Wary, guarded and a bit confused, Chris Christensen looked like any other Alzheimer’s patient as he shuffled into the nursing home clutching his battered suitcase—the one he had outfitted with a false bottom to conceal a cache of small notebooks, a cell phone and a tiny camera.

Christensen stood teary-eyed and stoop-shouldered in the cheerful reception area of the Ruidoso Care Center in Ruidoso, N.M., as smiling staff members assured him that living in the home would be like "staying in a hotel."

"I’d rather sleep in my car," he says now, looking back over the five days he spent at Ruidoso earlier this year as an undercover resident for the state of New Mexico.

Other states spring surprise inspections. But only New Mexico trains investigators, gives them detailed cover stories and sends them into questionable nursing homes as residents. While Christensen was hunkered down in the Alzheimer’s wing of the rambling 130-bed facility in Ruidoso, two other undercover residents—both former state workers familiar with the nursing home system—reported on problems in second and third homes. It was the state’s first such undertaking in five years.

Christensen, a strapping, 65-year-old ex-cop, lost 10 pounds in five days living at Ruidoso, where he ate the same bad food and endured the same sad indignities as his fellow residents. But unlike the others, he was able to report on the sorry treatment and haphazard care, writing notes about what he saw and hiding them, tightly folded, in his shoes.

"My contact was the woman who played my sister and visited me at the home," he says. "Each day I would pass my notes to her."

As part of the program, doctors and psychiatrists coached Christensen to play a resident with Alzheimer’s. Then he worked with state officials for more than two months constructing his new identity as a salesman—right down to fake doctor’s records and a fictitious family. The investigator who played his sister stayed in a nearby motel so that if anything went dangerously wrong "I could use my cell and call her for help."

The challenge is to play a role convincingly, beyond suspicion, he says. "The woman who played my sister couldn’t believe I could get real tears in my eyes like I did," he says proudly.

As an ex-cop, Christensen is cool, self-possessed, confident of his ability to handle any situation—from a suspecting administrator to an abusive nurse. Still, he struggled for emotional equilibrium at Ruidoso. "If I let all the things I see soak in," he says, "I’ll get depressed and do a lousy job.

"We had one guy undercover who called his contact 10 or 15 times the first day," Christensen says. "He said, ‘I can’t do this,’ and we got him out.

"You have to keep your sense of humor—keep your emotional distance—or you can’t pull it off," he says.

While he and the other undercover residents did not witness any physical abuse, they did see chilling indifference to the residents and a troubling lack of care. Christensen was in the lockdown Alzheimer’s unit, but because of staffing shortages, the nurses "propped the door open with a chair so they could watch our ward and another one," he says. "I wandered out of the unit, down the hall and all around, and no one ever stopped or questioned me."

As an Alzheimer’s patient, Christensen should have been prompted by the staff to change his clothes, bathe and groom himself, he says, but "I never took a shower or changed my clothes the entire time I was there."

He couldn’t stomach the cold, flavorless food and barely touched any of the meals—from the "gray, liquidy pancake" to the "canned stew." But according to the home’s records—which, Christensen says, were filled out before the meals were even served—he ate 50 percent of each meal.

Still, "even though the food was awful," he says, "I saw orderlies eating food off the patients’ plates."

And he once watched as an Alzheimer’s patient with crippling arthritis tried for minutes at a time to open a cellophane package of saltines.

"Most of them couldn’t open the crackers, and nobody offered to help," he says. Later, the staff gathered the unopened crackers and ate them.

Anyone who wanted water had to ask for it, he says, "so dehydration was an issue because some of these people couldn’t remember their own names, let alone remember to ask for water."

Other states are inquiring about New Mexico’s program because of its undercover residents’ ability to document abuses, says Michelle Lujan Grisham, secretary of the state’s Aging and Long-Term Services Department. But some long-term care advocates think such an effort reaches beyond their charge of investigating and resolving complaints from residents.

Grisham says, "We’re sending a strong message to the industry: You don’t know where we’ll be or when we’ll be there, so you need to behave all the time."

Ginny Archambault, a registered nurse and the coordinator of the Ruidoso Alzheimer’s unit, says the investigation was "totally unfair and biased. This was somebody with an agenda who wanted to make us look bad."

One of the three nursing homes investigated has been closed. The state is working to place monitors to oversee operations in Ruidoso and the third home. Grisham promises the undercover program will be ongoing and aggressive because "the administration is committed to it."

Christensen, though now an independent fraud investigator, remains with the program and says he is already arranging deep-cover stories for new residents.