How I did it

Learn from these journalists how they have covered various aspects of aging. They provide valuable tips and sources and explain how they got past the challenges to explain the complex issues to their audiences.

Reporters’ data analysis added credibility to anecdotal evidence of hospice neglect

JoNel Aleccia

Melissa Bailey

December 2017
Kaiser Health News reporters JoNel Aleccia and Melissa Bailey analyzed government inspection records to reveal that although U.S. hospices promise to be on call around the clock, dying patients and their families often face terrifying delays, no-shows and unanswered calls. Through a FOIA request, they received a spreadsheet of 20,000 records of hospice inspection reports for more than 4,000 hospices from January 2012 to February 2017. Inspections are conducted by state health officials and collected by CMS.

Lessons learned from one reporter’s immersion into end-of-life issues

September 2017
The End of Life radio series was made possible by the AHCJ fellowship program last year. My four-part series was broadcast in January on KALW, the public radio station where I am based in San Francisco.

I started reporting on death and dying 20 years ago and decided to revisit this topic following the death of my mother in 2015. Her death was (and still is) very much on my mind, and I thought that plunging into this new reporting project would help me process my grief and channel my energies into something useful.

Digging into nursing home data found correlation between spending, quality

May 2017
The Boston Globe's Kay Lazar followed the Medicaid money trail via the reports nursing homes must make to state regulators. What should have been a simple, straightforward story turned into an in-depth investigation that uncovered missing data, lax oversight and corporate shell games. Lazar also wanted to find out whether additional funding that nursing homes were receiving was correlating to better quality of care, as measured by health and safety inspections. Or whether Medicaid money was being stashed surreptitiously in myriad corporations affiliated with nursing home owners to line their own pockets. Here, she explains her process and offers tips to journalists who may want to tackle a similar project in their state.

Making it personal: Chronicling the end of life

February 2017
If you are terminally ill, in excruciating pain, and want a doctor to help you die, in most states you have few options. You can shoot yourself, poison yourself, pull on a hood and inhale helium. But if anyone helps you, even drives you to the store to buy supplies, that person can be held as an accessory to murder. So even if your spouse or daughter or doctor agrees you should be able to decide when to let go, they can’t help you.

Lane DeGregory wanted to explore the issue of physician-aid-in-dying, which was legal in a few states and had just been passed in Canada and California. She wondered: What options do people in other states have?

Here she tells us how she found a couple to write about, what she learned about end-of-life options and the challenges in reporting such an intimate part of people's lives.

Reporter: Oral health has become important gateway to other issues on his beat

November 2016
For low-income elders, dental care can be very hard to find. Medicare does not include routine dental benefits and seniors living on low or fixed incomes may lack the money to pay out of pocket for care. Untreated tooth decay causes pain and contributes to tooth loss, poor nutrition, social isolation and declining overall health.

In San Diego, an innovative nonprofit dental clinic that recently opened in a senior center is aiming to address the problem. Reporter Paul Sisson, who covers health care for the San Diego Union-Tribune paid a visit and provided readers with an engaging story that captured the spirit of the place and highlighted the deep needs it aims to serve. In this Q and A, Sisson talks about his work on the dental clinic feature and shares some wisdom on how he stays on top of his busy health care beat. 

How to break down a big topic into a reader-friendly multipart series

October 2016
Anna Gorman says the statistics were startling: About one-third of patients more than 70 years old, and more than half of patients over 85, leave the hospital more disabled than when they arrived.

She came across these numbers while researching a potential series of stories for Kaiser Health News about how elderly patients fare in hospitals. She was curious about the reasons for a high rate of disability. After extensive research, a common theme emerged and it was clear that this wasn't simply because the patients were old or sick.

Here, she describes how she researched the series, organized her reporting and the stories, and even shares what she thinks would have made the series even stronger.

How one reporter helped launch his paper's new section on aging

August 2016
Most reporters are multitasking experts. Not only are they reporting and writing the main story for a media outlet’s print edition and website, but they’re usually also compiling multimedia add-ons such as video, audio and photos. Then there’s the Tweeting, Facebooking, Snapchatting, Instagramming and other social media promotion they are asked to do to drive website traffic — all while getting a jump on their next story (or two).

So why would an experienced journalist approach his editor to take on even more responsibility? Gary Rotstein, a self-admitted anti-digital-anything reporter at the Pittsburgh Post-Gazette, realized that the online environment could actually be a place where stories about his beat — aging — could shine.

