Battling bad PR by preparing for negative news.

It was no easy task taking over a business that was partially destroyed by fire. It was even worse when that fire killed numerous elderly LTC residents. But it's a definite public relations nightmare when the blaze resulted from inadequate conditions, received wide media coverage and was branded as one of the nation's 10 worst nursing home fires of the past 50 years.

Sixteen residents died in the February 2003 Greenwood Health Center fire in Greenwood, Conn., after a mentally ill resident allegedly played with a cigarette lighter and caught her bed on fire. The blaze caused $1.5 million in damage to the building. But from a publicity standpoint, the worst was yet to come.

Photos like the one on the front page of the local paper--showing a sheet-covered body being carried out of the charred building--appeared in newspapers nationwide. Lawsuits alleging inadequate personnel and poor staff training followed, as did legislation requiring updated sprinkler systems in all LTC facilities within five years of the bill's enactment.

"It wasn't an easy task ahead of us," said Howard Dickstein, president and chief executive officer of Rockville, Conn.-based Spectrum Healthcare LLC, which purchased Greenwood in December 2003. "We had to take a building that was fire-devastated and rebuild it to where not only the residents felt safe, but also the community that the facility is in (felt safe). In short, we had to convince everyone that we were not the same building that had the fire."

No matter how unpleasant the event, it is possible to recover from bad publicity--whether it's from an event at your facility or something levied against the entire industry, according to Bill Smith, president of Smith Phillips, a public relations firm in Andover, Mass.

"When you're faced with that really broad brush from decades of negative imaging, you need (an) aggressive approach," Smith said. "You really have to stress what's great about you and your industry. If you have a good story to tell, you need to tell it and tell it right."

When a PR disaster happens, there's an immediate need to redefine your company's image by reaching out to the community, according to Smith. "You need to think strategically, recognize your place in the marketplace and how to reach that marketplace," he said.

Dickstein employed that strategy during the months of remodeling and planning, while rebuilding Greenwood--now known as Park Place Health Center. But, he said, Spectrum knew how it wanted to handle reintroduction of the facility as reconstruction was underway.

Dickstein explained, "we went to all of the neighborhood and business association meetings, visited local businesses and attended community events and reintroduced them to this nursing home. We encouraged them to come and see what we have done."

Dickstein said the company avoided the traditional "grand opening" gala because it would only stir up bad memories. "It would simply remind people of the nursing home before and right after the fire," he said. "All people would do is talk about what they remembered the place being like. We wanted them to talk about the positive changes we've made."

Instead, Spectrum offered a series of invitations and tours to individuals and community groups, demonstrating the facility's value throughout the community. "We showed them exactly what we did to create a safer, more responsible environment," Dickstein said. "And we were on hand to answer in detail any questions or concerns they might have. It was a lot more personal than when you have a large gathering to deal with."

It's also important to document all the improvements you make when trying to rebound from a crisis, according to Steve Chies, chairperson of the American Health Care Association in Washington, D.C. "That way, if a story comes out, the facility has empirical evidence when it can show, 'Yes, that was the situation, but here's what we've done since--here are the improvements we've done up to this point in time," Chies said.

The company also used a series of bilingual television and newspaper ads featuring facility employees that informed people why they should consider Park Place if they ever needed its services. "We were on all the local cable channels--about 18,000 spots," Dickstein said. "In the end, everyone knew what we were about."

Sometimes, all that good news can lessen the impact of an otherwise troublesome industry event, according to Chies. "It's been my experience--especially in the small towns--that it's easier to go out and talk with your local media representative about how to get them to cover the positives," he said. "That way, if you do have a minus side or a problem, they're more willing to (focus on those positives)."

Guilt by association 

While unfortunate events in your own company can be troublesome, facilities can also suffer when a regional or industry-wide problem occurs. In this case, Smith emphasized getting out the message that your business is not part of that problem. "You want to respond with a positive by saying, 'We're addressing a serious situation in our industry, and we're one of the few places to do so,'" he said.

