The Richmond nursing home where a hidden video camera caught nursing aides abusing an elderly resident last year is the second worst performing nursing home in the country—and the worst in the state—the U.S. Government Accountability Office said Tuesday.

The GAO, which provides oversight of federal agencies for Congress, said that of the 10 Kentucky nursing homes on a national list of poor performers, nine scored below the national median.

The specific rankings were based on December 2008 information that included deficiencies found in the facilities' three prior federal surveys, investigations of complaints and revisits, GAO official John Dicken said Tuesday.

Kerry Harvey, the Inspector General for the Kentucky Cabinet for Health and Family Services, would not respond to questions Tuesday about whether Richmond Health and Rehabilitation Complex-Madison, with the state's worst GAO score, and the other facilities are safe.

The Richmond nursing home, also known as Madison Manor, is part of a for-profit chain owned by Extendicare, which also owns two other homes on the list of 10. Extendicare has 21 homes in the state, according to the company's Web site.

Harvey said the inspector general's office works with all facilities to achieve compliance with state and federal regulations.

The GAO list follows the agency's earlier report that showed that only 15 states had more poorly performing nursing homes than Kentucky. While that report listed the state's worst nursing homes, it did not give their specific scores.

Officials with the 10 Kentucky nursing homes on the GAO's list said recently that the report doesn't reflect family and resident satisfaction. They said the nursing homes fared much better on recent inspections by state and federal officials than in the GAO report.

Britthaven of Somerset, which the GAO ranked as the second most poorly performing nursing home in the state, has had two inspections in the past 12 months, with only minor deficiencies cited on each survey, Brian K. Jaggers, administrator of Britthaven, said.

Jaggers said the facility is currently in compliance with all state and federal regulations.

Kim Majick, a spokeswoman for Villaspring of Erlanger, ranked third worst, said officials at that facility are "working very hard" to meet the needs of its residents.

"Although our state survey results prior to 2008 were not above average, we are very proud of the facility that we are today," Majick said Tuesday.

In September 2008, the family of the late Armeda Thomas, 84, of Irvine, hid a video camera in her room at Madison Manor in an effort to find out why she had dozens of bruises.

The videotape showed nursing assistants at Madison Manor physically abusing and taunting Thomas and failing to feed and clean her.

Thomas, who had Alzheimer's disease, died in November 2008.

The family sued the facility. Three of the nurses' aides who took care of Thomas were indicted and charged with abuse. They are Jaclyn Dawn VanWinkle, Amanda G. Sallee and Valerie Lamb.

VanWinkle pleaded guilty earlier this year; Sallee is scheduled for trial in March, and Lamb is set to enter a plea in January.

Officials of Extendicare, which owns Madison Manor, Pembroke Nursing and Rehabilitation Center and Salyersville Health Care Center, said that the facilities are now in substantial compliance with regulations.