Investigating cutbacks in Ontario's home care system

June 2016
The Globe and Mail's award-winning home care investigation began after Kelly Grant read local newspaper stories about home-care clients in two different Ontario cities having their care cut off or reduced because of funding shortages. Her hunch was that if it was happening in two places, chances were it was happening across the province.

She teamed up with senior reporter Elizabeth Church and they began to dig. 

That led to a three-month pursuit involving dozens of interviews – some with elderly clients who were afraid to talk to the media and, indeed, had been warned not to – and the difficult and often Byzantine task of getting documents from the government's 14 regional home-care agencies. 

In nursing home investigations, a small tip can lead to an iceberg of problems

June 2016
Serious problems at nursing homes are often easy to conceal. That is, unless you specifically dig for patterns of fraud, abuse, or misconduct. That’s exactly what Boston Globe journalist Kay Lazar did to uncover a pattern of high profits for the owners, while complaints and problems mounted. 

Her award-winning coverage involved trying to talk to unwilling company officials, hearing from frustrated employees and the families of people who received questionable care, public records requests and more.

In this article, Lazar explains the extensive efforts involved in pursuing a lead that still has unanswered questions.

Despite offerings, reporter finds nursing home beds and funds still lacking 

May 2016
Reporter Rick Jurgens started out to compare health services for low-income people in Vermont and New Hampshire because those states have similar populations and economies but noticeably different political cultures. He assumed the comparison would be doable because both states are small and geographically compact. 

He soon realized the volume of work entailed in doing such a broad comparison would be unmanageable.

Here, he shares his experience and some of the techniques he used to produce two packages comparing mental health care and nursing home care in the two states.

Real-world reminder of the dangers of a tiny study   

April 2016
As reporters we are constantly parachuting into situations and exiting again just as quickly. A great many of our stories are written from intense-but-limited observations of a situation.

Sometimes we get lucky and are allowed to do long term projects in which we can fully immerse our professional selves for a longer time but, in today's newsroom, those times are disappearing.

Mostly we're here, we take notes, record 60 seconds of video and we're back out. Follow up is usually done via phone, emails or messaging apps.

If I had been doing a story on a recent "assignment," that methodology would have been the wrong approach and a disservice to readers and the story. Let me tell you why.

Reporter explains how he turned a troubling hospice death into an investigative series

September 2015
“An Unquiet Death,” my five-part investigative narrative that appeared in August in The Sacramento Bee, looked into the death of Jerome Lackner, former maverick leader of California’s Department of Health, one-time personal physician to Cesar Chavez, and a savior of countless addicts. Jerome passed away in 2010 during hospice care in his Davis, Calif., home. His primary caregivers had been his second wife, Rebecca, then 72, from whom he was legally separated; and Joseph Poirier, a 51-year-old recovering addict who friends and family would claim later was having a clandestine affair with Rebecca.

How to wrap your arms around a topic as broad as poverty and aging

August 2015
This series in City Limits on aging in New York City began with a musing from my editor, Jarrett Murphy: how will the growing number of seniors make ends meet as they age?

Despite some national trends, it’s a question with very local answers. In New York City, it turned out that many seniors are struggling financially: one in five are poor, and senior poverty rates, which are dropping across the country, are on the rise.

Reporter explains how she cultivated sources for story on senior dental care

July 2015
Millions of seniors in America struggle to find dental care. Hanah Cho met a few of them who were grateful to find care at a clinic run by the North Dallas Shared Ministries.

The patients’ frank accounts of their pain and relief, included in a recent feature by Cho, brought the issue home for readers of the Dallas Morning News.

A personal journey with Alzheimer's

December 2014
Putting personal issues on public view can be tricky and even downright awkward for journalists. It is often difficult to maintain a level of objectivity when the focus of your effort concerns a loved one – particularly if that person has a condition like Alzheimer’s.

But it can be done. Pieter Droppert, a UK journalist now based in Miami, explains how he went about reporting and producing his radio documentary, "Living Well with Dementia – a personal journey."

How two elderly women prompted a hard look at Florida’s elder guardianship system

December 2014
This series that looks at the insular world of adult guardianship began for me more than two years ago, at a fairly lame seminar on elder fraud.

As attorneys and officials on the panel spoke about how relatives prey on older Floridians to separate them from their money, I saw two sweet-looking ladies nodding vigorously at each other. 