When the owner of a Chatham, Ill., personal care facility was indicted on a first-degree murder charge following the death of a resident last November, LTC facilities in neighboring Springfield cringed at the thought of how resulting negative publicity would affect their facilities. "It certainly hurts the industry overall when something terrible like that happens said Sr. Judith Morris, administrator at St. Joseph's Home of Springfield. "Any sort of elderly abuse in an institutional setting impacts the whole industry."

Morris said her facility regularly alerts media of good events at St. Joseph's, an effort that has helped reinforce the home's solid reputation. These good news tidbits could be anything from high marks on recent inspections to announcements of a resident's 100th birthday. "We want the media to know that there are good homes out there," she said. "Positive publicity is what we need. Every facility needs to take the responsibility of calling the media and marketing themselves. No one will know what good you do otherwise."

The American Association of Homes and Services for the Aging (AAHSA) recently took that approach prior to a CBS Evening News broadcast in late 2004 called "Nursing Homes Nightmares," which focused on how nursing homes nationwide "are taking in convicted sex offenders and violent criminals and don't even know it."

In a press release, AAHSA noted that it was one of several national aging-services organizations that supported Rep. Henry Waxman's, DCalif., effort to launch a study on the problem of sex offenders and prison parolees in nursing homes.

That's typically a very effective way to let everyone know what a facility is doing to solve a controversial problem, Smith said. "It's a perfect example of how an industry really needs to work with local legislators to establish best practices that will allow them to maintain control of their industry," he said. "You're also letting people know how much you care about what happens in your industry, and to the people who are directly and indirectly a part of it."

Silver screened

In addition to negative portrayals in mainstream news media, the LTC industry has also received less than sterling portrayals in motion pictures (see sidebar, page 13).

No surprise, then, that when the National Center of Assisted Living first caught wind of a new movie, "Assisted Living," now making its rounds nationwide on the independent film circuit, the association's early reaction was negative.

Based on early publicity, NCAL initially criticized the film, but upon seeing a preview, Dave Kyllo, executive director now views Elliot Greenebaum's film as fictional entertainment. "Even though the title is 'Assisted Living' and was shot in an assisted living facility, the location is simply a backdrop," Kyllo said. "It's not really the main theme of the movie at all."

Kyllo said he doubted the industry would feel much impact because of the film's limited release and the absurdity of the pot-smoking, prank-pulling main character, Todd. "Someone in the profession would sit back and say, 'that would never happen,'" he said. "In real life, people like (Todd) would be out the door, because that kind of behavior is simply not tolerated."

The film's realism of what it looks like to be a very senior citizen, however, might disturb people. "We have a very ageist society," Kyllo said. "Our idea of old is the golfing, country clubbing-set that look like they're in their 50s. When people see the picture of a 95-year-old and what his or her life is really like, it shocks them."

In that instance--as with other forms of negative publicity--the best thing a provider can do is be proactive, Kyllo said. "For example, if there's a TV report about nursing home abuse, inform families by newsletter, or talk about it at resident or family councils, noting that you do everything possible to prevent abuse and keep residents happy and safe," he said. "Remind them that if they ever suspect abuse, they should contact people at the facility or their ombudsman."

Louisville, Ky.-based Masonic Homes of Kentucky, where most of "Assisted Living" was shot, expects little negative response from the facility's appearance in the movie, according to Marketing and Communications Director Janine Linder. But, the facility has its long-standing good reputation to fall back on if needed, Linder said.

"Having been around since 1867 helps a lot," she said. "But if anyone asked, we would encourage people to come see for themselves."

In addition, the facility regularly runs ads with a "Tradition of Excellence" byline to reinforce nearly a century and a half of compassionate care, Linder said.

Chies said keeping the media informed on the true state of the industry can help reduce the number of negative portrayals by Hollywood and others. "It's so frustrating to get shots across the bow like that from entertainment venues and other individuals with their own agendas, who are not really looking at the changes that have occurred in the industry over the past number of years," he said.

