David Ball
David Ball

Nursing homes have a long history of negative news coverage, some of it justified, following incidents of elder abuse or patient neglect or financial malfeasance. But plenty of it stems from the social stigma attached to the place where many live out their last days far from the comforts of home and the company of family. Prompted by the public’s (mis)perceptions, the media frequently looks for what’s wrong with nursing homes and rarely for what’s right.

Against this backdrop came the coronavirus pandemic, the greatest challenge ever faced by the profession. Not only was this a healthcare challenge, but it was a communications challenge of enormous proportions.

Savvy nursing home administrators and operators recognized the dawning crisis and sought help from PR pros to handle the sudden influx of media inquiries, so they could focus on the core task at hand of saving lives. Others balked and bore the brunt of bad news headlines. Regardless, it quickly became clear that nursing homes needed to strengthen their communications to better inform worried families and other concerned stakeholders, in order to preserve their reputation.

The crisis unfolds

Nursing homes in many regions were ravaged by COVID-19 during the initial outbreak from March to June, despite concerted infection control efforts and public health protocols that evolved as more became known about the spread of the virus. While facility staff helped many residents recover from the disease, the public and the media often blamed them for jeopardizing the health of residents.

In reality, in many respects, the pandemic was the skilled nursing profession’s finest hour. They fought relentlessly against the spread of the virus, despite years of below-cost reimbursement from state Medicaid agencies, which pay for the care of the majority of nursing home residents. These buildings were simply never designed or envisioned to be a front line of pandemic defense.

Yet as their staff worked at great personal risk to protect and care for their vulnerable residents, the media focused on the heroics happening inside America’s hospitals, while pinning the death toll on nursing homes. No, there would be no spinning the data on the high numbers of COVID infections and deaths that nursing homes were required to report to health departments and that were subsequently disclosed in government press conferences; but there was more to the story than just those cold, hard facts.

Prioritize communication

Our firm worked with some 20 nursing homes during the brunt of the pandemic, responding to an urgent need from current clients and new crisis PR clients alike. They needed assistance not only with managing a flood of inbound media inquiries, but more importantly to communicate with worried families and other concerned stakeholders.

The crisis gave us an opportunity to apply and tailor crisis communications fundamentals to ensure that administrators could prioritize the health and safety of their residents and staff, all while better positioning their facilities for a post-COVID-19 recovery.

Job one for nursing homes was to keep families informed of COVID cases in the facility where their loved ones lived and received care. After the pandemic hit, nursing homes were closed to visitors. Families were cut off, left on the outside looking in, and understandably concerned.

Some family members that felt left in the dark turned to public officials and the media to find answers, and their heart-wrenching stories ended up on the evening news or in the next day’s paper. We advised our clients to communicate frequently with families, whether by email, letter, phone call or even text message. Many nursing homes posted COVID-19 updates to their websites, the more frequent the better.

The messages were direct and transparent, noting the rates of infections and tragic losses while reinforcing the common theme that they were working as hard as possible to keep residents and staff safe. It was important for family members to understand that they would have updated information as soon as it became available—that they’d be the first to know about developments in the building.

Sometimes staff members turned into sources for reporters digging deeper into the COVID story at nursing homes. Employees were worried about getting sick and troubled by the scarcity of testing resources. The message from the employers emphasized that their safety was paramount and that they would be protected to the greatest extent possible. We recommended regular meetings and updates for all team members.

A media onslaught

Healthcare communicators have had an outsized role during the COVID-19 pandemic. Robust communications teams supporting public health officials, hospitals and drug manufacturers were quick to spring into action. The news cycle was saturated by the spread of coronavirus.

Nursing homes became a singular target of the media, unfortunately, because they accounted for a large percentage of all COVID-related fatalities. They’re home to aging, infirm individuals who need specialized, round-the-clock, long-term care. Their residents are extremely vulnerable on a good day, let alone when a novel, deadly virus silently invades a community.

With enterprising reporters from local weeklies, aggressive anchors from metro TV news stations and seasoned journalists from national media outlets all aggressively covering the nursing home angle of the pandemic, our team went into crisis PR overdrive. It was important for us to gather information as quickly as possible from the chaotic environments our clients were working through. When holding statements no longer held, we fielded reporters’ questions so that our clients could remain focused on the task at hand.

We also pushed to change the media narrative about nursing homes that was demoralizing to the hardworking staff and leadership of nursing homes. Why were hospital nurses featured in all of the touching stories about healthcare heroes? Why were nursing homes portrayed as perpetrators in the pandemic when they were really victims of the virus?

We prepared an executive of one nursing home for a lengthy interview with the daily paper of record to demonstrate that facility’s commitment to quality care. We arranged for feature coverage of a staff chaplain who held the hands of residents as they passed away and became ill herself with COVID-19. We followed up with reporters to debunk bad information and to educate them about what nursing homes were really experiencing behind their closed doors. We disseminated homegrown photos of nursing home staff delivering Easter baskets dressed not in bunny suits but PPE gowns.

These were all traditional PR tactics, essentially, but they were infinitely more challenging to accomplish successfully amid the onslaught of negative media coverage. There was little daylight in all of the darkness, but we worked hard to shine a light where we could.

Be a realist and not a dreamer

Our experience working with nursing homes during this crisis has validated what we have long advocated and held to be true: in a crisis, you’re better off an eagle than an ostrich. By realistically assessing the situation, staying focused on your mission, developing messaging targeted to varied audiences and sequencing the communications, you can gain greater control over the situation.

Some facilities took the need to communicate seriously, while others did not fully embrace communicating with their communities. While nobody could blame them, given that they were just trying to keep their heads above water, those that got ahead of the crisis were able to manage public interest and it’s those facilities that will be better positioned as the pandemic continues.


David Ball is the President and CEO of Ball Consulting Group, LLC.