider Freddie Mac earned $11.0 billion last year, the first annual increase in its net income since 2006, the year the nation's housing bubble peaked.

Bank of America Corp BAC.N said in a securities filing on Thursday that the New York State Attorney General was investigating the bank over its purchase, securitization and underwriting of home loans.

Gap Inc's fourth-quarter profit beat estimates, helped by higher comparable store sales in North America and the apparel retailer raised its dividend for this year by 20 percent to 60 cents.

Salesforce.com Inc reported better-than-expected quarterly sales of $835 million on Thursday, as its cloud-based services continued to sell well despite an uncertain macroeconomic picture. Its shares gained 4.9 percent after hours to $177.50.

Paulson & Co, the largest shareholder of MetroPCS Communications Inc , said it will vote against the wireless service provider's proposed merger with T-Mobile USA, a unit of Deutsche Telekom AG , unless the companies sweeten the deal.

Best Buy Co ended talks with founder Richard Schulze over a deal in which he and a group of buyout firms were proposing to take a minority stake in the firm in exchange for three seats on the board, the Wall Street Journal reports, citing people familiar with the matter.

Friday's bumper data calendar features PCE inflation data for January alongside the Thomson Reuters/University of Michigan sentiment index and the Institute for Supply Management's manufacturing index for February.

The Dow Jones industrial average <.dji> fell 20.88 points, or 0.15 percent, to 14,054.49 on Thursday. The Standard & Poor's 500 Index <.spx> lost 1.31 points, or 0.09 percent, to 1,514.68. The Nasdaq Composite Index <.ixic> fell 2.07 points, or 0.07 percent, to end at 3,160.19.

(Reporting by Francesco Canepa and Toni Vorobyova; Editing by Catherine Evans)

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Western governments to discuss military assistance to Syrian rebels: source

ROME (Reuters) - Western and Arab officials will meet representatives of the Syrian opposition in Istanbul next Monday to discuss military and humanitarian support for rebels fighting President Bashar al-Assad, a European diplomatic source said on Thursday.

"The meeting aims to work directly with opposition structures to increase the level of support," the source said, adding that both civilian and military representatives of the Syrian opposition would attend.

The source spoke on the margins of a meeting in Rome between the Syrian National Coalition - the main civilian opposition group - and Western and Arab nations.

In a policy shift, the United States has decided to provide medical supplies and food to Syrian fighters, but will still oppose giving the rebels weapons, a source familiar with the matter said overnight.

(Reporting by Khaled Oweis, Editing By Barry Moody)

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ET at The Sunset Sessions: What do Fun The Black Keys and Jason Mraz Have in Common

When I'm driving home from work listening to the radio I sometimes wonder, How do these radio programmers know what new music is out there? I hear the constant streaming of Top 40 hits, but where are the underground singer-songwriters? Where can radio and music lovers find the new IT group or artist that is going to blow up? Well I found the answer and I have three words for you... the Sunset Sessions.

PICS: New Music Tuesday!

For over 16 years, the sessions have opened their doors to new and upcoming artists, and you won't believe the list of alumni: Grammy winners Jason Mraz, Colbie Caillat, The Zac Brown Band, The Black Keys, and Fun., just to name a few, and did I mention they are all Grammy winners?

Michele Clark, who founded the Sunset Sessions, wanted to create an event that would bring together music supervisors, radio programmers, music managers, all in one place to discover artists and bands no one else is playing.

This past weekend I got to spend some time in San Francisco with some of music's most talked about new artists and groups including the much buzzed about, AlphRev and Saints of Valory. When I arrived at the Grand Hyatt Hotel right in the center of downtown you could feel the energy of the musicians as you stepped into the many rooms and stages to watch the various artists. Though they were all music industry professionals there on business, at the end of the day they are all music lovers in search of new music.

The Parlotones, the multi-platinum selling Johannesburg-bred quartet, who has shared the stage with bands like Coldplay, say that the event has "a cool vibe, everyone's music lovers and meeting each other so it's just a cool vibe." Kansas born rock band, Gooding, who were at the sessions for the first time, said "one of the things that makes it very special is the quality of not only just talent, but the people ... there's just a lot of passion here."

The opportunity is very different than other music industry events as rock and roll songstress, Anna Rose, says "it's rare, you don't get to sit in front of people like this and play ... especially for an independent musician like myself." Country spitfire Emily Bell says that the music professionals "really accept all these up and coming artists with open arms."

The Sunset Sessions have also gathered artists all over the world to come and showcase their music including Sweden's Anna Bergendahl, who performed for the first time in the US during the sessions, Keith Harkin from Ireland, Chris Assaad from Canada, and they even went to the island of Hawaii to bring singer songwriter Anuhea to join the fun; throughout her career she has jammed with the likes of Bruno Mars and Ziggy Marley.

I wasn't sure what to expect but after a full weekend of new music, I was refreshed and cannot wait to see where this year takes all of these new and amazing artists.

To see what other up and coming artists like Faulkner, Savannah Philyaw, and Fernando Perdomo, had to say about the Sunset Sessions and their performances watch the video above and follow @sunsetsessions on Twitter or go to sunsetsessions.org for more details on the next Sunset Sessions in Carlsbad, California.

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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