"I think if we can somehow get the general media to take in what is occurring, the lives that have been improved and the outcomes that we're getting on a much better basis, they would have a much better perspective of it."

Still, for every negative influence, Smith warned, be careful how you handle the situation. "Sometimes, something ... happens (that) you're just better off ignoring it," he said. "It's one of those situations where you risk drawing an association for people that they might not otherwise make. You need to think carefully about whether a response is really warranted."

HANDLING A PR CRISIS

A few dos and don'ts for facilities when a PR crisis hits:

* Be out front. When the crisis happens, have the highest-ranking person possible go on the record and deal with the issue head-on, according to Steve Chies, chairperson of the American Health Care Association in Washington, D.C. Don't offer the "no comment" response. "The attorneys don't like it, but the best thing to do if you've done something wrong is to say you've done something wrong," Chies said. "The public appreciates an individual or organization going forward and saying, "We didn't do it right, but we'll do it betted.'"

* Be honest. Going on record does little good if what you're telling the public isn't true, according to Bill Smith, president of Smith Phillips, a public relations firm in Andover, Mass. "For this kind of communication to work, you have to be in the right," Smith said. "The worst thing you can ever do is get caught in a lie. But your legal people are most likely not going to let you be as honest as you want to be, because they're concerned about liability. You often run into situations where you have to weigh the two."

* Be prepared. Get a crisis plan in place before the crisis occurs, Smith said. This means establishing a plan as to who is permitted to speak to the public--including media and family members--during such a situation, and what that person is allowed to say. "You can't cobble something together when this type of thing happens," Smith said. "That's when the dumb mistakes happen. The worst thing you can do is have someone on the phone who starts talking about things that they are not fully informed on."

* Stay in touch with the media and the public. People want to know how you've handled the problem, according to Smith. Make sure it's obvious, via press releases, newsletters, media briefings and on-site tours. "Get out in front of it," Smith said. "Work with the local media, engage in local networking opportunities, and be very clear about what your problems have been in the past and what you've done to fix them."

RELATED ARTICLE: It's only a movie.

The silver screen historically hasn't been kind to long term care facilities. Here are a few films that don't always paint the industry in a flattering light:

* Rage Against the Darkness (2004 broadcast in Canada, U.S. release expected in 2005). An even-handed, truthful look at life in a nursing home, showing caring staff--and residents who feel "trapped" in a stressful, unhappy place. While the long term care industry might embrace John Kastner's three-part documentary, consumers might choose to see only the dark side.

* Bubba Ho-Tep (2004). A geriatric Elvis (Bruce Campbell) and racially changed John F. Kennedy (Ossie Davis) can't decide which is worse: being killed by a mummy preying on the residents of their east Texas nursing home (which apparently has only two employees), or simply dying there as unwanted, forgotten old folks.

* Assisted Living (2003, 2005 release). Elliot Greenebaum's tale of a mother-son-type relationship between a resident and a nurse's aide raised eyebrows with its portrayal of irresponsible facility staff, some of whom drink alcohol or smoke marijuana on the job, or play pranks on residents.

* Cocoon (1985). Ron Howard's elderly-meet-aliens story features an ideal retirement center--except for a brief scene where an entire wing of 30 residents sneaks out of the facility past an unobservant employee.

* "Kick the Can" from Twilight Zone:The Movie (1983). As in the original 1962 television episode, the fictional Sunnyvale Nursing Home is portrayed as a dismal, boring place where old people go to die.

* Killer Nun (1978). Sister Gertrude (Anita Ekberg) is one step away from being as crazy as some of her Catholic convalescent home's residents. She's also a drug addict, abuser of residents and a murderer. A nightmare portrait of "good" nursing.

* "Blind Alleys" from Tales From the Crypt (1972). Not to leave upper management out of the "bad guy" loop, this story based on an old EC horror comic features William Rogers as a former army major who becomes administrator of a home for the blind. He proceeds to starve, freeze and neglect the residents while he becomes rich.