New York Times Ripple Effect.

Can various groups that work in long-term care be sent scurrying in the wrong direction by an inaccurate news story? Yes, when that story appears in The New York Times--and for maximum exposure--front-page, right column, above the fold. The story, "U.S. Recommending Strict New Rules at Nursing Homes," published July 23 was, quite simply, wrong. The story erroneously disclosed findings of a then-unreleased Department of Health and Human Services research study, as well as stating that the agency will recommend that facilities be required to have minimum levels of skilled and unskilled staff.

"The government is recommending strict new rules that would require thousands of the homes to hire more staff," wrote Times reporter Robert Pear. The scurrying began as the American Health Care Association (AHCA) and the American Association of Homes and Services for the Aging (AAHSA) fired off statements connecting staffing problems to insufficient Medicare and Medicaid reimbursement. Also reacting, Senate Aging Committee Chairman Charles Grassley (R-IA) quickly put together a hearing for July 27.

The error of the Times story became obvious in Grassley's hearing, where HCFA Administrator Nancy-Ann DeParle and report researchers testified that no conclusions on mandating minimum staff ratios would be reached until completion of the study's second phase, perhaps in a year. The study's first phase simply presented data linking low staff levels to various measures of poor quality. Releasing the first phase at the hearing, researchers testified that 54% of nursing homes have less than the minimum staffing level for nurse's aides, as suggested by their time-motion study, and that 23% were below the suggested minimum staffing level for total licensed staff.

DeParle testified at the hearing: "While these findings are very troubling and represent a major step forward in understanding the relationship between staffing levels and quality of care, they are preliminary," based primarily on data from homes in only three states. She added that HCFA is "working to...expand our studies beyond the three states" and "determine the costs and feasibility of implementing minimum staffing requirements."

Even though the July 27 hearing brought out the truth, the myth continues, because the Times ignored the July 27 hearing in failing to correct the July 23 story. The error is further perpetuated by the story's remaining (as of this writing) in the archives of the newspaper's Web site. The Times seemed to back into a correction, without labeling it as such, in an August 7 editorial on the need for additional nursing home staffing, "Acceptable Nursing Home Care." It made no reference to the July 23 story but reported the facts as they should have been reported two weeks earlier, i.e., that the first phase of what will be a two-part, government-sponsored study examined staffing levels in nursing homes and found them wanting but made no recommendations. Also, as the editorial stated and the news story should have, "a comprehensive overhaul of the system should wait a year for the study to complete its second phase."

Incidentally, another organization sent scurrying by the July 23 story was the Associated Press, which rewrote the Times story, citing it as the source. Thus, the ripple effect included other newspapers that receive news feeds from the Times and the AP.

The world begs for a correction. As for providers, the advice is: Calm down, for now. The issue of staff ratios remains, as it has for years, a subject of debate.