Older Adults

Behind a story funded by a Community Solutions journalism grant: Families weigh the risks of sending a loved one to a nursing home during the coronavirus pandemic

August 10, 2020
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In June 2019, The Center for Community Solutions announced the winners of our inaugural Health and Human Services Journalism grant. All applicants submitted story proposals, and a panel of judges selected five winners. When the coronavirus pandemic struck Ohio, multiple grant winners asked if they could use funding from our grant to partially finance their reporting on the pandemic. Below, grant winners Rachel Dissell and Ginger Christ wrote about that process. You can read their story partially funded by grant dollars here.

By Ginger Christ and Rachel Dissell

HHS Reporting Grant winners

As the coronavirus pandemic evolved this spring, we heard stories start to trickle out from frontline workers trying to figure out how to care for patients, even as our understanding of the infection and how it spread changed daily. There were so many unknowns.

Ginger spotted a post on Twitter from a nurse who wrote that it was heartbreaking to help older patients being discharged from the hospital as they tried to find a nursing home that wouldn’t “kill them.”

We learned families were more often choosing to care for aging or ill loved ones at home.

Many patients and families, we realized, were likely wrestling with the toughest of decisions: how to choose a nursing facility for a loved one at a time when 70 percent of reported deaths in Ohio due to COVID-19 complications were happening in long-term care facilities.

*Note: As of July 31, nursing home facility deaths account for 56 percent of all COVID-19 deaths in Ohio.

For families, the statistics were more than startling. They were so frightening that, as we reported, we learned families were more often choosing to care for aging or ill loved ones at home.

One factor driving their reasoning was that, at the time, families could not visit nursing facilities, so they could not assess the type of care their loved ones were getting. This assessment was one of the primary pre-pandemic recommendations -- for families to assure care was high quality.

Before April 15, no information on nursing homes was shared at the state level. Health officials left it up to individual facilities to release data about outbreaks.

As Ohio started to collect and release more data on infection rates in specific nursing facilities, what was available to the public was confusing. It was unclear whether large numbers of COVID-19 cases meant facilities were unsafe, if they had performed more testing than other sites or if they had an early outbreak under control.

We learned families were more often choosing to care for aging or ill loved ones at home.

When information was released by the state, it showed positive tests from facility residents for each week, positive tests from facility staff for each week, and also showed the cumulative number of positive tests. But deaths were – and still are – only reported by county.

With little clear information, and our collective understanding of the virus still evolving, the best advice most aging care experts we spoke with could give was to look at recent pre-COVID-19 inspections and government ratings of facilities to gauge the safety of a site.

Were those still relevant, we wondered? We tapped data journalist Cid Standifer to compare the rate of positive coronavirus tests with the Centers for Medicare and Medicaid Services (CMS) facility ratings. The ratings give a facility from one to five “stars” based on performance on quality measures, staffing and inspections.

We looked only at long-term facilities, not assisted living facilities, because long-term facilities receive CMS funding and are required to report more information. There did not appear to be a correlation between ratings and COVID-19 infections.

That, we thought, was important to tell people.

  • While it was difficult to report on something without clear answers, we knew people making decisions about their loved ones were facing an even greater challenge - and could use any information we were able to find and vet.
  • We weren’t able to speak to as many families as we would have liked. Because information and circumstances were changing so quickly, we thought it was important to get information out that was still relevant to readers.
  • We think there is an opportunity for a follow-up piece talking to families who went through this process and see how the situation has changed in recent weeks.
  • The story was widely shared on social media and republished by various news outlets in Northeast Ohio. We hope it made the impossible decision easier for even one family member facing this dilemma.Read the full piece by Dissell and Christ, originally published in June, here.
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