Could you paraphrase the highlighted words "ratios" & "present" & "high" regarding this short passage, please?

The origins of the Omnibus Budget Reconciliation Act began in 1987 when the U.S. Congress addressed the problems regarding health care quality for the elderly. With increasing numbers of elderly entering nursing homes, great concern arose over the substandard care being provided, high nursing-to-patient ratios, and unhealthy conditions present. Requirements were set for those facilities participating in Medicare/Medicaid programs and addressed enforcement mechanisms.

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    Have you looked these up in a dictionary? What is confusing you? – StoneyB on hiatus Aug 16 '15 at 22:26
  • Does it say that the number of patients and nurses are increased? Does the ratio refer to interaction? Does the word "present" mean "things that there are" , Can we add "that are" before tge word "present" and make it " conditions that are present" ? – user5036 Aug 16 '15 at 22:33

I think this passage is poorly written; I will attempt to explain what I think its authors meant.

High ratios: It's common to talk about the average number of patients a nurse must look after, or the number of students a teacher has, etc., as the "X-to-Y ratio". For example, if a hospital has 6 nurses and 60 patients, it has a nurse-to-patient ratio of 1:10. From context, the passage is referring to not having enough nurses for the number of patients. I would usually consider that a low nurse-to-patient ratio (or a high patient-to-nurse ratio), but sometimes people use "high ... ratio" to simply mean a more unequal ratio, regardless of whether it is X:Y or Y:X.

present: At the nursing homes, there are unhealthy conditions. The unhealthy conditions are present at the nursing homes. In this sense, "to be present" means "to exist at that place and time". It is also frequently used to refer to people: a student is present in class; a suspect was present when the crime happened; etc.


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