The South Bend (Ind.) Tribune recently broke the news that state officials were considering yanking a license from an assisted-living center where troubling care deficiencies had been documented.
This topic – problematic conditions in assisted-living facilities – is receiving a considerable amount of attention across the country and may well be one that health reporters are asked to look into.
We asked Mary Kate Malone, author of the South Bend piece and a staff writer at the newspaper, how she came upon the story and fleshed out details. We also asked her to tell us a little bit about herself.
Mary Kate Malone (@MaloneMK) is a staff writer at the South Bend Tribune in Indiana.
Mary Kate Malone: I’ve been working in newspapers since I graduated from the University of Notre Dame in 2008. My first job was at The Courier, in Findlay, Ohio, where I covered health care and county government. I’ve been in South Bend for two years now, covering state and federal courts. Since we do not have a health care writer, I pick up health-related stories whenever I have time.
Q. How did you learn about the state health department’s move to revoke Inwood Hills’ license?
A. I received a tip, forwarded to me by my editor. The tipster had mailed the Tribune a copy of the health department’s most recent inspection (also called a “survey”) at Inwood Hills, as well as a copy of the department’s formal complaint, requesting that Inwood’s license be revoked. I needed to verify these documents were authentic, of course, but it was a good starting point.
Q. Did the state health department give you details of the recent inspections at Inwood Hills upon your request? Did you get this information over the phone or review documents detailing the results of these inspections? Did you have to file a freedom of information act request for this information?
A. Obtaining the inspection reports was a little tricky. The tipster had supplied the most recent inspection report, but I wanted to go back and see reports from previous years. The health department does not post those reports online for assisted living homes, only for nursing homes. Since the department was staying tight-lipped, I went a different route rather than doing a FOIA.
I went through our region’s Long Term Care Ombudsman’s office, which keeps all inspection reports on file. The office is separate from the health department and acts as an advocate for long-term care residents. They made copies of every report I requested, and I picked them up the following day. It ended up being hundreds of pages.
Q. Did the state surveyors talk to you directly? (I note they’re not named in the article.) If so, did they place conditions on the terms of those conversations?
A. No, the surveyors did not speak with me directly. When I attributed information to surveyors in my story, it was based on what they wrote in the state inspections.
Q. What did you find most difficult in reporting this story?
A. The most difficult part was making sense of volumes of inspection reports. I had to read (or skim very closely) every page of every inspection, to ensure that I did not over-report a particular violation or overlook an egregious one. The documents were filled with medical jargon, so the challenge was distilling the big themes.
Q. Have you been following assisting living facilities and other long-term care operations in Indiana over time? If so, what kinds of stories have you done previously?
A. This was my first story on a long-term care facility in this area. At my previous newspaper, in Findlay, Ohio, I did several stories on violations at a nursing home there. I have always found the topic both interesting and vitally important for newspapers to monitor, since it involves a vulnerable population.
Q. Is there a history of assisted-living operators providing substandard care or caring for residents who need a higher level of care in Indiana?
A. I don’t believe so. Although, it is hard to track because a lot of these violations go unreported. Newspapers/media outlets don’t monitor long-term care facilities the way they do crime or courts or city government, and so I think there could be many cities with, say, unlicensed assisted-living homes, and no one knows about it.
Q. How do you plan to follow up on this story?
A. I plan to get in touch with the health department on the day of the next pre-trial hearing. Unfortunately, the pre-trial hearings are not public, but I’m hoping to at least have access to any related documents. I also want to examine two other assisted living homes owned by Assisted Living Concepts in our area.
Q. What would you advise young reporters who might be interested in finding similar kinds of stories in their communities?
A. A lot of the information on nursing homes is accessible online. For example, you can look up any nursing home in your area on the Center for Medicare and Medicaid’s website. The site provides access to inspection reports and also rates nursing homes against each other. With my story, I was unable to use this site, because it is only for nursing homes, not assisted-living homes.
[Editor’s note: AHCJ offers the Nursing Home Compare data as a series of spreadsheets, allowing the user to filter, sort and use other analysis tools to compare more nursing homes in a more sophisticated way. Obtained from CMS and updated when the agency updates its data, the spreadsheet files include only more serious nursing home deficiencies and star ratings for nursing homes in a format to easily sort and compare.]
For reporters who want to find out more about assisted living, I think the best route to take is getting in touch with the long-term care ombudsman (or equivalent) in your area, and they are often a treasure trove of information, and also can provide good, quotable perspective for a story.
