Knight Chair in Investigative & Enterprise Reporting
How-to guide:
Investigation of the ‘worst-performing nursing home’
By Donnie Forti
A reporter may find a nursing home patient has survived the Great Depression, World War II and the atomic era, and be denied a glass of water.
Incidents and accounts of abuse of patients in nursing homes are on the Internet in official reports of government regulatory agencies. From this information, a reporter can gain an understanding of how nursing homes operate.
Being a citizen of a nursing home today sometimes means facing the risk of serious physical and verbal abuse. A report by the U.S. House of Representatives Committee on Government Reform (in PDF) found nearly one-third of U.S. nursing homes were cited for abuse from 1999 to 2001.
According to the American Association of Homes and Services for the Aging, 1.6 million people live in 18,000 nursing homes across the country. The Agency for Healthcare Research and Quality found that almost two-thirds of all nursing homes are for-profit businesses.
Background
The Centers for Medicare and Medicaid Services puts state governments in charge of inspecting nursing homes. In the Social Security Act, Congress mandated minimum requirements that nursing homes need to meet to pass an inspection. Every nine to 15 months, the state inspects nursing homes that participate in Medicaid and Medicare. Poorly performing nursing homes are often inspected more frequently.
While these inspections make nursing homes fix violations related to patient care, staff-patient relationships and quality-of-life issues, many nursing homes are repeat violators of government regulations.
The public needs to know which nursing homes are giving 'careless care.' Like the other two investigations illustrated on this site, reporters can work on the nursing home investigation right from their computers.
Setting up the investigation/Creating a spreadsheet
All violations found during state inspections are listed on the CMS Nursing Home Compare Web site at www.medicare.gov/NHCompare/. This site includes violations of every Medicare- and Medicaid-certified nursing home in any county. Search the "By Geography" heading, click on "County," then select your state from the dropdown menu. Next, select the county you want and then the "next step" button. The names of nursing homes in your county will appear. The site allows you to view violations for ten nursing homes at a time.
You also can review information on the number of health and fire safety violations through links on the site. The results can be entered into a spreadsheet to help compare violations.
In the University of Illinois investigative reporting class, the students used the following headings in MS Excel to create a comparison spreadsheet: Nursing Home, Medical Violations, Housekeeping Violations, Food Violations, Building Safety Violations, Nursing Care Violations and Administrative Violations. By copying and pasting all the violations into the spreadsheet for each nursing home, you can use the spreadsheet to determine which nursing home has the most egregious violations by category.
The information in the spreadsheet can serve as the basis for your investigation. One possible angle for a story is to find out whether for-profit or nonprofit nursing homes have more violations in your county.
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Forti graduated from the College of Media at the University of Illinois at Urbana-Champaign.