They were sisters-in-law, and in June 2013 we published the story of their unsuccessful legal struggle to rescue their husband and brother, a former county judge, from a guardianship they believed was depleting his finances and his health. The attorneys and guardians I spoke with insisted that this case was an outlier in a system that works well to protect vulnerable elders. Then I started to get calls and emails from others who felt trapped and frustrated by this same well-intended system.

Calif. reporter finds dearth of public records on assisted-living homes

October 2014
I knew next to nothing about the fast-growing assisted-living industry when I started reporting in early 2013 on problem homes in San Diego.

For example, I did not know that many seniors in today’s assisted-living homes are so frail and medically needy that they would have been in nursing homes 20 or 30 years ago. Many live in facilities with no medically trained staff.

Most astonishing to me was the lack of public access to state regulatory reports revealing the quality of care in homes, not only in California but nationally. We’re so accustomed to NursingHomeCompare and HospitalCompare – whatever their flaws – that the hoops families and journalists must leap through to judge an assisted-living home’s quality seem downright primitive.

With serious effort, important records can be tracked down, as my U-T San Diego reporting partners and I learned while working on “Deadly Neglect,” an investigative series produced by the U-T and the CHCF Center for Health Reporting.

How one reporting team used public records to find questionable Medicare Advantage spending 

July 2014
Medicare billing records are all the rage. Almost every day, it seems, there’s a new article about doctors cheating Medicare, based on billing data released earlier this year by the Centers for Medicare and Medicaid Services.

But there’s a lot federal officials don’t want the public to see when it comes to Medicare Advantage, a type of Medicare plan administered by private insurance companies. Federal officials refuse to disclose detailed financial records of these health plans – even though these plans are growing fast and insure almost one in three people eligible for Medicare. That’s nearly 16 million people, at a cost to taxpayers likely to top $150 billion this year.

Dominated by some of the nation’s mightiest insurance carriers, Medicare Advantage has faced little scrutiny from lawmakers or the media despite years of audits and research papers showing that overbilling is widespread. So while it’s open season on “fee-for-service” charges by doctors and hospitals, Medicare Advantage data remain under wraps. One government official called it a “black box.”

Investigation: Officials sent sick, dying homeless people to unlicensed facility

March 2014
"A home, but no help" was the fifth story in our seven-part investigative series on Hillsborough County's Homeless Recovery program. Earlier in 2013, we had been tipped off that the chairman of the Tampa Port Authority was running an illegal slum trailer park. That story turned into an investigative project when we learned some of the people living there had been sent there by Homeless Recovery, a government agency which paid their rent with public money. As we started to amass records, it became clear the Port chairman's slum was one of dozens the county had subsidized for years with a steady stream of homeless people.

Author makes transition from print to blogging

August 2012
Howard Gleckman, formerly a senior correspondent in the Washington, D.C. bureau of Business Week, explains his metamorphosis into a blogger who focuses on long-term care, health policy and tax policy. While at Business Week, he covered two beats that seemed disconnected but were not – tax and budget policy and health policy. But, as Gleckman points out, we’ve all learned in recent months that tax and health policy turn out to be closely linked.

Gleckman discusses the range of topics he covers, the value of feedback he receives through his social media efforts, how much time he spends on various projects and more.

Documentary reveals struggles of aging LGBT community

August 2012
For a generation of lesbian, gay, bisexual and transgender adults now in their 60s, 70s and 80s, silence was, for a long time, a way of life. Often they struggled with fear, shame, and isolation, along with a deep-seated distrust of authority and a dread of discrimination.

Growing old and becoming ill and dependent can stir up painful feelings. Am I a worthwhile person? Will others stay by me or abandon me if I show them who I really am? Can I trust that I won’t be judged? Will I be treated well if I display my vulnerability, or do I have to put up my guard?

Filmmaker Stu Maddux, a former television journalist, anchor and producer, takes us inside this world in Gen Silent, a film that profiles six LGBT seniors and the issues they’re facing as they age. Maddux recently spoke at length with AHCJ topic leader Judith Graham about making this film and we share highlights of that conversation.

Tracking antipsychotic use in nursing homes

July 2012
Research published in 2010 found that patients newly admitted to nursing homes with some of the highest rates for prescribing antipsychotics were significantly more likely to receive the drugs than patients entering homes with the lowest prescribing rates – regardless of whether they had conditions that warranted use of the drugs.

