WASHINGTON (AP) - Nursing home patients have been dragged down hallways, doused with ice water, sexually assaulted and beaten in their beds, yet few prosecutions have resulted, a congressional investigation found.

The Senate Special Committee on Aging's 18-month review concluded that many physical and sexual abuse cases in nursing homes are not treated the same as similar crimes elsewhere, and it is presenting evidence that includes a dramatic deathbed interview with one victim.

Helen Love sat with a metal band pinned to her skull and described a 1998 beating she said was delivered by a caretaker at her Sacramento, Calif., nursing home after she soiled herself.

"He started beating me all along the bed," the elderly women said in a slurred voice as she described the attacks to lawyers. "He choked me and he went and broke my neck. He broke my wrist bones, my hand. He put his hand over my mouth."

Love died two days later from the trauma. The nursing home staffer eventually pleaded no-contest in the 1998 attack and served a year in prison.

The investigation found that nursing homes rarely call police for attacks that would bring an instant response if they occurred elsewhere.

"A crime is a crime, whether in or outside of a nursing home, where residents should not spend their days living in fear," said Sen. John Breaux, D-La., chairman of the aging committee.

About 1.6 million Americans are cared for in 17,000 nursing homes. The homes received $58.4 billion in reimbursements from Medicare and Medicaid in 2001.

Government figures show that from July through September 2000, nearly 26 percent of nursing homes were cited for violations that ranged from actual harm to residents to poor record keeping and failure to put into practice policies to prevent abuse. Fewer than 2 percent of the cases, however, involved actual harm to residents.

Nursing home-industry officials said most facilities provide quality care. "We deplore any that do not," said Alan DeFend, spokesman for the American Health Care Association, which represents 12,000 mostly for-profit nursing homes.

"We are concerned that the bad actions of 2 percent of nursing homes would overshadow the good work of hundreds of thousands of caring health professionals who provide quality, compassionate care every hour of every day," DeFend said.

Love's videotape was to be aired Monday at a hearing by the Senate committee. In it, she recounts how a Valley Skilled Nursing Facility staff member "got real nasty" after she soiled herself.

Love's son, Bruce, didn't learn of the attack until the next day and called police, his wife said in an interview.

Trina Kaplow, the current Valley Skilled administrator who was not at the facility in 1998, said records show the home "contacted all of the appropriate authorities." She could not say whether police were called, but added it is her practice to notify them of any suspected crimes.

Kaplow said state officials could not substantiate the woman was choked and suffered a broken neck.

The federal Centers for Medicare and Medicaid Services, or CMS, does not require nursing homes to call police when there is suspicion of a crime, but officials said the agency is acting to speed notification.

CMS Administrator Thomas A. Scully said the agency will instruct state enforcement agencies to immediately notify local law enforcement or state Medicaid fraud units, depending on the crime.

The agency also has developed a poster for nursing homes with phone numbers to report problems to ombudsmen, the state compliance agency and the CMS Medicare number, 1-800-Medicare.

The Senate committee plans to review cases that weren't reported properly to police.

Helen Straukamp was knocked unconscious and bloodied by another resident at the Westpark Rehabilitation Center in Evansville, Ind., in September 1999. She died a month later. The home initially reported to a hospital that she had fallen, according a transfer record describing her condition.

"Her mouth was bloody, her eye and forehead were black-and-blue, there was a knot on her jaw," her daughter-in-law, Barbara Becker, said in an interview.

Becker said she didn't accept the explanation that Straukamp fell. She went to the news media and police, and eventually a third investigation uncovered the beating by a resident.

The attacker died several months later while awaiting a competency hearing, after he had assaulted another resident. Becker later found he had a long history of violence.

Holly Gould, spokeswoman for Westpark's parent company, Extendicare in Milwaukee, said she couldn't comment because settlement discussions were under way in a lawsuit filed by Straukamp's family. She said the home was fined $39,520 by the government.

Copyright 2002 The Associated Press. All rights reserved.