Context:Although observers have long highlighted the relationship of public distrust, government regulation, and media depictions of nursing-home scandals, no study has systematically analyzed the way in which nursing homes have been portrayed in the national media. This study examines how nursing homes were depicted in four leading national newspapers-the New York Times, Washington Post, Chicago Tribune, and Los Angeles Times-from 1999 to 2008.
Methods:We used keyword searches of the LexisNexis database to identify 1,704 articles pertaining to nursing homes. We then analyzed the content of each article and assessed its tone, themes, prominence, and central actor. We used basic frequencies and descriptive statistics to examine the articles' content, both cross-sectionally and over time.Findings: Approximately one-third of the articles were published in 1999/2000, and a comparatively high percentage (12.4%) appeared in 2005. Most were news stories (89.8%), and about one-quarter were on the front page of the newspaper or section. Most focused on government (42.3%) or industry (39.2%) interests, with very few on residents/family (13.3%) and community (5.3%) concerns. Most were negative (45.1%) or neutral (37.0%) in tone, and very few were positive (9.6%) or mixed (8.3%). Conclusions: Overall, our findings highlight the longitudinal variation in the four widely read newspapers' framing of nursing-home coverage, regarding not only tone but also shifts in media attention from one aspect of this complex policy area to another. The predominantly negative media reports contribute to the poor public opinion of nursing homes and, in turn, of the people who live and work in them. These reports also place nursing homes at a competitive disadvantage and may pose challenges to health delivery reform, including care integration across settings.Keywords: long-term care, nursing homes, media, newspapers, agenda setting. D espite progress improving the quality of nursing homes over the last two decades, significant challenges remain Mor 2006, 2008;Wiener, Freiman, and Brown 2007). Just one-quarter of Americans rank nursing-home operators as "very high" or "high" in honesty and ethics, while only one-third believe that nursing homes are doing a "good job," both figures falling far below those for other health care providers (Jones 2010; Kaiser Family Foundation 2001, 2005. More than half of long-term care opinion leaders ranked the quality of care provided by the average nursing home as "fair or poor," compared with one-quarter to one-third of the leaders who ranked assisted-living facilities, hospitals, and home care agencies this way, just 14.2 percent for adult day care providers, and 5.8 percent for hospice workers (Miller, Clark, and Mor 2010).The mass media can play a significant role in shaping people's views of the importance and nature of particular issues (Baumgartner and Jones 1993;Dearing and Rogers 1996;Iyengar and Reeves 1997;Kingdon 1995;McCombs, Shaw, and Weaver 1997). Media scholars refer to both first-order agend...