The Boston Globe project, “A rampant prescription, a hidden peril,” aimed to pull back the curtain on a long-running but shrouded practice in many nursing homes of using antipsychotic drugs to sedate residents, particularly those with dementia who often have challenging behaviors.

Reporter explores difficult end-of-life questions through father's death

July 2012
It took months for Lisa Krieger to decide to write about her father’s death and minutes for readers to begin responding after her article appeared in the San Jose Mercury News.

At the center of Krieger’s unflinching account of her father’s last days is an uncomfortable question: “Just because it's possible to prolong a life, should we?”

Hundreds of readers wrote in to thank Krieger for sharing her story and going beyond the “death panel” rhetoric that so often stifles honest discussion of end-of-life concerns. Her work demonstrates that reporters can sometimes tell the story from an unusual perspective – their own – and touch readers in a different way than would be possible with more traditional coverage.

Columnist writes about intersection
of finance, aging and health

June 2012
What is it like to be a columnist covering the aging beat?

We asked Mark Miller, who writes twice weekly for Reuters and monthly for Morningstar.com.

Miller is an experienced business and financial journalist who examined demographic trends several years back and realized that writing about aging would be an in-demand specialty.

Since Medicare is such an important issue for anyone age 65 or older, Miller gave himself a crash course on that government health care program. His columns on Medicare are some of his best-read pieces.

Miller know that writing about health will be an important part of his work going forward and recently joined AHCJ to connect with other journalists and pick up story ideas. We welcome the voice and experience that he brings.

Embedded reporter takes multifaceted look at end-of-life issues

June 2012
The Toronto Globe and Mail treated readers last year to an unusually intimate look at issues that arise at end of life.

Lisa Priest, lead reporter for the newspaper’s series, spent 10 weeks embedded in a critical care unit at a local hospital, where she tracked the experiences, thoughts and feelings of patients, family members, doctors and other medical staff.

Here she describes some key questions that arose as she embarked upon this multimedia project, and the inspiration that she felt at being privy to some of life’s deepest, rawest moments.

Gone without a case: Suspicious elder deaths rarely investigated

May 2012
At the end of last year, ProPublica turned a spotlight on seniors who perish from abuse, neglect, or other forms of mistreatment – deaths that are almost never investigated by coroners or medical examiners.  

Who knew that doctors can fill out death certificates in most states without ever seeing an elderly patient’s body and determining what actually happened to the person?

Experts told ProPublica that the failure to examine suspicious senior deaths reflects denial as well as prejudice.

"We're where child abuse was 30 years ago," said Dr. Kathryn Locatell, a geriatrician who specializes in diagnosing elder abuse. "I think it's ageism -- I think it boils down to that one word. We don't value old people. We don't want to think about ourselves getting old."

Here, ProPublica’s A.C. Thompson describes how reporting for this story evolved and how it fits into the news organization’s broader investigation of coroners and medical examiners, a joint project with PBS “Frontline” and NPR.

Whistleblower suits form basis for reporting on for-profit hospices

April 2012
Jordan Rau of Kaiser Health News has turned a sharp eye on for-profit hospices during the past year, writing about allegedly abusive practices detailed in whistleblower lawsuits.

The whistleblowers – former company insiders – claim that some operators are enrolling patients in hospice care inappropriately in an attempt to maximize Medicare revenues. Lawsuits have been settled out of court, and companies haven’t admitted any wrongdoing.

Here, Rau explains how he came upon the trail of his New York Times story and pursued it, with a few twists and turns, over the course of several years.

Tip points reporter to troubled assisted-living facility

January 2012
The South Bend 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.

Boomerangst: Series helps explain what the aging of the boomers means

January 2012
Reporters in Canada have done some pretty spectacular reporting on aging issues.

The largest effort, Boomerangst, came from The Province in Vancouver, British Columbia. The Province has a weekday circulation of about 157,000 and Sunday circulation of 171,000. The weekly readership in print and online is 957,500.

The first piece in the newspaper’s 14-part series ran in mid-October; follow-up stories are ongoing.

Ros Guggi, deputy editor at the paper, describes how this exceptional effort came together and the community’s strong response.

Falsified charts in nursing homes linked to patient care

December 2011
Sacramento Bee reporter Marjie Lundstrom recently wrote a two-part series on the falsification of patient records in nursing homes. Her investigation turned up a narrow aspect of nursing home care that has gotten little public attention.

