Express-News investigates Texas nursing homes

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San Antonio Express-News reporters Karisa King, John Tedesco and Melissa Fletcher Stoeltje took advantage of a number of tools to assemble a broad investigation into the city’s nursing homes.

Slow action on nursing home problems

In the package’s centerpiece, the reporters plowed through 2,200 claims filed against the town’s 55 licensed nursing homes from 2006 to 2009 and found that investigators arrived long after the incidents in question and marked so many claims “unsubstantiated” that the state attorney general posted a notice advising residents that they should take even unsubstantiated claims into account when evaluating nursing homes. They also consulted ratings and visited 10 local nursing homes.

nursing
Photo by Susan NYC via Flickr.

With the ratings as a guide, the newspaper examined more than 3,000 pages of abuse and neglect investigations and annual inspections of 10 nursing homes with the lowest scores. It also reviewed dozens of wrongful-death lawsuits filed against local nursing homes to examine how Texas watches over its elderly.

In addition to a few dangerous homes and some disquieting anecdotes, the reporters found an unenforced reporting law:

(Department of Aging and Disability Services) also is failing to enforce a state law that requires nursing homes to report details about every resident who dies. State officials are supposed to analyze the fatality reports to publicize problems and trends, but that research isn’t being done.

To top off this tale of dysfunction, they also unearthed at least five cases in which would-be nursing home whistle blowers were fired.

Ratings don’t tell full story

Stoeltje added a sidebar on nursing home rating systems, their utility and their shortcomings. She addresses both the local Texas system and the federal Nursing Home Compare database. She talks to both nursing home operators and patient advocates; the operators tend to dwell on ratings’ weaknesses while advocates spoke on their strengths.

LIST: Examples of problems found at nursing homes
Six more examples culled from complaints and often backed with interviews.

MAP: Quality of nursing homesA Yahoo! map linking nursing home location, size and rating.

Texas Public Radio
Terry Gildea, host of a news discussion program called “The Source,” interviewed all three Express-News reporters about their investigation.

Covering the Health of Local Nursing HomesSlim guide:
Covering the Health of Local Nursing Homes

This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.

AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.

AHCJ resources

More investigations of nursing homes
Aging Nation: Troublesome Health Care Issues
Headlines an advocate for seniors would like to see
The impact of aging upon health care
Covering nursing homes and other issues of aging
How will retiring boomers affect the national health agenda?
You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
Biology of Aging: Sources and Resources