News stories paint negative picture of nursing homes

Analysis of media portrayals of nursing homes finds that negative stories outnumber positive stories by five to one, reports a study in the December issue of Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Negative news coverage of nursing homes may shape public perceptions and consumer care choices, suggest Edward Alan Miller, PhD, MPA, of University of Massachusetts Boston and Denise A. Tyler, PhD, of Brown University. They write, "Our findings suggest that negative reporting predominates and its impact on public perceptions and government decision making may be reinforced by its prominence and focus on industry interests/behavior."

News Stories Paint Negative Picture of Nursing Homes
Drs Miller and Tyler performed a database search to identify more than 1,500 articles related to nursing homes, published in four major American newspapers between 1999 and 2008. Using a standardized approach, they categorized the tone of each news story as positive, negative, or neutral. The characteristics of articles in the three categories were analyzed as well.

"Most articles were negative or neutral; comparatively few were positive," Drs Miller and Tyler write. Overall, 49.2 percent of articles were classified as negative and 10.5 percent as positive. The remaining 40.3 percent were categorized as neutral in tone.

There were some prominent differences in the content of positive versus negative or neutral articles. Positive articles were more likely to discuss the quality of nursing home care, while negative articles were often about cases involving negligence or fraud.

"Negative articles were more likely to focus on the nursing home industry; positive articles on the broader community and residents/families," Drs Miller and Tyler write. Many of the neutral articles covered financing and business/property issues.

Negative News More Likely to Make the Front Page
Negative articles involving negligence/fraud were more likely to be found on the front page, compared to positive or neutral articles. "Editorial decisions about the placement of such articles make sense from a business perspective to the extent that negative, sensationalistic coverage sells newspapers," according to the authors.

Other negative stores were related to natural disasters—particularly to several high-profile incidents in which nursing home residents endangered by Gulf Coast hurricanes. Many of the positive stories were related to local quality-improvement initiatives—particularly ongoing "culture change" efforts seeking to make nursing homes more home-like environments.

The results draw attention to the overall negative depictions of nursing homes found in U.S. newspapers. Such negative coverage has had a significant impact on public perceptions of nursing homes and the nursing home industry, Drs Miller and Tyler believe.

They also think that negative media coverage has probably influenced consumer behavior—especially at a time of increasing competition from "alternative care sources with more robust reputations," such as home- and community-based care and assisted living. Drs Miller and Tyler suggest that nursing homes and the nursing home industry may want to develop "more effective media strategies," highlighting the culture change movement and other innovations to improve care and quality of life for nursing home residents.