THOUSANDS of vulnerable nursing home patients die of neglect and abuse in this country every year. Officially, the causes are thirst, malnutrition or untreated bedsores. But the real killer is apathy.

If we cared, those deaths would be prevented. Abusers - and those in charge of them - would be punished. Nursing home owners and operators whose penny-pinching led to patient neglect would be put out of business. Homes that did the best job would become national models, and their methods would be widely emulated.

The will to make it happen has been sorely lacking, despite decades of studies suggesting that as many as five million elderly Americans are abused, neglected or exploited each year. Last week, a bill was introduced in the U.S. Senate that may finally nudge the nation to action.

The Elder Justice Act may be the most sweeping federal nursing home reform ever introduced. Staff members who abuse or neglect elderly patients could face up to 20 years in prison. Companies that permit patients to be mistreated could be fined up to $3 million. Owners of multiple homes could face fines of up to $6 million if a pattern of abuse or neglect can be proved.

The bill requires that suspected abuse be reported to police within hours after it is first noticed. It gives federal and state prosecutors new tools to go after homes where patients have been harmed. And it requires national background checks for nursing home workers.

Sens. John Breaux, D-La., and Orrin Hatch, R-Utah, wrote the bill. Among its 16 bipartisan co-sponsors is Sen. Christopher "Kit" Bond, R-Mo. The bill also has been endorsed by a coalition of more than 60 organizations, including the AARP, which previously has been noticeably absent from nursing home reform.

The bill is certain to face fierce opposition from the nursing home industry. Through lobbying efforts and targeted campaign contributions, the nursing home industry has managed to derail reform efforts in Missouri each of the past three years. In Illinois, the industry lobby kept a bill bottled up in committee a few years ago. On the national level, the industry is sure to take issue with some of the bill's most important provisions. But advocates for the elderly point to strong bipartisan support as an indication that the bill has a good chance of winning approval.

Even if federal legislation were to pass, it would not diminish the need for reform at the state level in Missouri and Illinois. The federal bill would complement nicely a package of reforms developed by Gov. Bob Holden and Lt. Gov. Joe Maxwell. Their proposal calls for changing a law that lets nursing homes escape fines for serious violations. Importantly, the proposed laws would require all deaths in nursing homes to be reported to local authorities before the body could be removed. Mandatory reporting of all deaths would greatly improve efforts to detect abuse and neglect.

A yearlong ((ITAL))Post-Dispatch((ITAL)) investigation documented thousands of abuse and neglect deaths in nursing homes around the nation. It clearly demonstrated the need for new state and federal laws to protect the elderly.

Those reforms will come about only if voters demand them. Now is the time to let Congress and state legislators know that the abuse and neglect of our nation's elderly no longer will be tolerated.