Sen. Bob Casey worries that many of the 1 million-plus people living in 15,000 nursing homes across the United States are in facilities that haven’t been inspected for a long time. About one in four nursing homes hadn’t been inspected in at least 16 months, as required by federal law.

As the chairman of the U.S. Senate Special Committee on Aging, the Democrat from Pennsylvania’s staff spent the past year investigating nursing home oversight. They found that state inspection agencies are chronically understaffed. The Pennsylvania Department of Health, for example, has been hiring retired inspectors on a limited capacity to try to fill in the gap.

“It’s a really long standing problem,” Casey said. “We don’t have the investment in quality that we should have.”

The Inquirer spoke to Casey about the findings of the investigation, and why he fears the problem may worsen.