Senior care facilities have been devastated by COVID-19. Tap these ideas to stay ahead of the story

Late last year, I was awarded an impact grant from the Center for Health Journalism to cover the assisted living industry.

COVID-19 upended the project.

Suddenly, my proposal to cover relicensing issues in the assisted living industry held less relevance. Ultimately, I managed to fold the idea into a COVID-19 piece, but my original plan paled to the pandemic’s deadly toll on senior facilities. Shortages in staffing, testing and personal protective equipment emerged. Transparency issues abounded.

Across eight articles, I’ve charted problems — and possible solutions — in nursing homes and assisted living facilities during COVID-19. There’s still much that I’m planning to cover.

I encourage other reporters to jump into senior care. We need more eyes on the industry. One statistic reinforces why: About 40% of COVID-19 deaths have been linked to nursing homes and other long-term care facilities. The moment calls for scrutiny. It calls for coverage of potential reforms after COVID-19 exposed deep industry flaws.

Here is a primer:

1) Data and regulators

Inspection reports can identify trends or add context. For instance, say you’re planning to cover a lawsuit against a nursing home. What’s the facility’s track record?

The California Department of Public Health keeps nursing home inspection, complaint and enforcement data. These reports influence a facility’s star rating, a jumping-off point for quality that’s also visible on the portal.

Using this database, I dug into infection-control histories at facilities with COVID-19 cases as part of an article on doctors not getting vital COVID-19 information from these facilities.

The same inspection data can be found on a federal government website. But I’ve found the federal database lags behind the state one.

Zooming out, another California Department of Public Health website contains citation data, among other enforcement actions, at the county or state level. This can point to oversight trends, like the number of fines against facilities so far this year, and how that compares with the same period in prior years.

This data, combined with data from public records requests, led to my piece on state investigators substantiating dramatically fewer complaints against nursing homes during the pandemic.

Going back to our hypothetical lawsuit article, you’d also want to include the number of COVID-19 cases and deaths at the facility. The California Department of Public Health houses that data here.

What about COVID-19 data at assisted living facilities? A different agency — the California Department of Social Services — regulates them, so you’d visit this website for facility cases and deaths. Likewise, the agency houses inspection and complaint reports.

Many don’t realize the difference between nursing homes and assisted living facilities. Unlike nursing homes, the federal government doesn’t oversee assisted living facilities. They are non-medical and typically paid for privately, and they often market themselves as more homelike than other options.

But as I recently wrote, thin medical staffing in the assisted living industry faces greater scrutiny as COVID-19 cuts a deadly swath through elder care facilities. I’ve also covered California’s call for universal testing in nursing homes, while a less-ambitious testing plan for assisted living facilities rolled out later.

The point is that despite nursing homes and assisted living facilities caring for a similar population, they’re regulated very differently. It’s worth recognizing, that itself could be a source of article ideas. More and more, there’s a recognition that assisted living residences have been overlooked during the pandemic.

Relatedly, it’s important to ask sources where we’re falling short. What policies should be changed? Are there any models we can look to?

2) Finding sources

One of the more challenging aspects of reporting on this industry: putting a face to an issue. That could be a senior in a nursing home, or that person’s loved ones.

As a starting point, join Facebook neighborhood pages where facilities are located and search for past posts referencing the homes. You could also join caregiver or industry Facebook groups.

But I refrained from parachute journalism. I created posts introducing myself to these groups, noted what I’m covering and highlighted that I’m hoping to learn. It led to some good conversations, and eventually, connections to those affected by senior care issues.

Both online and offline, I built a wide-spanning network. It took time. In searching for contacts, think about those who are frequently in and out of senior facilities. Hospice nurses. Paramedics. Inspectors. These folks are a goldmine for article ideas, and they can point you toward families willing to speak with you.

Keep an eye on news coverage, too. It’s vital for being clued into fast-changing developments. It seems like new regulations roll out every few days.

3) Finding story ideas

The Center for Health Journalism hosted a webinar on covering nursing homes amid COVID-19, which I recommend to generate article ideas.

For instance, Charles Ornstein, deputy managing editor at ProPublica, recommended telling the story of a nursing home that kept COVID-19 away, and how its practices compare with a home that got swamped.

He also advocated for assessing the characteristics of homes with the most COVID-19 deaths, including staffing levels and infection control practices.

Another area to watch: visitation. In March, facilities clamped down on visitors to keep out COVID-19. But some facilities are staying in lockdown, despite recent guidance permitting outdoor or window visits at a minimum. Families, doctors and advocacy groups have sought an expansion in visitation, saying that isolation’s health effects can’t be ignored.

I wrote about this two months ago, yet families say in some instances that it’s still difficult to secure outdoor visits and other access.

4) Tracking reform

It’s been said many times that COVID-19 laid bare glaring problems in the senior care industry. What needs to change? What payment reforms might incentivize change?

That’s where the conversation is heading, I believe. In talking with doctors, advocates and those in the industry, there’s a recognition that nothing will be the same again.