She used public records, court records and patients' stories to document false record-keeping and blatant cover-ups that went right to the heart of patient care. She found cases of altered records to minimize blame and legal liability; filling out charts en masse, out of laziness or necessity because of under-staffing; improperly dispensing medications and therapists that continued to bill Medicare for high-priced therapy for patients too ill to participate.

Finding the patterns linked the falsification issue directly to patient care. In some instances, vulnerable nursing home residents died because their medical charts failed to reflect their true conditions.

Group effort documents effects of cutting services to seniors

November 2011
Services that mean a world of difference to needy seniors – everything from meals on wheels to specially equipped vans that take older people to doctors’ appointments – are threatened as financially-strapped states take a knife to over-extended budgets.

The California HealthCare Foundation Center for Health Reporting has undertaken one of the most extensive explorations of this trend in a series called Home Alone, a look at the impact of planned cuts to a program that funds California adult day care centers. The project was executed with nine other partners, some of which publish in languages other than English.

Richard Kipling, managing editor of the Center, describes how this project came together and what was involved in making it work.

Young reporters put together a comprehensive look at aging

October 2011
Brave Old World is a fascinating multimedia look at aging produced by News21 fellows from Columbia University’s Graduate School of Journalism.

The site debuted in September after a team of 13 young reporters spent 10 weeks interviewing older adults, their families and a wide variety of experts. On-the-ground research took the group to eight states.

The resulting stories, told through text, audio, photographs, interactive graphics and video, provide a nuanced look at aging trends unfolding across the country. Parts of the project appeared in The Washington Post, on The New York Times website, on forbes.com and in Kaiser Health News.

Paula Span, the project leader, and some of her students discuss their contributions to Brave Old World and what they learned from this endeavor.

Compromised care: What Chicago Tribune reporters learned about felons in nursing homes

Photo via Flickr by ulrichkarljoho.

January 2010
Chicago Tribune reporters David Jackson and Gary Marx, in a three-month investigation into the policies and practices of Illinois nursing homes, found that Illinois is an outlier among states in its reliance on nursing homes to house younger adults with mental illness, including thousands of felons whose disabilities qualify them for Medicaid-funded nursing care.

Jackson and Marx documented numerous recent cases in which violent psychiatric patients who were not receiving proper treatment assaulted, raped and even murdered their elderly and disabled housemates. The stories also showed how the chaotic and harmful behavior can spill outside the nursing home walls when patients are not properly supervised.

In this piece for AHCJ members, Jackson and Marx describe some of the techniques they used in the investigation.

Reporter discovers data missing from federal Nursing Home Compare

September 2009
Duane Schrag of the Salina (Kan.) Journal discovered critical data was missing from the federal Nursing Home Compare data online.

The federal government encourages consumers to use Nursing Home Compare to help them choose long-term care facilities. It takes into account variables such as health inspection results, nursing home staff data, quality measures and fire safety inspections. Additionally, reporters have used the data to investigate nursing homes.

In this article, Schrag shares how he discovered the holes in the data and what he learned about Nursing Home Compare.

Building a database reveals deficient nursing homes

July 2008
Matt Canham of The Salt Lake Tribune scoured nursing home inspection reports – not available online in Utah – and found details of hundreds of deficiencies. He used those reports to build a database that's now available on the paper's Web site for the public to search. Through the data, Canham was able to identify problem homes. Most were “yo-yo” facilities, dipping in and out of compliance. The series also found that ownership is a top predictor of quality, though neither the state nor federal government has good information on who owns these facilities. This article is accompanied by a number of resources, including tip sheets, a video of story ideas, related articles and Web sites.

Courant reporters investigate nursing home chain

February 2008
Lisa Chedekel and Lynne Tuohy of The Hartford Courant used health inspection records, cost reports and court records to disclose that one of Connecticut's largest nursing home chains was repeatedly cited for serious patient-care deficiencies, was deep in debt and that there numerous allegations of wrongdoing in pending litigation. They write about how they went about researching and reporting the story.

Inspection reports reveal deficiencies in assisted-living care

August 2007
Ziva Branstetter of The Tulsa World recently reported a series of articles about assisted-living centers. She found that the public is remarkably uninformed about major issues such as what services to expect in assisted living, when to choose a higher level of care and what a center's inspection records reveal. In addition, "assisted living" can mean different things to different people and in different states, and there are no specific federal regulations governing assisted-living centers; each state has its own standards.