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“Dying for Care”

Excellence in Business/Financial Reporting

USA Today, 2023

Author(s): Letitia Stein, Jayme Fraser and Nick Penzenstadler with Jeff Kelly Lowenstein


Reporters for USA Today set out to analyze how nursing homes performed during the deadliest period of the COVID-19 pandemic. Their investigation led them to Real Estate Investment Trust, or REIT, ownership of nursing home chains and the impact Wall Street aspirations for profits are having on patient care. 

Supported by the University of Southern California Annenberg Center for Health Journalism and the Economic Hardship Project, the USA Today investigation prompted congressional hearings into ownership structures of the largest nursing home chains and highlighted the plight of overworked and low-paid staff. The reporting also has gained the attention of the Biden administration, which has indicated it will incorporate the findings into its plans for nursing home reforms. The impact of REIT ownership of nursing homes hadn’t been on the White House’s radar. 

The USA Today investigative journalists leading the project spent hours analyzing government data and created a tool that enabled them to determine how every nursing home in America performed during the deadliest months of the pandemic.  

Their analysis led them to a single, REIT-owned nursing home chain with the highest percentage of deaths, which became the focal point of the story. The reporters discovered widespread, substandard staffing among U.S. nursing homes that goes unchecked, unresolved and unpunished. As a public service, USA Today also published a guide for readers on how to choose a nursing home. 

The database-rich project was brought to life by dozens of interviews with nursing home workers, managers, residents, senior care experts, corporate executives, financial experts and investors. Importantly, they talked to grieving relatives, providing them with a platform to share their stirring recollections of sad, final goodbyes.